Inspection Reports for
Antioch Valley Senior Living
12700 Antioch Rd, Overland Park, KS 66213, KS, 66213
Back to Facility ProfileDeficiencies (last 8 years)
Deficiencies (over 8 years)
4 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
33% better than Kansas average
Kansas average: 6 deficiencies/yearDeficiencies per year
16
12
8
4
0
Occupancy
Latest occupancy rate
63% occupied
Based on a January 2025 inspection.
This facility has shown a decline in demand based on occupancy rates.
Occupancy rate over time
Inspection Report
Re-Inspection
Deficiencies: 0
Date: Mar 3, 2025
Visit Reason
An offsite revisit survey was conducted to verify correction of all previous deficiencies cited on 2025-01-29.
Findings
All deficiencies have been corrected as of the compliance date of 2025-02-27, and no new noncompliance was found. The facility is in compliance with all regulations surveyed.
Inspection Report
Re-Inspection
Census: 75
Deficiencies: 16
Date: Jan 29, 2025
Visit Reason
Resurvey with attached complaints at an assisted living facility to evaluate compliance with regulatory requirements.
Complaint Details
This was a resurvey with attached complaints #192790, #192091, #192092, #192042, and #190127.
Findings
The facility failed to complete required Functional Capacity Screens and Negotiated Service Agreements following significant changes for multiple residents. Deficiencies were found in medication administration, staff qualifications, emergency preparedness, infection control, and chemical storage.
Deficiencies (16)
KAR 26-41-201(c)(2) The facility failed to complete a Functional Capacity Screen for Resident 5 following a significant change when admitted to hospice.
KAR 26-41-202(a)(1)(2) The facility failed to ensure Negotiated Service Agreements for Residents 2, 4, 5, and 6 described services provided and identified service providers.
KAR 26-41-202(d)(2) The facility failed to complete significant change Negotiated Service Agreements for Residents 4 and 5 following significant changes.
KAR 26-41-202(h) The facility failed to ensure all individuals involved in developing Negotiated Service Agreements signed the agreements for all residents.
KAR 26-41-204(d) The facility failed to name the licensed nurse responsible for implementing and supervising Healthcare Service Plans in all residents' Negotiated Service Agreements.
KAR 26-41-204(i) The facility failed to ensure a licensed nurse assessed Resident 5 to confirm bed assist device was not a restraint and assessed safety and entrapment risk.
KAR 26-41-205(a)(1) The facility failed to ensure a licensed nurse performed an assessment to determine if Resident 6 could self-administer insulin safely.
KAR 26-41-205(b) The facility failed to ensure Resident 6's Negotiated Service Agreement identified who was responsible for administration and management of select medications.
KAR 26-41-205(d)(1) The facility failed to ensure only licensed nurses and medication aides administered and managed medications; a CNA was observed administering medications.
KAR 26-41-205(d)(4) The facility failed to ensure three Certified Medication Aides received training and completed competencies for delegated insulin pen preparation for resident self-administration.
KAR 26-41-205(g)(3) The facility failed to ensure licensed pharmacist or nurse placed full resident names on original packages of five over-the-counter medications.
KAR 26-41-205(l)(2) The facility failed to ensure a licensed nurse notified Resident 3's medical care provider of medication regimen variances and sought a response.
KAR 26-41-102(d)(2) The facility failed to maintain evidence of criminal background checks for five sampled staff.
KAR 26-41-104(d)(3)(4) The facility failed to provide evidence of quarterly reviews of emergency management plan and annual evacuation drills with residents and staff.
KAR 26-41-207(c) The facility failed to comply with tuberculosis guidelines for all sampled residents and staff, lacking required TB screening documentation.
KAR 28-39-254(a) The facility failed to ensure all chemicals were stored within locked areas; unsecured chemicals were observed in laundry and housekeeping areas.
Report Facts
Resident census: 75
Residents in sample: 6
Medication carts: 3
OTC medications without resident names: 5
Staff lacking criminal background checks: 5
Residents marked for insulin injection: 11
Employees mentioned
| Name | Title | Context |
|---|---|---|
| CNA J | Certified Nurse Aide | Observed administering medications without proper authorization |
| Licensed Nurse D | Licensed Nurse | Terminated for delegating medication administration to CNA |
| Administrative Nurse B | Administrative Nurse | Confirmed lack of policies and documentation for multiple deficiencies |
| Administrative Nurse C | Administrative Nurse | Confirmed multiple deficiencies including medication and TB screening |
| Administrative Staff A | Administrative Staff | Provided information on staff records and investigations |
| Certified Medication Aide F | Certified Medication Aide | Witnessed CNA J administering medications; confirmed OTC meds lacked resident names |
| Certified Medication Aide G | Certified Medication Aide | Confirmed insulin preparation by CMA's without documented competencies |
Inspection Report
Re-Inspection
Deficiencies: 0
Date: May 28, 2024
Visit Reason
An offsite revisit survey was conducted to verify correction of all previous deficiencies cited on 2024-05-07.
