Above average — CMS composite of the measures below.
The next survey window likely opens around December 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Kendallville Manor during CMS and state inspections, most recent first.
The facility failed to maintain a safe and comfortable environment in 4 out of 7 observed rooms, with issues such as missing paint, exposed drywall, and non-functioning light bulbs. Staff interviews revealed communication gaps in reporting maintenance issues, and the Maintenance Director was unaware of specific problems. The facility's policies require work orders to be entered into the TELS program, but documentation was lacking.
A facility failed to ensure proper oxygen orders for a resident, who was observed using a nasal cannula with an oxygen concentrator set at 1.75 lpm, while the correct order was for 1 lpm. The resident's medical record lacked physician orders for oxygen administration, and staff were unaware of the correct flow rate. The DON confirmed the oversight and noted that the order might not have been carried over after a recent hospitalization.
A resident continued to receive antibiotic eye drops and sliding scale insulin beyond the recommended stop dates, despite pharmacy recommendations and physician agreement to discontinue. The facility failed to clarify medication stop dates and adjust insulin regimens, as revealed in interviews with the DON.
The facility failed to protect two residents from abuse by a CNA. One resident, with cerebral palsy and moderate cognitive impairment, had their arm flung by the CNA. Another resident, cognitively intact but with behavioral issues, was involved in a door-related incident where the CNA used excessive force. The CNA admitted to using foul language and force, with other staff and residents noting the CNA's impatience.
Facility Fails to Maintain Safe and Comfortable Environment
Penalty
Summary
The facility failed to maintain a comfortable and safe environment for residents in 4 out of 7 observed rooms. Observations revealed multiple issues, including missing paint and exposed drywall in several rooms, missing cove base trim in bathrooms, and non-functioning light bulbs. Additionally, there were black specks on bathroom floors, likely due to wax buildup or glue, and cracks in the walls. These deficiencies were noted during various observations conducted over several days. Interviews with staff, including an LPN, the Maintenance Director, and a housekeeper, highlighted communication and procedural gaps in reporting and addressing maintenance issues. The Maintenance Director was unaware of the specific problems in certain rooms and indicated that the facility had only one maintenance employee. The facility's policies require work orders to be entered into the TELS program for maintenance issues to be addressed, but there was a lack of documentation to verify that these procedures were being followed effectively. The Maintenance Director also mentioned that a repair list for each room was nearly complete, but he was unable to produce it for review.
Failure to Ensure Proper Oxygen Orders for a Resident
Penalty
Summary
The facility failed to ensure proper oxygen orders were obtained and implemented for Resident 47. During an observation, the resident was found using a nasal cannula attached to an oxygen concentrator running at 1.75 liters per minute (lpm), while a piece of tape on the concentrator indicated 3.5 lpm. Upon reviewing the resident's medical record, it was discovered that there were no physician orders for oxygen administration or the rate of flow, despite the resident's care plan indicating the need for oxygen as ordered. The resident's diagnoses included adult failure to thrive and a personal history of pulmonary embolism, and their Minimum Data Set (MDS) indicated they used supplemental oxygen. Interviews with facility staff revealed that the Licensed Practical Nurse (LPN) was unaware of the correct oxygen flow rate due to the absence of a physician's order. The Director of Nursing (DON) acknowledged that the oxygen order might not have been carried over after the resident's recent hospitalization and confirmed that a physician's order for oxygen administration and flow rate should be present in the medical record. The DON reviewed the readmission orders from the hospital and found that the resident should have been receiving oxygen at 1 lpm. The facility's policy, dated October 2010, required staff to verify the physician's order before administering oxygen, which was not followed in this case.
Failure to Follow Pharmacy Recommendations for Medication Management
Penalty
Summary
The facility failed to ensure that pharmacy recommendations were followed for a resident, leading to the continued administration of medications beyond the recommended stop dates. The resident, who was cognitively intact, had been prescribed Maxitrol Ophthalmic Suspension for eye inflammation, with a pharmacy note indicating the medication should be stopped on a specific date. However, the medication was administered beyond this date, and the facility ordered more eye drops without clarifying the stop date. Additionally, the resident's sliding scale insulin and blood sugar checks were not adjusted as recommended by the pharmacist, despite the physician's agreement to the changes. Interviews with the Director of Nursing (DON) revealed a lack of awareness regarding the continuation of the eye drops and the failure to adjust the insulin regimen. The DON acknowledged that the facility should have clarified the stop date for the eye drops and that the insulin and blood sugar checks should have been adjusted according to the pharmacist's recommendations. The facility's policy required notifying physicians of significant medication errors, but it appears this was not adequately followed in this case.
Failure to Protect Residents from Abuse by Staff
Penalty
Summary
The facility failed to protect residents from abuse, as evidenced by incidents involving two residents, Resident A and Resident B. Resident A, who has cerebral palsy, aphasia, and moderate cognitive impairment, was involved in an incident where a Certified Nurse Aide (CNA) flung their arm out of the way. This occurred after Resident A, who is nonverbal, extended their arm to gain attention. The CNA admitted to pushing Resident A's hand to pass by, citing a stressful shift as a contributing factor. Another CNA witnessed the incident and corroborated the account of physical contact. Resident B, who is cognitively intact but has a history of behavioral disorders, was involved in a separate incident with the same CNA. Resident B attempted to prevent the CNA from entering their room by holding the door shut. The CNA forcefully pushed the door open, which could have resulted in harm to Resident B. A fellow CNA intervened to prevent the door from striking Resident B. The CNA involved admitted to using excessive force and foul language during the incident. Interviews with other staff and residents indicated that the CNA had a history of impatience and negative interactions with residents.
What surveyors are citing around you — mapped
All 10 risk areas, ranked with evidence
Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the 169 citations issued within 25 miles in the last 12 months — including the 2 immediate-jeopardy cases — and tell you exactly what happened, in plain English, matched to your record.
Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
Illustrative
A prioritized, do-first checklist
Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.
Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Kendallville
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Lutheran Life Villages | 0.4 mi | ★★★★★ | 2 | 0 |
| Orchard Pointe Health Campus | 2.9 mi | ★★★★★ | 7 | 0 |
| Ascension Living Sacred Heart Village | 4.8 mi | ★★★★★ | 8 | 0 |
| Miller's Merry Manor | 9.4 mi | ★★★★★ | 11 | 0 |
| Betz Nursing Home | 10.4 mi | ★★★★★ | 1 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.