Indiana State Department of Health

Division of Long Term Care

CONSUMER REPORT

HICKORY CREEK AT ROCHESTER

NURSING HOME

SKILLED NURSING FACILITY / NURSING FACILITY DUALLY CERTIFIED

Created on: 07/25/2025

Posted to the Web on: 08/06/2025
Basic Information
FACILITY CONTACT INFORMATION: Address: 340 E 18TH STREET City: ROCHESTER Telephone: (574) 223-5100 Web Site: NAME CHANGES: Most recent name change: N/A Date of most recent name change: N/A LICENSE INFORMATION: License number: 25-000326-1 License effective date: 04/01/2025 License expiration date: 03/31/2026
Administration and Staff
Administrator: TOMMI PRUITT Start date: 05/02/2022 Director of Nursing: KELLY CLARY Start date: 05/19/2025 Medical director: David Ilo Start date: / / Wound care specialist: Start date: / / Infection preventionist: Start date: / /
Ownership
CURENT OWNERSHIP: Owning corporation: PULASKI MEMORIAL HOSPITAL 616 E 13TH STREET WINAMAC IN 46996 Ownership type: OTHER Officer(s): MICHAEL MCKAY LINDA WEBB CHARLES HUTTON GREGG MALOTT CLINT KAUFFMAN STEVE JAROSINSKI ADAM BENNETT JENNIFER SMITH TAYLOR WHITE JENNIFER MELLON PREVIOUS OWNERSHIP CHANGES: Name of previous owner: HENRY COUNTY MEMORIAL HOSPITAL Date of last change of ownership: 04/01/2023
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): 36 Number of non-certified comprehensive care beds (State Licensed only): 0 Total number of comprehensive care beds: 36 RESIDENTIAL CARE BEDS: Total number of residential beds: 0 Total number of beds in facility: 36 CENSUS: Facility census: 29 As reported by the facility on: 01/13/2022 Number of comprehensive care beds occupied in this facility. 0 As reported by the facility on: 01/13/2022 Residential care beds occupied: 0 As reported by the facility on: 01/13/2022 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: 18 Number of comprehensive care resident rooms with battery operated smoke detectors: 18 Number of comprehensive care resident rooms with hard wired and/or wireless smoke detectors: 0 Person completing form - TOMMI PRUITT Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. ADMINISTRATOR Date form completed - 04/03/2025
Nurse Aide Training
NURSE AIDE TRAINING PROGRAM APPROVALS: Nurse aide training and competency evaluation program (NATCEP) approved: 12/19/2016 Nurse aide training and competency evaluation program (NATCEP) expires: 04/01/2018 Nurse aide training and competency evaluation program (NATCEP) banned: Yes Nurse aide training and competency evaluation program (NATCEP) ban expires: 02/05/2027 CLINICAL TRAINING SITES: This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: HICKORY CREEK AT WINAMAC Approved: 02/16/2000 Terminated: 06/11/2002 HICKORY CREEK AT ROCHESTER Approved: 12/19/2016 Terminated: 02/06/2025 IVY TECH COMMUNITY COLLEGE Approved: 09/15/2011 Terminated: 10/13/2021 ASC TRAINING CENTER Approved: 10/01/2021 Terminated: 02/06/2025
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 395 363 363 396
Rank of Score 30 45 46 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 No No No
Substandard Quality of Care No No No
Administrator Change No Yes Yes
Owner Change No Yes 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: 02/06/2025 Date Ended: 02/06/2025 Amount proposed per day: Civil Money Penalty Date Imposed: 12/05/2022 Date Ended: 12/19/2022 Amount proposed per day: 1075 Amount proposed per day: 1613 Amount proposed per day: 2151 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
ZFKE21 Life Safety Code, Recertification 07/01/2025
153Z12 Complaint, Follow Up 05/08/2025
68BJ11 Complaint 05/07/2025
153Z11 Complaint 04/15/2025
FIDJ12 Complaint, Follow Up 03/05/2025
FIDJ11 Complaint 02/06/2025
UBLO22 Follow Up, Life Safety Code, Recertification 08/22/2024
UBLO12 Recertification, Follow Up, State Licensure 07/05/2024
UBLO21 Recertification, Life Safety Code 07/01/2024
UBLO11 Recertification, Complaint, State Licensure 06/10/2024
DK0H11 Complaint 02/21/2024
MSCS11 Complaint 08/03/2023
8S4Z22 Recertification, Follow Up, Life Safety Code 06/29/2023
8S4Z12 Recertification, Follow Up, State Licensure 06/14/2023
8S4Z21 Recertification, Life Safety Code 05/30/2023
7J3O11 Complaint 05/05/2023
8S4Z11 Recertification, Complaint, State Licensure 04/21/2023
 
 
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.