Indiana State Department of Health

Division of Long Term Care

CONSUMER REPORT

GOOD SAMARITAN HOME & REHABILITATIVE CENTER

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: 231 N JACKSON ST City: OAKLAND CITY Telephone: (812) 749-4774 Web Site: NAME CHANGES: Most recent name change: N/A Date of most recent name change: N/A LICENSE INFORMATION: License number: 25-000327-1 License effective date: 06/01/2025 License expiration date: 05/31/2026
Administration and Staff
Administrator: KAYLA HEMBREE Start date: 05/19/2022 Director of Nursing: SHERYL BRUBAKER Start date: 09/02/2021 Medical director: Start date: / / Wound care specialist: Start date: / / Infection preventionist: Start date: / /
Ownership
CURENT OWNERSHIP: Owning corporation: HENRY COUNTY MEMORIAL HOSPITAL 798 NORTH 16TH ST NEW CASTLE IN 47362 Ownership type: NON-PROFIT Officer(s): JOHN PIDGEON SHELDON DYNES DEBI WARE BUD SHORE BRIAN RING MARK DICE DAVID BARR PREVIOUS OWNERSHIP CHANGES: Name of previous owner: HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY Date of last change of ownership: 06/01/2023
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): 103 Number of non-certified comprehensive care beds (State Licensed only): 0 Total number of comprehensive care beds: 103 RESIDENTIAL CARE BEDS: Total number of residential beds: 0 Total number of beds in facility: 103 CENSUS: Facility census: 66 As reported by the facility on: 01/11/2022 Number of comprehensive care beds occupied in this facility. 0 As reported by the facility on: 01/11/2022 Residential care beds occupied: 0 As reported by the facility on: 01/11/2022 Alzheimer Beds: 27 Alzheimer Beds Occupied: 25 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: 52 Number of comprehensive care resident rooms with battery operated smoke detectors: 52 Number of comprehensive care resident rooms with hard wired and/or wireless smoke detectors: 0 Person completing form - KAYLA HEMBREE Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. HFA Date form completed - 04/14/2025
Nurse Aide Training
NURSE AIDE TRAINING PROGRAM APPROVALS: Nurse aide training and competency evaluation program (NATCEP) approved: 06/20/2018 Nurse aide training and competency evaluation program (NATCEP) expires: 04/01/2020 Nurse aide training and competency evaluation program (NATCEP) banned: Yes Nurse aide training and competency evaluation program (NATCEP) ban expires: 09/08/2021 CLINICAL TRAINING SITES: This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: GOOD SAMARITAN HOME & REHABILITATIVE CENTER Approved: 06/20/2018 Terminated: 09/09/2019 WOOD MEMORIAL HIGH SCHOOL Approved: N/A Terminated: 03/03/2002 ASC TRAINING CENTER Approved: 12/06/2021 Terminated: N/A LEFFLER ACADEMY Approved: 05/10/2021 Terminated: 09/09/2019
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 325 311 302 296
Rank of Score 62 67 71 73
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 Yes
Substandard Quality of Care No No Yes
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 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
PQ3222 Recertification, Follow Up, Life Safety Code 02/26/2025
PQ3212 Recertification, Follow Up, State Licensure 02/20/2025
PQ3221 Recertification, Life Safety Code 02/03/2025
PQ3211 Recertification, State Licensure 01/09/2025
TGT211 Complaint 10/15/2024
6NEZ11 Complaint 02/29/2024
MJFR12 Recertification, Complaint, Follow Up, State Licensure 01/11/2024
MJFR21 Recertification, Life Safety Code 12/05/2023
MJFR11 Recertification, Complaint, State Licensure 11/17/2023
OQ6211 Complaint, Other 06/08/2023
Z5JR11 Complaint 03/21/2023
 
 
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.