SKILLED NURSING FACILITY / NURSING FACILITY DISTINCT PART
Created on: 07/25/2025
Posted to the Web on: 08/06/2025
Basic Information
FACILITY CONTACT INFORMATION:
Address: 640 W ELLSWORTH ST
City: COLUMBIA CITY
Telephone: (260) 248-8101
Web Site:
NAME CHANGES:
Most recent name change: MILLER'S MERRY MANOR
Date of most recent name change: 11/15/2022 12:43:39 PM
LICENSE INFORMATION:
License number: 25-000071-1
License effective date: 03/01/2025
License expiration date: 02/28/2026
Administration and Staff
Administrator: LAURIE BARNES
Start date: 02/20/2023
Director of Nursing: ANN HILL
Start date: 02/27/2023
Medical director: Thomas Van Den Driessche
Start date: / /
Wound care specialist:
Start date: / /
Infection preventionist:
Start date: / /
Ownership
CURENT OWNERSHIP:
Owning corporation: JOHNSON MEMORIAL HOSPITAL
1125 W JEFFERSON ST
FRANKLIN IN 46131
Ownership type: OTHER
Officer(s): SAUNDRA (SANDI) HUDDLESTON
R MARTIN UMBARGER
KEVIN MCGINNIS
DAVID WIESMAN
RICK KESTER
ROBERT DECOLA
DAVID DUNKLE
ANNE-MARIE SCHENK
WILLIAM MINK
ADAM PUTVIN
WILLIAM LONG
TAMMY SHEETS
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: MILLER'S HEALTH SYSTEMS INC
Date of last change of ownership: 03/01/2013
Bed Counts and Census
COMPREHENSIVE CARE BEDS:
Number of Medicaid beds (NF): 0
Number of Medicare beds (SNF): 21
Number of Medicare/Medicaid beds (SNF/NF): 63
Number of non-certified comprehensive care beds (State Licensed only): 0
Total number of comprehensive care beds: 84
RESIDENTIAL CARE BEDS:
Total number of residential beds: 0
Total number of beds in facility: 84
CENSUS:
Facility census: 42
As reported by the facility on: 01/12/2024
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 01/12/2024
Residential care beds occupied: 0
As reported by the facility on: 01/12/2024
Alzheimer Beds: 0
Alzheimer Beds Occupied: 0
As reported by the facility on: / /
Ventilator Beds: 0
Ventilator Beds Occupied: 0
As reported by the facility on: / /
Sprinklers and Smoke Detectors
This facility is: FULLY SPRINKLERED
Number of comprehensive care resident rooms: 40
Number of comprehensive care resident rooms with battery
operated smoke detectors: 40
Number of comprehensive care resident rooms
with hard wired and/or wireless smoke detectors: 0
Person completing form - LAURIE BARNES
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. HFA
Date form completed - 04/08/2025
Nurse Aide Training
NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved: 03/07/2005
Nurse aide training and competency evaluation program (NATCEP) expires: 04/01/2025
Nurse aide training and competency evaluation program (NATCEP) banned: Yes
Nurse aide training and competency evaluation program (NATCEP) ban expires: 02/21/2026
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites:
WATERS OF HUNTINGTON SKILLED NURSING FACILITY, THE
Approved: 07/10/2006
Terminated: 02/22/2024
WATERS OF WABASH SKILLED NURSING FACILITY EAST THE
Approved: 10/25/2006
Terminated: 02/22/2024
IVY TECH COMMUNITY COLLEGE
Approved: 07/27/2009
Terminated: 02/22/2024
WATERS OF FORT WAYNE SKILLED NURSING FACILITY, THE
Approved: 12/07/2010
Terminated: 02/22/2024
MILLER'S MERRY MANOR
Approved: 01/10/2011
Terminated: 02/22/2024
FWCS CAREER ACADEMY AT ANTHIS
Approved: 02/17/1998
Terminated: 05/05/2001
WATERS OF COLUMBIA CITY SKILLED NURSING FACILITY
Approved: 06/13/2003
Terminated: 02/22/2024
HAGEN HEALTH EDUCATION
Approved: 04/17/2015
Terminated: 02/22/2024
MILLER'S AT OAK POINTE
Approved: 06/27/2017
Terminated: 02/22/2024
Complaints
NUMBER OF SUBSTANTIATED COMPLAINTS:
Current year: 0
Previous year: 0
2 years previous: 0
Facility Report Card
03/01/2020 Current QTR
12/01/2019 Previous QTR
09/01/2019 Previous QTR
06/01/2019 Previous QTR
Report Card Score
389
392
404
404
Rank of Score
33
31
27
27
Average Score
302
296
295
296
*Facility report card scores have not been updated since March 1, 2020 due to changes in the survey process during the ongoing COVID-19 pandemic.
The facility report card score is calculated four times per calendar year
for the two most recent nursing home health surveys. The facility report card score
also includes all complaint surveys, life safety code surveys, emergency preparedness surveys,
and any follow-up surveys that occur within the two most recent nursing home health surveys.
The facility report card score ranges from 500 to 0, with 500 being the best score possible.
View the Scope and Severity gridView the scoring methodology
Overview of Survey findings
The Most Recent Set
2ND Most Recent Set
3RD Most Recent Set
Immediate Jeopardy
Yes
No
No
Substandard Quality of Care
Yes
No
No
Administrator Change
No
Yes
No
Owner Change
No
No
No
Number of Substantiated Complaints With Deficiencies
0
0
0
Deficiency Free Standard Health Survey
No
No
Yes
The term 'Recent Set' referenced above relates to the referenced annual survey,
and any other surveys performed between it and the previous annual survey.
Enforcement Actions
Federal Certification Actions Imposed
Civil Money Penalty
Date Imposed: 02/16/2024 Date Ended: 02/23/2024
Amount proposed per day: 15000
Amount proposed per day: 265
Date terminated from Medicare/Medicaid: N/A
Survey History
The survey report is not posted until the report has been provided to the facility and their plan of correction submitted and approved.
The survey report therefore will likely not be posted until four to six weeks after the exit date.
In the grid below click on an event ID that is underlined to see the survey report for that event.
