01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-02-13 | 1 | 2026-02-13 | 0 |
| Cycle 2 | 2024-12-16 | 2 | 2024-12-16 | 5 |
| Cycle 3 | 2023-12-21 | 3 | 2023-12-21 | 2 |
CMS CCN 1553632026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Willowdale Village
404 W Willow Rd · Dale, IN 47523 · Spencer County
Certified beds50CMS provider file
Recent citation rows13current 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
13 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 1 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-02-13 · 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 · 2026-03-132024-12-16 · 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 · 2025-01-312024-12-16 · HEALTHF0727Severity E · pattern; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Correction field: Deficient, Provider has date of correction · 2024-12-262024-12-16 · 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 · 2024-12-262024-12-16 · FIREK0291Severity C · widespread; potential for minimal harm
Egress Deficiencies
Install emergency lighting that can last at least 1 1/2 hours.
Correction field: Deficient, Provider has date of correction · 2025-01-312024-12-16 · 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 · 2025-01-312024-12-16 · FIREK0916Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have a battery powered remote alarm panel in a location accessible by operating personnel.
Correction field: Deficient, Provider has date of correction · 2025-01-312024-12-16 · FIREK0921Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure that testing and maintenance of electrical equipment is performed.
Correction field: Deficient, Provider has date of correction · 2025-01-312023-12-21 · 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 · 2024-01-192023-12-21 · HEALTHF0657Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Correction field: Deficient, Provider has date of correction · 2024-01-192023-12-21 · HEALTHF0761Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Correction field: Deficient, Provider has date of correction · 2024-01-192023-12-21 · HEALTHF0849Severity D · isolated; potential for more than minimal harm
Administration Deficiencies
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
Correction field: Deficient, Provider has date of correction · 2024-01-192023-12-21 · 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 · 2024-01-1903 / 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
- KELSEY, DONNAIndividual · CONTRACTED MANAGING EMPLOYEENOT APPLICABLE · since 06/01/2019
- VAN CAMP, STEVENIndividual · CONTRACTED MANAGING EMPLOYEENOT APPLICABLE · since 09/06/2019
- DRUMMER, CARLIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2017
- FEHRIBACH, GREGORYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/14/2004
- HANIFY, THOMASIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2022
- LAZARD, ROBERTIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/29/2021
- MANTRAVADI, GEETAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/21/2021
- MUKES-GAITHER, BEVERLYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2022
- PAYNE, MONICAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 08/09/2021
- BABCOCK, PAULIndividual · CORPORATE OFFICERNOT APPLICABLE · since 09/30/2020
- CAINE, VIRGINIAIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/10/1994
- HARRIS, LISAIndividual · CORPORATE OFFICERNOT APPLICABLE · since 12/22/2003
- AMERICAN SENIOR COMMUNITIES LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2003
- DENTON, KRISTYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/19/2022
- STEPHENS, RACHELIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/06/2018
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 hours3.77per resident day
RN hours1.14per resident day
Weekend nurse hours3.15per resident day
Staff turnover32.1%CMS reported field
06 / LOCAL RECORDS
Open the Dale ledger →