Indiana State Department of Health
Division of Long Term Care
 
CONSUMER REPORT
 
OAK GROVE CHRISTIAN RETIREMENT VILLAGE
 
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: 221 W DIVISION ST
City: DEMOTTE
Telephone: (219) 987-7005
Web Site:  
 
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
 
LICENSE INFORMATION:
  License number: 25-010823-1
  License effective date: 01/01/2025
  License expiration date: 12/31/2025
 


Administration and Staff

Administrator: BETH INGRAM
  Start date: 05/13/2024
 
Director of Nursing: PATRICIA JOHNSON
  Start date: 04/05/2023
 
Medical director: Chirag Patel
  Start date:   /  /  
 
Wound care specialist:  
  Start date:   /  /  
 
Infection preventionist:  
  Start date:   /  /  
 


Ownership

CURENT OWNERSHIP:
 
Owning corporation: WOODLAWN HOSPITAL
1400 E NINTH STREET
ROCHESTER IN 46975
 
Ownership type:  OTHER
 
Officer(s): STEVE FURNIVALL
            JIM STRAETER
            PAULA MCKINNEY
            ALISON HEYDE
            JOHN WINENGER
            ALAN FISHER
            TRAVIS ALBRIGHT
            GREG MELLONGER
            TERRI JOHNSON
            GLEN BODE
            KENDRA CHUDZYNSKI
            GREG MELLINGER
            HARRY WEBB
 
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: OAK GROVE CHRISTIAN RETIREMENT VILLAGE INC
Date of last change of ownership: 01/01/2016
 


Bed Counts and Census

COMPREHENSIVE CARE BEDS:
Number of Medicaid beds (NF):                     0
Number of Medicare beds (SNF):                    29
Number of Medicare/Medicaid beds (SNF/NF):        44
Number of non-certified comprehensive care beds (State Licensed only):     0
Total number of comprehensive care beds:     73
 
RESIDENTIAL CARE BEDS:
 
Total number of residential beds:            50
 
Total number of beds in facility:            123
 
CENSUS:
Facility census:  93
As reported by the facility on: 07/01/2025
 
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 07/01/2025
 
Residential care beds occupied:  30
As reported by the facility on: 07/01/2025
 
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: 58
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: 58
 
  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 - JEFF HOLM-HANSEN
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. PLANT MANAGER
Date form completed - 04/21/2025
 


Nurse Aide Training

NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved: 03/03/2005
Nurse aide training and competency evaluation program (NATCEP) expires: 04/01/2009
Nurse aide training and competency evaluation program (NATCEP) banned: Yes
Nurse aide training and competency evaluation program (NATCEP) ban expires: 07/25/2009
 
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: 
     IVY TECH COMMUNITY COLLEGE
         Approved: 04/07/2005
         Terminated: N/A
     IN TRAINING COLLEGE OF ADULT EDUCATION
         Approved: 07/25/2012
         Terminated: N/A
     TIPPECANOE SCHOOL CORPORATION
         Approved: 06/08/2010
         Terminated: N/A
     PREFERRED MEDICAL ACADEMY
         Approved: 04/28/2015
         Terminated: N/A
     KANKAKEE VALLEY HIGH SCHOOL
         Approved: 06/10/2015
         Terminated: N/A
     PORTER COUNTY CAREER CENTER
         Approved: 01/19/2010
         Terminated: N/A
     SAINT JOSEPH'S COLLEGE
         Approved: 10/31/2019
         Terminated: N/A
     NORTH NEWTON SCHOOL CORPORATION
         Approved: 10/28/2022
         Terminated: N/A
     DESTINATION UNLIMITED TRAINING CENTER
         Approved: 01/26/2023
         Terminated: N/A
 


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
374
380
380
287


Rank of Score
40
37
40
76


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
Yes
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: 10/18/2022  Date Ended: 10/14/2022
 
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

IPUI12
Complaint, Follow Up
06/10/2025


IPUI11
Complaint
05/07/2025


DF6413
Recertification, Follow Up, State Licensure
01/21/2025


DF6422
Recertification, Follow Up, Life Safety Code
01/08/2025


DF6412
Recertification, Complaint, Follow Up, State Licensure
12/05/2024


DF6421
Recertification, Life Safety Code
10/28/2024


DF6411
Recertification, Complaint, State Licensure
10/22/2024


PL1212
Complaint, Follow Up
08/20/2024


PL1211
Complaint
07/24/2024


0VJ912
Complaint, Follow Up
06/10/2024


0VJ911
Complaint
05/14/2024


BBZ012
Complaint, Follow Up
05/11/2024


BBZ011
Complaint
04/17/2024


JIWI22
Recertification, Follow Up, Life Safety Code
02/15/2024


JIWI12
Recertification, Follow Up, State Licensure
01/23/2024


JIWI21
Recertification, Life Safety Code
12/18/2023


JIWI11
Recertification, State Licensure
11/20/2023


TQWP12
Complaint, Follow Up
11/09/2023


TQWP11
Complaint
09/26/2023


630712
Complaint, Follow Up
08/31/2023


630711
Complaint, Other
07/11/2023


ZLXG22
Recertification, Follow Up, Life Safety Code
10/31/2022


ZLXG12
Recertification, Complaint, Follow Up, State Licensure
10/21/2022


ZLXG21
Recertification, Life Safety Code
10/03/2022


ZLXG11
Recertification, Complaint, State Licensure
09/14/2022


 
 


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.