Indiana State Department of Health
Division of Long Term Care
 
CONSUMER REPORT
 
GOLDEN YEARS HOMESTEAD
 
NURSING HOME
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: 3136 GOEGLEIN RD
City: FORT WAYNE
Telephone: (260) 749-9655
Web Site:  
 
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
 
LICENSE INFORMATION:
  License number: 24-000282-1
  License effective date: 07/01/2024
  License expiration date: 06/30/2025
 


Administration and Staff

Administrator: SHAUNA SHAFER
  Start date: 06/16/2025
 
Director of Nursing: RHONDA CHAPMAN
  Start date: 05/12/2021
 
Medical director: Christopher Baltes
  Start date:   /  /  
 
Wound care specialist:  
  Start date:   /  /  
 
Infection preventionist:  
  Start date:   /  /  
 


Ownership

CURENT OWNERSHIP:
 
Owning corporation: WOODLAWN HOSPITAL
1400 E NINTH STREET
ROCHESTER IN 46975
 
Ownership type:  NON-PROFIT
 
Officer(s): STEVE FURNIVALL
            JIM STRAETER
            PAULA MCKINNEY
            ALISON HEYDE
            JOHN WINENGER
            ALAN FISHER
            TRAVIS ALBRIGHT
            GREG MELLONGER
            TERRI JOHNSON
            GLEN BODE
            KENDRA CHUDZYNSKI
            GREG MELLINGER
            HARRY WEBB
 
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: ADAMS COUNTY MEMORIAL HOSPITAL
Date of last change of ownership: 07/01/2018
 


Bed Counts and Census

COMPREHENSIVE CARE BEDS:
Number of Medicaid beds (NF):                     0
Number of Medicare beds (SNF):                    5
Number of Medicare/Medicaid beds (SNF/NF):        106
Number of non-certified comprehensive care beds (State Licensed only):     0
Total number of comprehensive care beds:     111
 
RESIDENTIAL CARE BEDS:
 
Total number of residential beds:            54
 
Total number of beds in facility:            165
 
CENSUS:
Facility census:  131
As reported by the facility on: 07/11/2025
 
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 07/11/2025
 
Residential care beds occupied:  41
As reported by the facility on: 07/11/2025
 
Alzheimer Beds:  39
Alzheimer Beds Occupied:  37
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:  
 
Number of comprehensive care resident rooms: 109
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: 109
 
  If hard wired and/or wireless smoke detectors are provided in resident's room, do they:
    (A) Provide a visual and audible signal at the nurses'stations that attend each room? - Yes
    (B) Transmit to a central station service - Yes
    (C) Connect to the health facility's fire alarm system - Yes
 
Person completing form - BRENDAN WISEMAN
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. DIRECTOR OF MAINTENA
Date form completed - 04/02/2025
 


Nurse Aide Training

NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved: 03/20/2000
Nurse aide training and competency evaluation program (NATCEP) expires: 04/01/2002
Nurse aide training and competency evaluation program (NATCEP) banned: Yes
Nurse aide training and competency evaluation program (NATCEP) ban expires: 01/29/2026
 
