Indiana State Department of Health
Division of Long Term Care
 
CONSUMER REPORT
 
WATERS OF WAKARUSA SKILLED NURSING FACILITY, THE
 
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: 300 N WASHINGTON ST
City: WAKARUSA
Telephone: (574) 862-4511
Web Site:  
 
NAME CHANGES:
Most recent name change: MILLER'S MERRY MANOR
Date of most recent name change: 11/16/2022 9:19:07 AM
 
LICENSE INFORMATION:
  License number: 25-000521-1
  License effective date: 03/01/2025
  License expiration date: 02/28/2026
 


Administration and Staff

Administrator: DAVID HENKE
  Start date: 02/24/2025
 
Director of Nursing: MARY DAMM
  Start date: 06/11/2025
 
Medical director: Israr Siddiqi
  Start date:   /  /  
 
Wound care specialist: Kathryn Boothe
  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):                    24
Number of Medicare/Medicaid beds (SNF/NF):        109
Number of non-certified comprehensive care beds (State Licensed only):     0
Total number of comprehensive care beds:     133
 
RESIDENTIAL CARE BEDS:
 
Total number of residential beds:            0
 
Total number of beds in facility:            133
 
CENSUS:
Facility census:  83
As reported by the facility on: 02/27/2025
 
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 02/27/2025
 
Residential care beds occupied:  0
As reported by the facility on: 02/27/2025
 
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: 72
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: 72
 
  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 - STEVE TROOP
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. MAINTENACE DIRECTOR
Date form completed - 06/10/2025
 


Nurse Aide Training

NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved: 08/09/2010
Nurse aide training and competency evaluation program (NATCEP) expires: 04/01/2026
Nurse aide training and competency evaluation program (NATCEP) banned: Yes
Nurse aide training and competency evaluation program (NATCEP) ban expires: 06/06/2027
 
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: 
     ELKHART AREA CAREER CENTER-HEALTH
         Approved: 07/26/2010
         Terminated: 04/01/2022
     IVY TECH COMMUNITY COLLEGE NORTH-CENTRAL
         Approved: 11/17/2000
         Terminated: 05/02/2008
     WATERS OF WAKARUSA SKILLED NURSING FACILITY, THE
         Approved: 08/09/2010
         Terminated: 05/25/2025
     IVY TECH COMMUNITY COLLEGE-ELKHART COUNTY
         Approved: 12/18/2012
         Terminated: 05/25/2025
     MILLER'S MERRY MANOR
         Approved: 04/11/2016
         Terminated: 05/29/2025
 


Complaints

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

 


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
353
359
359
311


Rank of Score
49
46
48
66


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 
No
No
No


Administrator Change
Yes
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
     Directed Plan of Correction
     Date Imposed: 02/01/2025  Date Ended: 01/28/2025
     Directed Inservice Training
     Date Imposed: 02/01/2025  Date Ended: 01/28/2025
     Civil Money Penalty
     Date Imposed: 01/08/2025  Date Ended: 01/08/2025
     Amount proposed per day: 
     Directed Plan of Correction
     Date Imposed: 05/06/2023  Date Ended: 05/10/2023
 
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

BGJG23
Recertification, Follow Up, Life Safety Code
06/19/2025


BGJG22
Recertification, Follow Up, Life Safety Code
06/06/2025


BGJG12
Recertification, Complaint, Follow Up, State Licensure
04/25/2025


BGJG21
Recertification, Life Safety Code
04/21/2025


BGJG11
Recertification, Complaint, State Licensure
03/14/2025


0PJT12
Complaint, Follow Up
02/20/2025


0PJT11
Complaint
01/08/2025


694X11
Complaint
11/15/2024


T4ND22
Follow Up, Life Safety Code, Recertification
07/01/2024


T4ND12
Recertification, Follow Up, State Licensure
05/06/2024


T4ND21
Recertification, Life Safety Code
05/01/2024


T4ND11
Recertification, State Licensure
04/03/2024


6YR112
Complaint, Follow Up
03/22/2024


6YR111
Complaint
02/21/2024


2JRI11
Complaint
01/24/2024


U0MJ11
Complaint
10/25/2023


2DU011
Complaint
06/06/2023


SCP122
Complaint, Follow Up, Life Safety Code
05/10/2023


XH0323
Follow Up, Life Safety Code, Recertification
05/10/2023


SCP121
Complaint, Life Safety Code
04/19/2023


XH0322
Recertification, Follow Up, Life Safety Code
04/17/2023


XH0312
Recertification, Follow Up, State Licensure
03/28/2023


XH0321
Recertification, Life Safety Code
02/28/2023


XH0311
Recertification, State Licensure
02/06/2023


 
 


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.