Indiana State Department of Health

Division of Long Term Care

CONSUMER REPORT

MCGIVNEY HEALTH CARE 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: 2907 EAST SMOKY ROW City: CARMEL Telephone: (317) 846-0265 Web Site: NAME CHANGES: Most recent name change: N/A Date of most recent name change: N/A LICENSE INFORMATION: License number: 25-000545-1 License effective date: 04/01/2025 License expiration date: 03/31/2026
Administration and Staff
Administrator: RANDALL SHERA Start date: 04/07/2018 Director of Nursing: JODY VOELKER Start date: 02/17/2023 Medical director: Robert Lebow Start date: / / Wound care specialist: Start date: / / Infection preventionist: Start date: / /
Ownership
CURENT OWNERSHIP: Owning corporation: BOARD OF TRUSTEES OF THE FLAVIUS J WITHAM MEMORIAL 2605 NORTH LEBANON STREET LEBANON IN 46052 Ownership type: OTHER Officer(s): C ARCHIBALD HAWKINS JOHN BRAND KELLY L. P. BRAVERMAN BRETT BAYSTON ANDREA CASTETTER MICHAEL JASON HORNBECKER DANIEL SELLERS PREVIOUS OWNERSHIP CHANGES: Name of previous owner: GIBAULT CARE, INC. Date of last change of ownership: 04/01/2015
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): 37 Number of non-certified comprehensive care beds (State Licensed only): 0 Total number of comprehensive care beds: 37 RESIDENTIAL CARE BEDS: Total number of residential beds: 0 Total number of beds in facility: 37 CENSUS: Facility census: 34 As reported by the facility on: 07/07/2025 Number of comprehensive care beds occupied in this facility. 0 As reported by the facility on: 07/07/2025 Residential care beds occupied: 0 As reported by the facility on: 07/07/2025 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: 18 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: 18 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 - JON EFFNER Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. DIR OF FACILITIES AN Date form completed - 04/08/2025
Nurse Aide Training
NURSE AIDE TRAINING PROGRAM APPROVALS: Nurse aide training and competency evaluation program (NATCEP) approved: Nurse aide training and competency evaluation program (NATCEP) expires: Nurse aide training and competency evaluation program (NATCEP) banned: Yes Nurse aide training and competency evaluation program (NATCEP) ban expires: 10/19/2025 CLINICAL TRAINING SITES: This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: PRIMEWAY INSTITUTE Approved: 01/26/2006 Terminated: 06/24/2015 CNA INSTITUTE OF INDIANA Approved: 04/05/2006 Terminated: 06/24/2015
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 326 332 362 338
Rank of Score 60 57 47 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 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 Directed Plan of Correction Date Imposed: 12/12/2024 Date Ended: 12/12/2024 Discretionary Deny Pay for New Admits Date Imposed: 10/20/2023 Date Ended: 10/27/2023 Directed Plan of Correction Date Imposed: 10/20/2023 Date Ended: 10/27/2023 Civil Money Penalty Date Imposed: 09/22/2023 Date Ended: 09/22/2023 Amount proposed per day: Directed Plan of Correction Date Imposed: 10/21/2022 Date Ended: 10/31/2022 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
WQD023 Recertification, Follow Up, Life Safety Code 12/17/2024
682V11 Complaint 12/16/2024
WQD022 Recertification, Follow Up, Life Safety Code 11/21/2024
WQD012 Recertification, Follow Up, State Licensure 10/31/2024
WQD021 Recertification, Life Safety Code 10/22/2024
WQD011 Recertification, State Licensure 10/02/2024
4ZK111 Complaint 08/15/2024
797S11 Complaint 06/04/2024
CKNY11 Complaint 12/08/2023
410M12 Recertification, Follow Up, State Licensure 12/08/2023
410M22 Recertification, Follow Up, Life Safety Code 12/07/2023
410M21 Recertification, Life Safety Code 10/26/2023
OH5811 Complaint 10/11/2023
410M11 Recertification, State Licensure 09/22/2023
VGXU11 Complaint 02/27/2023
TKUJ12 Complaint, Follow Up 01/30/2023
S1IY24 Recertification, Follow Up, Life Safety Code 12/08/2022
S1IY23 Recertification, Follow Up, Life Safety Code 11/28/2022
TKUJ11 Complaint 11/14/2022
998W12 Complaint, Follow Up, Other 11/04/2022
S1IY12 Recertification, Follow Up, State Licensure 11/04/2022
I1MU11 Complaint 10/24/2022
S1IY22 Recertification, Follow Up, Life Safety Code 10/11/2022
998W11 Complaint, Other 09/27/2022
S1IY21 Recertification, Life Safety Code 08/15/2022
S1IY11 Recertification, State Licensure 07/26/2022
 
 
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.