01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-01-22 | 0 | 2026-01-22 | 4 |
| Cycle 2 | 2024-10-16 | 7 | 2024-10-16 | 4 |
| Cycle 3 | 2023-09-22 | 0 | 2023-09-22 | 9 |
CMS CCN 1554952026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Paddock Springs
2695 Sheldon Street · Warsaw, IN 46582 · Kosciusko County
Certified beds60CMS provider file
Recent citation rows24current CMS citation release
Penalty rows0current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
24 rows in the current release
1 rows carry G–L scope/severity codes; 0 carry J–L. 3 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-01-22 · FIREE0039Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Correction field: Deficient, Provider has date of correction · 2026-02-232026-01-22 · FIREE0041Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Implement emergency and standby power systems.
Correction field: Deficient, Provider has date of correction · 2026-02-232026-01-22 · FIREK0353Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2026-02-232026-01-22 · FIREK0918Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Correction field: Deficient, Provider has date of correction · 2026-02-232025-03-31 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2025-04-14 · complaint2025-03-31 · HEALTHF0686Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Correction field: Deficient, Provider has date of correction · 2025-04-14 · complaint2024-10-16 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2024-11-072024-10-16 · HEALTHF0686Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Correction field: Deficient, Provider has date of correction · 2024-11-072024-10-16 · HEALTHF0755Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Correction field: Deficient, Provider has date of correction · 2024-11-072024-10-16 · HEALTHF0760Severity G · isolated actual harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2024-11-072024-10-16 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2024-11-072024-10-16 · FIREK0345Severity C · widespread; potential for minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2024-11-292024-10-16 · FIREK0712Severity C · widespread; potential for minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2024-11-292024-10-16 · FIREK0761Severity E · pattern; potential for more than minimal harm
Miscellaneous Deficiencies
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Correction field: Deficient, Provider has date of correction · 2024-11-292024-10-16 · FIREK0920Severity E · pattern; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure proper usage of power strips and extension cords.
Correction field: Deficient, Provider has date of correction · 2024-11-292023-09-22 · FIREE0037Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish staff and initial training requirements.
Correction field: Deficient, Provider has date of correction · 2023-11-292023-09-22 · FIREK0223Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
Correction field: Deficient, Provider has date of correction · 2023-11-292023-09-22 · FIREK0321Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Correction field: Deficient, Provider has date of correction · 2023-11-292023-09-22 · FIREK0324Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2023-11-292023-09-22 · FIREK0345Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2023-11-292023-09-22 · FIREK0351Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Install an approved automatic sprinkler system.
Correction field: Deficient, Provider has date of correction · 2023-11-292023-09-22 · FIREK0353Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2023-11-292023-09-22 · FIREK0511Severity C · widespread; potential for minimal harm
Services Deficiencies
Have properly installed electrical wiring and gas equipment.
Correction field: Deficient, Provider has date of correction · 2023-11-292023-09-22 · FIREK0932Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Meet other general requirements.
Correction field: Deficient, Provider has date of correction · 2023-11-2903 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- HANCOCK REGIONAL HOSPITALOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 11/01/2014
- BOND, MARIAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 07/01/2021
- CLARK, TIMOTHYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 05/01/2015
- DAUGHERTY, JOSHUAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2020
- FELKER, DEANIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 05/01/2015
- JOYNER, SARAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2022
- LONG, STEVENIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 11/14/2018
- WILLARD, LACEYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 07/01/2022
- WILSON, ROYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 05/01/2015
- TRILOGY HEALTHCARE OF MILFORD, LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/01/2014
- LONG, STEVENIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/13/2022
- MATHEW, PEKKAKUZHIYILIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/15/2025
- NUNEZ, HUMBERTOIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/14/2024
- BARNEY, LEIGHIndividual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNFNOT APPLICABLE · since 08/12/2025
- DAVIS, DAVIDIndividual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNFNOT APPLICABLE · since 08/12/2025
- BOND, MARIAIndividual · TRUSTEE OF THE SNFNOT APPLICABLE · since 07/01/2021
- CLARK, TIMOTHYIndividual · TRUSTEE OF THE SNFNOT APPLICABLE · since 05/01/2015
- DAUGHERTY, JOSHUAIndividual · TRUSTEE OF THE SNFNOT APPLICABLE · since 01/01/2020
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours3.91per resident day
RN hours0.43per resident day
Weekend nurse hours3.81per resident day
Staff turnover37.3%CMS reported field