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: 
     MANNIA GREEN HEALTHCARE ADVANTAGE, INC
         Approved: 08/22/2002
         Terminated: 01/19/2007
     QUALITY CARE TRAINING
         Approved: 03/23/2006
         Terminated: 01/19/2007
     PROFESSIONAL MEDICAL REGISTRY
         Approved: 05/07/1998
         Terminated: 08/18/2000
     GOLDEN YEARS HOMESTEAD
         Approved: 03/20/2000
         Terminated: 09/12/2021
     HARRISON COLLEGE
         Approved: 04/14/2015
         Terminated: 05/07/2021
     FORT WAYNE COMMUNITY SCHOOLS NEIGHBORHOOD CONNECTI
         Approved: 09/14/2010
         Terminated: 09/12/2021
     FWCS CAREER ACADEMY AT ANTHIS
         Approved: 01/14/2010
         Terminated: 09/12/2021
     UNIVERSITY OF SAINT FRANCIS
         Approved: 08/18/1997
         Terminated: 08/18/2000
     M & G QUALITY SERVICE
         Approved: 04/27/2010
         Terminated: 04/01/2014
     PREMIER NURSING ACADEMY
         Approved: 08/02/2017
         Terminated: 08/04/2021
     EAST ALLEN CAREER CENTER
         Approved: 07/29/2020
         Terminated: 09/12/2021
     LEGACY MEDICAL ACADEMY
         Approved: 08/15/2022
         Terminated: 09/12/2021
     IVY TECH COMMUNITY COLLEGE
         Approved: 02/11/2009
         Terminated: 09/12/2021
     FIRST CROWN HEALTH CARE
         Approved: 03/25/2019
         Terminated: 09/12/2021
     ESSENTIAL HEALTHCARE ACADEMY, LLC
         Approved: 11/17/2022
         Terminated: 09/12/2021
     LEGACY MEDICAL ACADEMY
         Approved: 08/15/2022
         Terminated: 09/12/2021
     EAST ALLEN CAREER CENTER
         Approved: 04/28/2023
         Terminated: 09/12/2021
     LEGACY MEDICAL ACADEMY
         Approved: 02/20/2024
         Terminated: 01/30/2024
     FIRST CROWN HEALTH CARE
         Approved: 06/05/2024
         Terminated: 01/30/2024
     IVY TECH COMMUNITY COLLEGE
         Approved: 07/23/2025
         Terminated: N/A
     LEGACY MEDICAL ACADEMY
         Approved: 12/11/2023
         Terminated: 01/30/2024
 


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
371
371
395
395


Rank of Score
42
41
32
32


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
Yes
No
No


 Substandard Quality of Care 
Yes
No
No


Administrator Change
Yes
No
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: 01/30/2024  Date Ended: 01/30/2024
     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

PQTN12
Complaint, Follow Up
06/16/2025


PQTN11
Complaint
05/07/2025


II8S11
Complaint
04/15/2025


JYWN11
Complaint
02/24/2025


AMVS11
Complaint
12/17/2024


O3CJ22
Recertification, Follow Up, Life Safety Code
12/03/2024


23FD11
Complaint
11/25/2024


O3CJ12
Recertification, Complaint, Follow Up, State Licensure
10/18/2024


VZJ611
Complaint
10/16/2024


O3CJ21
Recertification, Life Safety Code
10/10/2024


O3CJ11
Recertification, Complaint, State Licensure
09/23/2024


44WF11
Complaint
07/30/2024


OPPP11
Complaint
07/15/2024


6TCO11
Complaint
06/10/2024


RUPK12
Complaint, Follow Up
04/25/2024


SW8312
Complaint, Follow Up
04/10/2024


RUPK11
Complaint
04/04/2024


SW8311
Complaint
03/12/2024


JDN212
Complaint, Follow Up
02/15/2024


JDN211
Complaint
01/30/2024


2XMN11
Complaint
12/08/2023


JEV022
Recertification, Follow Up, Life Safety Code
11/15/2023


JEV012
Recertification, Complaint, Follow Up, State Licensure
10/23/2023


GM3312
Complaint, Follow Up
10/23/2023


JEV021
Recertification, Life Safety Code
10/12/2023


S9K011
Complaint
10/11/2023


GM3311
Complaint
09/12/2023


JEV011
Recertification, Complaint, State Licensure
09/12/2023


98P611
Complaint
08/22/2023


2ZUK11
Complaint
05/12/2023


6OQL11
Complaint
02/07/2023


2UO812
Recertification, Follow Up, State Licensure
12/08/2022


2UO821
Recertification, Life Safety Code
11/22/2022


H26W11
Complaint
10/21/2022


2UO811
Recertification, State Licensure
10/21/2022


19GZ11
Complaint
09/07/2022


 
 


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.