Indiana State Department of Health
Division of Long Term Care
 
CONSUMER REPORT
 
SIGNATURE HEALTHCARE OF MUNCIE
 
NURSING HOME
SKILLED NURSING FACILITY / NURSING FACILITY DUALLY CERTIFIED
Created on: 3/8/2024
 
Posted to the Web on: 3/20/2024
 
 



Basic Information

FACILITY CONTACT INFORMATION:
Address: 4301 N WALNUT ST
City: MUNCIE
Telephone: (765) 282-0053
Web Site:  
 
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
 
LICENSE INFORMATION:
  License number: 23-000146-1
  License effective date: 5/1/2023
  License expiration date: 4/30/2024
 


Administration and Staff

Administrator: ERIC AHLBRAND
  Start date: 9/22/2023
 
Director of Nursing: PENNY SHENEFIELD
  Start date: 12/16/2022
 
Medical director: Jeffrey Hiltz
  Start date:   /  /  
 
Wound care specialist: Lori Reff
  Start date:   /  /  
 
Infection preventionist:  
  Start date:   /  /  
 


Ownership

CURENT OWNERSHIP:
 
Owning corporation: JACKSON COUNTY SCHNECK MEMORIAL HOSPITAL
411 WEST TIPTON ST
SEYMOUR IN 47274
 
Ownership type:  OTHER
 
Officer(s): RICK SMITH
            JACK MCCORY
            MATTHEW REEDY
            COURTNEY KLEBER
            SUSAN BEVERS
            ANDREW MARKEL
            ROBERT GILLASPY JR.
            DEBORAH MANN
            ERIC FISH
            TERRENCE GILLILAND
            BRANDON HARPE
 
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: KINDRED NURSING CENTERS LIMITED PARTNERSHIP
Date of last change of ownership: 5/1/2013
 


Bed Counts and Census

COMPREHENSIVE CARE BEDS:
Number of Medicaid beds (NF):                     0
Number of Medicare beds (SNF):                    0
Number of Medicare/Medicaid beds (SNF/NF):        140
Number of non-certified comprehensive care beds (State Licensed only):     0
Total number of comprehensive care beds:     140
 
RESIDENTIAL CARE BEDS:
 
Total number of residential beds:            0
 
Total number of beds in facility:            140
 
CENSUS:
Facility census:  115
As reported by the facility on: 7/5/2022 1
 
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 7/5/2022 1
 
Residential care beds occupied:  0
As reported by the facility on: 7/5/2022 1
 
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: 105
Number of comprehensive care resident rooms with battery 
                    operated smoke detectors: 0
Number of comprehensive care resident rooms 
             with hard wired and/or wireless smoke detectors: 0
 
Person completing form - SPENCER JONES
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. CENTRAL SUPPLY DIREC
Date form completed - 4/8/2022
 


Nurse Aide Training

NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved: 6/13/2016
Nurse aide training and competency evaluation program (NATCEP) expires: 4/1/2020
Nurse aide training and competency evaluation program (NATCEP) banned: Yes
Nurse aide training and competency evaluation program (NATCEP) ban expires: 6/7/2023
 
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: 
     MUNCIE AREA CAREER CENTER
         Approved: 10/15/2008
         Terminated: 1/26/2021
     IVY TECH COMMUNITY COLLEGE REGION 6
         Approved: 5/12/2010
         Terminated: 1/26/2021
     SIGNATURE HEALTHCARE OF MUNCIE
         Approved: 6/13/2016
         Terminated: 1/26/2021
     ALL HEART NURSE'S AIDE TRAINING CENTER, LLC
         Approved: 1/21/2016
         Terminated: 1/26/2021
     SIGNATURE HEALTHCARE OF BLUFFTON
         Approved: 6/6/2016
         Terminated: 1/26/2021
     LEFFLER ACADEMY, LLC
         Approved: 3/2/2021
         Terminated: 1/26/2021
     MUNCIE AREA CAREER CENTER
         Approved: 10/20/2023
         Terminated: N/A
 


Complaints

NUMBER OF SUBSTANTIATED COMPLAINTS: 
 