Findings
All deficiencies have been corrected as of the compliance date of 2024-05-23, and no new noncompliance was found. The facility is in compliance with all regulations surveyed.
Inspection Report
Complaint Investigation
Census: 83
Deficiencies: 2
Date: May 7, 2024
Visit Reason
The inspection was conducted as an abbreviated survey for multiple complaints (#187358, #187289, #187291, #187292, #187923, #187189, and #186222) at the facility on 05/06/24 and 05/07/24.
Complaint Details
The investigation was triggered by multiple complaints regarding the facility's failure to accurately assess and document Resident 1's functional capacity and service needs related to impaired vision. The complaints were substantiated by observations, interviews, and record reviews.
Findings
The facility failed to ensure that the Functional Capacity Screen (FCS) and the Negotiated Service Agreement (NSA) accurately reflected Resident 1's impaired vision and related service needs. The administrator and staff did not properly document or address the resident's vision impairment, resulting in inadequate support and frequent disorientation.
Deficiencies (2)
KAR 26-41-201(d) Functional Capacity Screen was inaccurate as the facility failed to reflect Resident 1's impaired vision on the screening form.
KAR 26-41-202(a)(1) Negotiated Service Agreement did not describe the services Resident 1 received based on her functional capacity screening and service needs for impaired vision.
Report Facts
Resident census: 83
Complaints investigated: 7
Inspection Report
Plan of Correction
Deficiencies: 0
Date: May 6, 2024
Visit Reason
The document is a plan of correction responding to findings from an abbreviated survey conducted on 05/06/24 and 05/07/24 related to multiple complaints at the facility.
Findings
The plan of correction addresses citations resulting from an abbreviated survey triggered by complaints numbered #187358, #187289, #187291, #187292, #187923, #187189, and #186222.
Inspection Report
Abbreviated Survey
Deficiencies: 0
Date: Jan 16, 2024
Visit Reason
The abbreviated survey was conducted in response to multiple complaints numbered #184937, #184455, #184396, #184218, #180557, #180122, and #179684.
Complaint Details
The survey was complaint-related, but no deficiencies were found, indicating no substantiated violations.
Findings
The survey resulted in a finding of no deficiency citations at the assisted living facility.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Jan 16, 2024
Visit Reason
The abbreviated survey was conducted in response to multiple complaints against the assisted living facility.
Findings
The abbreviated survey conducted on 01/16/24 and 01/17/24 resulted in a finding of no deficiency citations.
Inspection Report
Follow-Up
Deficiencies: 0
Date: May 15, 2023
Visit Reason
An offsite revisit survey was conducted to verify correction of all previous deficiencies cited on 2023-04-25.
Findings
All deficiencies have been corrected as of the compliance date of 2023-05-10, and no new noncompliance was found. The facility is in compliance with all regulations surveyed.
Inspection Report
Re-Inspection
Census: 83
Deficiencies: 6
Date: Apr 24, 2023
Visit Reason
The inspection was a resurvey with multiple complaints to verify correction of previous deficiencies at Rose Estates Assisted Living Community.
Complaint Details
This resurvey was conducted in response to multiple complaints (#179109, #177613, #170940, #169564, #169538, #169371, #169000, #168560, #168507, #167541, #165948, #166047, and #165901).
Findings
The facility failed to ensure negotiated service agreements (NSA) were reviewed and revised annually and signed by all involved parties. Verbal medication orders were not signed by medical providers within seven working days. Over-the-counter medications were not labeled with residents' full names. The facility did not comply with tuberculosis screening guidelines for new employees. Cleaning chemicals were not stored in a locked, secured area, posing a safety hazard.
Deficiencies (6)
KAR 26-41-202(d)(1) The administrator failed to ensure facility staff completed a negotiated service agreement based on resident's functional capacity screen every 365 days for Resident 5.
KAR 26-41-202(h) The administrator failed to ensure each individual involved in the development of the negotiated service agreement signed the agreement for six sampled residents.
KAR 26-41-205(e) The administrator failed to ensure all verbal medication orders were signed by the medical care provider within seven working days for Residents 1, 2, 4, and 5.
