Created on: 4/4/2025
Posted to the Web on: 4/16/2025
Basic Information
FACILITY CONTACT INFORMATION:
Address: 801 N HUNTINGTON AVE
City: WARREN
Telephone: (260) 375-2201
Web Site:
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
LICENSE INFORMATION:
License number: 24-000542-1
License effective date: 6/1/2024
License expiration date: 5/31/2025
Administration and Staff
Administrator: TERRENCE JENT
Start date: 1/8/2024
Director of Nursing: ALLYSON HURST
Start date: 12/6/2024
Medical director: Lloyd Williams
Start date: / /
Wound care specialist: Brandi Richardson
Start date: / /
Infection preventionist:
Start date: / /
Ownership
CURENT OWNERSHIP:
Owning corporation: ADAMS COUNTY MEMORIAL HOSPITAL
1100 MERCER AVENUE
DECATUR IN 46733
Ownership type: OTHER
Officer(s): RUSSELL FLUECKIGER
DANE WHEELER
SCOTT SMITH
LARRY MACKLIN
DAVID MCINTIRE
SCOTT LEHMAN
KYLE SPRUNGER
TIFFANY WILLIAMS
ELIZABETH FISHER
ADAM MILLER, J.D.
AMBER LAUTZENHEISE
CANDICE BORNE-BAUMAN
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: PULASKI MEMORIAL HOSPITAL
Date of last change of ownership: 6/1/2022
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): 119
Number of non-certified comprehensive care beds (State Licensed only): 0
Total number of comprehensive care beds: 119
RESIDENTIAL CARE BEDS:
Total number of residential beds: 248
Total number of beds in facility: 367
CENSUS:
Facility census: 240
As reported by the facility on: 2/4/2020 7
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 2/4/2020 7
Residential care beds occupied: 121
As reported by the facility on: 2/4/2020 7
Alzheimer Beds: 95
Alzheimer Beds Occupied: 79
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: 0
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: 0
Person completing form - BRENDA M JOHNS
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. HFA
Date form completed - 3/16/2023
Nurse Aide Training
NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved: 5/12/2023
Nurse aide training and competency evaluation program (NATCEP) expires: 4/1/2025
Nurse aide training and competency evaluation program (NATCEP) banned: Yes
Nurse aide training and competency evaluation program (NATCEP) ban expires: 4/4/2023
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites:
IVY TECH COMMUNITY COLLEGE
Approved: 1/6/2003
Terminated: 4/5/2021
UNIVERSITY OF SAINT FRANCIS
Approved: 11/9/1999
Terminated: 4/5/2021
HERITAGE POINTE OF WARREN
Approved: N/A
Terminated: 4/5/2021
HEALTH SERVICES HUNTINGTON NORTH HIGH
Approved: 12/3/2009
Terminated: 4/5/2021
NORTHERN WELLS COMMUNITY SCHOOLS/NORWELL HIGH SCHO
Approved: N/A
Terminated: 4/5/2021
HERITAGE POINTE OF HUNTINGTON
Approved: 5/31/2023
Terminated: N/A
ESSENTIAL HEALTHCARE ACADEMY, LLC
Approved: 12/7/2023
Terminated: N/A
HERITAGE POINTE OF WARREN
Approved: 5/12/2023
Terminated: N/A
Complaints
NUMBER OF SUBSTANTIATED COMPLAINTS:
Current year: 0
Previous year: 0
2 years previous: 0
Facility Report Card
3/1/2020 Current QTR
12/1/2019 Previous QTR
9/1/2019 Previous QTR
6/1/2019 Previous QTR
Report Card Score
348
341
341
314
Rank of Score
52
52
55
65
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 gridView the scoring methodology
Overview of Survey findings
The Most Recent Set
2ND Most Recent Set
3RD Most Recent Set
Immediate Jeopardy
No
No
Yes
Substandard Quality of Care
No
No
Yes
Administrator Change
Yes
No
No
Owner Change
No
Yes
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
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.
