Indiana State Department of Health
Division of Long Term Care
 
CONSUMER REPORT
 
GREY STONE HEALTH & REHABILITATION CENTER
 
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: 10445 DUPONT OAKS BLVD
City: FORT WAYNE
Telephone: (260) 471-4770
Web Site:  
 
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
 
LICENSE INFORMATION:
  License number: 25-012935-1
  License effective date: 01/01/2025
  License expiration date: 12/31/2025
 


Administration and Staff

Administrator: CRAIG NELSON
  Start date: 05/15/2025
 
Director of Nursing: MELISSA MARTINEZ
  Start date: 03/26/2025
 
Medical director:  
  Start date:   /  /  
 
Wound care specialist:  
  Start date:   /  /  
 
Infection preventionist: Allison Prince
  Start date:   /  /  
 


Ownership

CURENT OWNERSHIP:
 
Owning corporation: MAJOR HOSPITAL
2451 INTELLPLEX DR
SHELBYVILLE IN 46176
 
Ownership type:  OTHER
 
Officer(s): DANA CALDWELL
            JEFF BEATY
            JOHN COFFIN
            JAN SANDMAN
            SHERRI TANDY
            PAULA GUSTAFSON
            GENE JONES
            RALPH MERCURI
            LINDA WESSIC
            ROB KINDER
            RYAN CLAXTON
            MELANIE STEVENS
            PHILP MATTHEW HAEHL
            ALEXANDER ISAKOVAN
 
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: FORT WAYNE HEALTHCARE GROUP LLC
Date of last change of ownership: 01/01/2015
 


Bed Counts and Census

COMPREHENSIVE CARE BEDS:
Number of Medicaid beds (NF):                     0
Number of Medicare beds (SNF):                    16
Number of Medicare/Medicaid beds (SNF/NF):        84
Number of non-certified comprehensive care beds (State Licensed only):     0
Total number of comprehensive care beds:     100
 
RESIDENTIAL CARE BEDS:
 
Total number of residential beds:            0
 
Total number of beds in facility:            100
 
CENSUS:
Facility census:  82
As reported by the facility on: 01/06/2025
 
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 01/06/2025
 
Residential care beds occupied:  0
As reported by the facility on: 01/06/2025
 
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: 80
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: 80
 
  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 - KIRT DOLLASHIDE
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. MAINTENANCE DIRECTOR
Date form completed - 04/04/2025
 


Nurse Aide Training

NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved: 07/09/2015
Nurse aide training and competency evaluation program (NATCEP) expires: 04/01/2017
Nurse aide training and competency evaluation program (NATCEP) banned: Yes
Nurse aide training and competency evaluation program (NATCEP) ban expires: 04/29/2027
 
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: 
     GREY STONE HEALTH & REHABILITATION CENTER
         Approved: 07/09/2015
         Terminated: 01/30/2017
     IVY TECH COMMUNITY COLLEGE
         Approved: 08/21/2015
         Terminated: 01/30/2017
     PREMIER NURSING ACADEMY
         Approved: 02/25/2019
         Terminated: 12/17/2020
 


Complaints

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

 


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
419
413
419
333


Rank of Score
20
19
18
58


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
     Discretionary Deny Pay for New Admits
     Date Imposed: 10/15/2024  Date Ended: 10/21/2024
     Civil Money Penalty
     Date Imposed: 09/17/2024  Date Ended: 10/21/2024
     Amount proposed per day: 1390
 
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

HWBW11
Complaint
05/22/2025


5R6212
Complaint, Follow Up
05/22/2025


5R6211
Complaint
04/30/2025


7T9X11
Complaint
04/21/2025


72BU12
Complaint, Follow Up
04/21/2025


72BU11
Complaint
03/31/2025


BNK711
Complaint
03/24/2025


NYO711
Complaint
03/17/2025


TZPO12
Complaint, Follow Up
03/13/2025


TZPO11
Complaint
02/25/2025


MSDI11
Complaint
01/22/2025


4U8Z12
Complaint, Follow Up
12/30/2024


4U8Z11
Complaint
12/06/2024


PCB112
Complaint, Follow Up
11/08/2024


MPDM12
Recertification, Complaint, Follow Up, State Licensure
11/08/2024


OLZL11
Complaint
11/08/2024


MPDM22
Recertification, Follow Up, Life Safety Code
10/29/2024


PCB111
Complaint
10/15/2024


MPDM21
Recertification, Life Safety Code
10/07/2024


MPDM11
Recertification, Complaint, State Licensure
09/23/2024


H18M11
Complaint
09/06/2024


X2ZA11
Complaint
08/16/2024


KTK311
Complaint
07/29/2024


0PNX11
Complaint
03/26/2024


RDJB12
Complaint, Follow Up
02/28/2024


RDJB11
Complaint
01/25/2024


RO9011
Complaint
12/15/2023


NB5P11
Complaint
11/08/2023


9DL422
Recertification, Follow Up, Life Safety Code
11/03/2023


9DL412
Recertification, Complaint, Follow Up, State Licensure
10/02/2023


9DL421
Recertification, Life Safety Code
09/21/2023


XXRL11
Complaint
09/19/2023


9DL411
Recertification, Complaint, State Licensure
08/16/2023


WCRL11
Complaint
04/14/2023


JPEC11
Complaint
03/27/2023


4NYF12
Complaint, Follow Up
03/20/2023


4NYF11
Complaint
02/23/2023


3G4L11
Complaint
01/26/2023


ZSXD12
Complaint, Follow Up
01/06/2023


KVDP22
Recertification, Follow Up, Life Safety Code
01/05/2023


RR0811
Complaint
12/30/2022


ZSXD11
Complaint
12/14/2022


KVDP21
Recertification, Life Safety Code
11/16/2022


JO9111
Complaint
11/16/2022


KVDP12
Recertification, Follow Up, State Licensure
10/26/2022


9RO111
Complaint
10/07/2022


KVDP11
Recertification, State Licensure
10/07/2022


 
 


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.