Created on: 3/26/2021
Posted to the Web on: 4/7/2021
Basic Information
FACILITY CONTACT INFORMATION:
Address: 1104 E GRACE ST
City: RENSSELAER
Telephone: (219) 866-5141
Web Site:
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
LICENSE INFORMATION:
License number: 19-004199-1
License effective date: 7/1/2019
License expiration date: 10/5/2020
CURENT OWNERSHIP:
Owning corporation: FRANCISCAN HEALTHCARE JASPER COUNTY, INDIANA, INC
N/A
N/A N/A N/A
Ownership type: PROFIT
Officer(s): AKHIL SHARMA
DANIEL MARSHALL GUILL
JACK CALLISON, JR
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: FRANCISCAN HEALTH RENSSELAER, INC
Date of last change of ownership: / /
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): 0
Number of non-certified comprehensive care beds (State Licensed only): 0
Total number of comprehensive care beds: 0
RESIDENTIAL CARE BEDS:
Total number of residential beds: 21
Total number of beds in facility: 21
CENSUS:
Facility census: 12
As reported by the facility on: 1/3/2020 8
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 1/3/2020 8
Residential care beds occupied: 12
As reported by the facility on: 1/3/2020 8
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: / /
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: No
Nurse aide training and competency evaluation program (NATCEP) ban expires: N/A
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites:
MEDICAL TRAINING CENTER
Approved: 4/6/2005
Terminated: N/A
TIPPECANOE SCHOOL CORPORATION
Approved: 11/16/2005
Terminated: N/A
KANKAKEE VALLEY HIGH SCHOOL
Approved: 6/10/2015
Terminated: 3/7/2019
PREFERRED MEDICAL ACADEMY
Approved: 6/9/2015
Terminated: N/A
IN TRAINING COLLEGE OF ADULT EDUCATION
Approved: 1/3/2019
Terminated: N/A
SAINT JOSEPH'S COLLEGE
Approved: 10/31/2019
Terminated: N/A
Complaints
NUMBER OF SUBSTANTIATED COMPLAINTS:
Current year: 0
Previous year: 0
2 years previous: 0
State Licensure Surveys
The ISDH conducts a state licensure survey at each licensed residential facility
approximately once per year. If state findings are cited on a survey, the
residential facility may be requested by the ISDH to complete a plan of
correction on how and when they will correct each state finding and who will be
responsible to ensure the corrections are made and will not reoccur in the future.
The plan of correction is generally submitted by the residential facility and
reviewed by the ISDH within fifteen (15) days of the survey.
To read an overview of the survey process, click hereNOTE:
The residential consumer report survey information begins with surveys that
have been completed on or after December 1, 2008. Any survey performed prior
to that date will not have any information in the state findings count rows or
columns or will show zero.
9/5/2019 Most Recent
11/5/2018 2nd Most Recent
11/28/2017 3rd Most Recent
Number of state findings
8
3
2
State Average for the year of the survey (rounded to nearest whole integer).