KAR 26-41-205(g)(3) The administrator failed to ensure a licensed pharmacist or nurse placed the full names of residents on original packages of over-the-counter medications.
KAR 26-41-207(c) The administrator failed to ensure the facility complied with tuberculosis screening guidelines for adult care homes for three of five sampled staff.
KAR 28-39-254(a) The facility failed to keep cleaning chemicals in a locked, secured area, posing a potential safety hazard.
Report Facts
Resident census: 83
Number of residents in sample: 6
Number of verbal orders lacking signatures: 4
Number of verbal orders lacking signatures: 17
Number of verbal orders lacking signatures: 7
Number of verbal orders lacking signatures: 4
Number of residents with impaired cognition: 19
Number of OTC medication bottles without resident names: 17
Days delayed TB test: 206
Days delayed TB test: 140
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Apr 24, 2023
Visit Reason
This document is a plan of correction submitted in response to a resurvey with multiple complaints for an assisted living facility conducted on April 24 and 25, 2023.
Findings
The plan of correction addresses findings from a resurvey triggered by numerous complaints related to the assisted living facility.
Inspection Report
Abbreviated Survey
Deficiencies: 0
Date: Jul 30, 2020
Visit Reason
The visit was a special infection control survey for COVID-19 conducted at the assisted living facility.
Findings
The survey resulted in findings of no deficiency citations related to infection control.
Inspection Report
Re-Inspection
Deficiencies: 0
Date: Jun 5, 2018
Visit Reason
A re-survey for licensure and investigation into attached complaints was conducted at the assisted living facility in Overland Park, KS on 5/31/18, 6/4/18, and 6/5/18.
Findings
The re-survey resulted in a finding of no deficiency citations.
Inspection Report
Renewal
Deficiencies: 0
Date: Feb 28, 2017
Visit Reason
The licensure resurvey was conducted as a renewal inspection of the assisted living facility.
Findings
The inspection resulted in a finding of no deficiency citations on 2-27-17 and 2-28-17.
Inspection Report
Follow-Up
Deficiencies: 2
Date: May 31, 2016
Visit Reason
This visit was conducted as a follow-up to verify that previously reported deficiencies have been corrected.
Findings
The report confirms that the deficiencies previously cited under regulations 26-41-206 (d) and 26-41-206 (e)(1) have been corrected as of the revisit date.
Deficiencies (2)
Regulation 26-41-206 (d) deficiency was corrected by the revisit date.
Regulation 26-41-206 (e)(1) deficiency was corrected by the revisit date.
Inspection Report
Follow-Up
Deficiencies: 1
Date: May 5, 2016
Visit Reason
This visit was conducted as a follow-up to verify that previously reported deficiencies have been corrected.
Findings
The report confirms that the deficiencies previously cited have been corrected as of the dates indicated.
Deficiencies (1)
Regulation 26-41-205 (l) (2) deficiency was corrected by 05/04/2016.
Inspection Report
Re-Inspection
Census: 87
Deficiencies: 2
Date: May 5, 2016
Visit Reason
Special revisit conducted on 2016-05-04 and 2016-05-05 to evaluate compliance with food preparation and storage regulations following prior deficiencies.
Findings
The facility failed to ensure food was prepared using safe methods that conserved nutritive value, flavor, and appearance and served at proper temperatures. Additionally, food storage practices were unsafe and unsanitary, including unlabeled and undated food containers, dirty kitchen equipment, and improper freezer conditions.
Deficiencies (2)
KAR 26-41-206(d) Food preparation was not performed using safe methods to conserve nutritive value, flavor, and appearance, and food was not served at proper temperatures as cold food temperatures were not documented.
KAR 26-41-206(e)(1) Facility staff failed to store all food under safe and sanitary conditions, evidenced by unlabeled repackaged foods, food debris on floors, spillage in coolers, uncovered foods, greasy kitchen equipment, and improper freezer temperatures.
Report Facts
Resident census: 87
Inspection Report
Re-Inspection
Census: 88
Deficiencies: 3
Date: Mar 16, 2016
Visit Reason
The inspection was a resurvey with complaint investigations conducted on multiple dates in March 2016 to assess compliance with regulatory requirements.
Complaint Details
The inspection included complaint investigations numbered 89485, 92935, 93786, 93865, and 98073.
Findings
The facility failed to notify medical care providers of medication regimen variances, did not properly monitor and document food temperatures, and failed to store food under safe and sanitary conditions.
Deficiencies (3)
KAR 26-41-205(l)(2) Medication Regimen Review: The licensed nurse failed to notify the medical care provider upon discovery of any variance identified in the medication regimen review for residents #420 and #430.