  Current year:  0
  Previous year:  0
  2 years previous:  1

 


Facility Report Card



 


 
3/1/2020 Current QTR
12/1/2019 Previous QTR
9/1/2019 Previous QTR
6/1/2019 Previous QTR


Report Card Score
320
398
338
338


Rank of Score
64
28
56
56


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 grid
 
View the scoring methodology
 



Overview of Survey findings




 
 The Most Recent Set
 2ND Most Recent Set
 3RD Most Recent Set

Immediate Jeopardy
No
No
No


 Substandard Quality of Care 
No
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
No


 
    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: 9/23/2021  Date Ended: 9/23/2021
     Amount proposed per day: 5000
     Amount proposed per day: 
     Discretionary Deny Pay for New Admits
     Date Imposed: 6/8/2021  Date Ended: 6/13/2021
     Directed Plan of Correction
     Date Imposed: 4/10/2021  Date Ended: 4/7/2021
     Civil Money Penalty
     Date Imposed: 3/18/2021  Date Ended: 3/18/2021
     Amount proposed per day: 
 
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.


 
Event ID
Survey Type
Exit Date

VYXV21
Life Safety Code, Recertification
2/22/2024


91U511
Complaint
1/10/2024


66J312
Complaint, Follow Up, Other
12/22/2023


66J311
Complaint, Other
11/30/2023


1VL212
Complaint, Follow Up
10/25/2023


VJU712
Complaint, Follow Up
10/25/2023


1VL211
Complaint
9/28/2023


VJU711
Complaint
9/12/2023


02BW11
Complaint
7/18/2023


5X8511
Complaint
6/5/2023


KEFM11
Complaint
4/3/2023


131C22
Recertification, Follow Up, Life Safety Code
1/24/2023


131C12
Recertification, Follow Up, State Licensure
1/20/2023


131C21
Recertification, Life Safety Code
1/9/2023


131C11
Recertification, State Licensure
12/21/2022


8J5D11
Complaint
11/29/2022


HS3011
Complaint
8/4/2022


256611
Complaint
7/26/2022


GIDG11
Complaint
7/13/2022


K9BQ11
Complaint
7/7/2022


11Q311
Complaint, Other
5/26/2022


R1U211
Complaint
4/11/2022


OUK512
Complaint, Follow Up, Other
2/9/2022


OUK511
Complaint, Other
1/6/2022


9DMZ12
Recertification, Complaint, Follow Up, State Licensure
12/29/2021


9DMZ22
Recertification, Follow Up, Life Safety Code
12/8/2021


9DMZ11
Recertification, Complaint, State Licensure
11/16/2021


NHM912
Complaint, Follow Up
10/19/2021


WFNW12
Complaint, Follow Up
10/19/2021


9DMZ21
Recertification, Life Safety Code
10/18/2021


WFNW11
Complaint
9/23/2021


XW7H11
Complaint
8/10/2021


NHM911
Complaint
7/26/2021


WS0Z12
Complaint, Follow Up
6/23/2021


413711
Complaint
6/11/2021


WS0Z11
Complaint
5/17/2021


94BL11
Complaint, Other
4/27/2021


LKMU12
Complaint, Follow Up, Other
4/13/2021


LKMU11
Complaint, Other
3/18/2021


 
 


Links and Resources

 
CMS nursing home compare page 
 
    In addition to the information provided on this 
    web site, the Centers for Medicare & Medicaid Services (CMS) has a web site 
    which contains information on every Medicare and Medicaid certified nursing 
    home in the country. The CMS nursing home survey results contain summary information 
    about a facility's noncompliance of regulations regarding the care of residents 
    found in the nursing homes. You can locate nursing homes in your area and find 
    information about compliance with federal regulations.
 
Resources and links to other organizations
 
Choosing a Nursing Home
 
Overview of the Survey Process
 
State Wide Grouping of all Scores
   
Overview of current comprehensive facility scores
   
Spreadsheet of current comprehensive facility names and scores
   
Legal Disclaimer for Long Term Care Reports.