Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record

GRACE VILLAGE HEALTH CARE FACILITY

WINONA LAKE, IN · 71 certified beds · Last Life Safety survey March 24, 2025

CMS Certification Number 155635 · first certified August 1997

Ownership

Independently operated (no chain recorded by CMS) · Government - County

No change of ownership on CMS record since January 1, 2016, when the records begin.

44
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
6
Tags cited more than once
Across separate surveys
19
Inspection & testing records
Of the citations on file

Position within IN

44 citations — more than 98% of the 507 certified nursing homes in IN. Compared within IN rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated

Improvingfewer citations at the latest survey than at its earlier surveys in the window.

The latest survey found 13 citations; the earlier surveys in the window averaged 15.5. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

Well past the typical window (March 2026 to May 2026), and past the point by which nine in ten IN facilities have been surveyed. This facility’s last Life Safety survey was March 2025. Facilities in IN are typically surveyed 11–14 months after the last one (median 13), measured over 883 consecutive surveys in the last two years of CMS records.

A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured

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Which alerts

5 inspection-and-testing tags have been cited here at more than one survey. Nationally, that pattern is common: about three quarters of cited facilities have at least one repeated tag, and half of the facilities ever cited for sprinkler inspection and testing are cited for it again. A repeat is usually a recordkeeping gap rather than a new hazard.

Emergency preparedness

10 of the 44 citations on file are Emergency Preparedness E-tags. E-tags are cited under 42 CFR §483.73 and concern the emergency plan, training, drills, communications and supplies. Nationally about half of certified facilities have at least one. The Emergency Preparedness Index

Physical environment (health survey)

1 physical-environment citation on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 44 Life Safety citations above. The Physical Environment Index

  • F-0880 Provide and implement an infection prevention and control program.

How that compares

Citations on file over three years

Compared with the median facility in IN, and nationally. Surveyors differ markedly between states, so the IN figure is the meaningful one.

This facility44IN median15National median11
Citations on file over three years, compared
MeasureCitations
This facility44
Median facility in IN15
Median facility nationally11

Survey history

Citations at each Life Safety survey
172023-03142024-05132025-03
Citations at each Life Safety survey
Survey dateCitations
March 31, 202317
May 24, 202414
March 24, 202513

Most-cited tags

Most-cited tags at this facility
K-05113K-07613K-03533K-03453K-07123E-00392K-09161K-02511
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0511Have properly installed electrical wiring and gas equipment.32025-03-24
K-0761To conduct inspection, testing and maintenance of fire doors by qualified individuals.32025-03-24
K-0353Inspect, test, and maintain automatic sprinkler systems.32025-03-24
K-0345Have approved installation, maintenance and testing program for fire alarm systems.32025-03-24
K-0712Have simulated fire drills held at unexpected times.32025-03-24
E-0039Conduct testing and exercise requirements.22025-03-24
K-0916Have a battery powered remote alarm panel in a location accessible by operating personnel.12024-05-24
K-0251Conform to length requirements for dead end corridors.12023-03-31

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 11
  • Emergency Preparedness Deficiencies 10
  • Miscellaneous Deficiencies 8
  • Services Deficiencies 5
  • Other 10
Citations by CMS category
CategoryCitations
Smoke Deficiencies11
Emergency Preparedness Deficiencies10
Miscellaneous Deficiencies8
Services Deficiencies5
Gas, Vacuum, and Electrical Systems Deficiencies5
Egress Deficiencies4
Construction Deficiencies1

Every citation on file

As published by CMS, newest survey first. Descriptions are CMS’s own wording.

March 24, 2025 — 13 citations

Citations issued on March 24, 2025
TagWhat the surveyor checksStatus
E-0039Conduct testing and exercise requirements.Deficient, Provider has date of correction (May 18, 2025)
E-0041Implement emergency and standby power systems.Deficient, Provider has date of correction (May 18, 2025)
K-0131Meet requirements for sections of health care facilities separated by fire resistive construction.Deficient, Provider has date of correction (May 18, 2025)
K-0300Meet other general requirements that are deficient.Deficient, Provider has date of correction (May 18, 2025)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (May 18, 2025)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (May 18, 2025)
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.Deficient, Provider has date of correction (May 18, 2025)
K-0500Meet other general requirements that are deficient.Deficient, Provider has date of correction (May 18, 2025)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (May 18, 2025)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (May 18, 2025)
K-0761To conduct inspection, testing and maintenance of fire doors by qualified individuals.Deficient, Provider has date of correction (May 18, 2025)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (May 18, 2025)
K-0921Ensure that testing and maintenance of electrical equipment is performed.Deficient, Provider has date of correction (May 18, 2025)

May 24, 2024 — 14 citations

Citations issued on May 24, 2024
TagWhat the surveyor checksStatus
E-0025Create arrangements with other facilities to receive patients.Deficient, Provider has date of correction (July 13, 2024)
E-0026Establish roles under a Waiver declared by secretary.Deficient, Provider has date of correction (July 13, 2024)
K-0271Have exits that are accessible at all times.Deficient, Provider has date of correction (July 13, 2024)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (July 13, 2024)
K-0331Construct fire resistant interior walls.Deficient, Provider has date of correction (July 13, 2024)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (July 13, 2024)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (July 13, 2024)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (July 13, 2024)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (July 13, 2024)
K-0741Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.Deficient, Provider has date of correction (July 13, 2024)
K-0753Have restrictions on the use of highly flammable decorations.Deficient, Provider has date of correction (July 13, 2024)
K-0761To conduct inspection, testing and maintenance of fire doors by qualified individuals.Deficient, Provider has date of correction (July 13, 2024)
K-0916Have a battery powered remote alarm panel in a location accessible by operating personnel.Deficient, Provider has date of correction (July 13, 2024)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (July 13, 2024)

March 31, 2023 — 17 citations

Citations issued on March 31, 2023
TagWhat the surveyor checksStatus
E-0004Develop and maintain an Emergency Preparedness Program (EP).Deficient, Provider has date of correction (June 1, 2023)
E-0013Develop Emergency Preparedness policies and procedures.Deficient, Provider has date of correction (June 1, 2023)
E-0029Develop a communication plan.Deficient, Provider has date of correction (June 1, 2023)
E-0036Establish emergency prep training and testing.Deficient, Provider has date of correction (June 1, 2023)
E-0037Establish staff and initial training requirements.Deficient, Provider has date of correction (June 1, 2023)
E-0039Conduct testing and exercise requirements.Deficient, Provider has date of correction (June 28, 2023)
K-0251Conform to length requirements for dead end corridors.Deficient, Provider has date of correction (June 1, 2023)
K-0293Have properly located and lighted "Exit" signs.Deficient, Provider has date of correction (June 1, 2023)
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.Deficient, Provider has date of correction (June 1, 2023)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (June 1, 2023)
K-0352Properly install and monitor supervisory attachments on automatic sprinkler systems.Deficient, Provider has date of correction (June 1, 2023)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (June 1, 2023)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (June 1, 2023)
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.Deficient, Provider has date of correction (June 1, 2023)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (June 1, 2023)
K-0761To conduct inspection, testing and maintenance of fire doors by qualified individuals.Deficient, Provider has date of correction (June 1, 2023)
K-0914Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.Deficient, Provider has date of correction (June 1, 2023)

Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.