KAR 26-41-206(d) Food Preparation: The administrator failed to ensure food was prepared using safe methods that conserved nutritive value, flavor, and appearance and served at proper temperatures, with multiple dates lacking food temperature documentation.
KAR 26-41-206(e)(1) Facility Food Storage: The administrator failed to ensure all food was stored under safe and sanitary conditions, including unlabeled containers, broken glass, lack of thermometers, and unsanitary kitchen conditions.
Report Facts
Census: 88
Sample size: 6
Dates lacking food temperature documentation: 50
Inspection Report
Renewal
Deficiencies: 0
Date: Jun 30, 2014
Visit Reason
The licensure resurvey was conducted as a renewal inspection of the assisted living facility.
Findings
The inspection resulted in no deficiency citations on the dates 6-25-14, 6-26-14, and 6-30-14.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Feb 20, 2014
Visit Reason
This document is a Plan of Correction related to a prior inspection or deficiency report for the facility identified by State ID N046060.
Findings
No deficiency records or findings are included in this Plan of Correction document.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: N046060 POC 1F6311
Visit Reason
This document is a Plan of Correction related to a previous inspection report for Rose Estates Assisted Living Community concerning COVID-19 dated 7.30.2020.
Findings
No specific findings or deficiencies are detailed in this document. It serves as a placeholder or reference to the linked deficiency report.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: N046060 POC 1KY011
Visit Reason
This document is a Plan of Correction related to a prior inspection event identified as 1KY011 for the facility with State ID N046060.
Findings
No deficiency details or findings are included in this Plan of Correction document. It only references the related deficiency report but states no records found.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: N046060 POC 6Y4I11
Visit Reason
This document is a Plan of Correction related to a previously identified deficiency report for the facility.
Findings
No deficiency details or findings are included in this document. It only references the Plan of Correction status and contact information for assistance.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: N046060 POC BI4X11
Visit Reason
This document is a Plan of Correction related to a previous deficiency report for Rose Estates Assisted Living dated 3/16/2016.
Findings
No specific findings or deficiencies are detailed in this document. It serves as a placeholder or administrative record for the Plan of Correction submission.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: N046060 POC BI4X12
Visit Reason
This document is a Plan of Correction related to a prior deficiency report for the facility identified as Aspen, State ID N046060.
Findings
No specific findings or deficiencies are detailed in this document. It serves as a record of the Plan of Correction submission and modification dates.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: N046060 POC BI4X13
Visit Reason
This document is a Plan of Correction related to a prior inspection or regulatory finding for the facility identified by State ID N046060 and Event ID BI4X13.
Findings
No deficiency records or findings are included in this document. It serves as a placeholder or administrative record for the Plan of Correction submission.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: N046060 POC CZPT11
Visit Reason
This document is a Plan of Correction related to a prior inspection or regulatory finding for the facility identified as State ID N046060 ASPEN Event ID CZPT11.
Findings
No deficiency records or findings are included in this Plan of Correction document. It only provides contact information for assistance and notes the Plan of Correction was added and modified on specified dates.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: N046060 POC F98C11
Visit Reason
This document is a Plan of Correction related to a prior deficiency report for the facility identified as Aspen with State ID N046060.
Findings
No specific findings or deficiencies are detailed in this document. It serves as a record of the Plan of Correction submission and modification dates.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: N046060 POC GWUY11
Visit Reason
This document is a Plan of Correction related to a prior inspection event identified as GWUY11 for the facility with State ID N046060.
Findings
No deficiency details or findings are provided in this document. It serves solely as a record of the Plan of Correction submission and modification dates.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: N046060 POC Q92L11
Visit Reason
This document is a Plan of Correction related to a previously identified deficiency report for the facility.
Findings
No deficiency details or findings are included in this document. It only references the Plan of Correction status and contact information for assistance.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: N046060 POC VHX511
Visit Reason
This document is a Plan of Correction related to a prior deficiency report for the facility identified as Aspen with State ID N046060.
Findings
No specific findings or deficiencies are detailed in this document. It serves as a placeholder or administrative record for the Plan of Correction with no records found.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: N046060 POC TOB811
Visit Reason
This document is a Plan of Correction submitted in response to deficiencies identified in a prior inspection.
Findings
The document does not provide specific findings but indicates that corrective actions are in progress to address previously cited deficiencies.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: N046060 POC UQRX11
Visit Reason
This document is a Plan of Correction related to a prior deficiency report for Rose Estates AL.
Findings
No specific findings or deficiencies are detailed in this document; it serves as a record of the Plan of Correction submission and modification dates.
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