Inspection Report Summary
The most recent inspection on February 6, 2012, identified deficiencies related to the absence of a certified dietary manager and the lack of a Ground Fault Interrupter in the therapy room. Earlier inspections did not require a plan of correction for identified issues, indicating some prior concerns were addressed or minimal. The main themes of deficiencies involved dietary management and environmental safety equipment. There were no complaint investigations or enforcement actions listed in the available reports. The inspection history suggests isolated issues rather than a clear pattern of improvement or decline.
Deficiencies (last 4 years)
Deficiencies (over 4 years)
14.8 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
147% worse than Kansas average
Kansas average: 6 deficiencies/yearDeficiencies per year
16
12
8
4
0
Census
Latest occupancy rate
107 residents
Based on a September 2025 inspection.
Census over time
Inspection Report
Routine
Census: 107
Deficiencies: 16
Date: Sep 10, 2025
Visit Reason
Routine inspection of Azria Health Olathe nursing home to assess compliance with regulatory requirements including resident dignity, assistive device use, abuse prevention, documentation, care planning, pressure ulcer care, dialysis services, trauma-informed care, dementia care, pharmaceutical services, food safety, hospice services, and staff training.
Findings
The facility was found deficient in multiple areas including failure to provide dignified care, improper use of assistive devices, failure to prevent sexual abuse, inadequate documentation of transfers and discharge summaries, incomplete baseline care plans, improper pressure ulcer care, incomplete dialysis orders and care plans, failure to assess trauma triggers and provide trauma-informed care, inconsistent dementia-related behavioral interventions, inaccurate medication reconciliation, unlocked medication carts and oxygen storage rooms, food safety violations, incomplete hospice care coordination, and insufficient nurse aide in-service training.
Deficiencies (16)
Failed to provide a dignified care environment for residents, including delayed meal service and verbal abuse incidents.
Failed to utilize foot pedals during wheelchair transports for multiple residents, risking preventable accidents.
Failed to protect residents from sexual abuse by cognitively impaired resident with inappropriate touching behaviors.
Failed to provide timely written notification of transfer and discharge summaries for hospitalized residents.
Failed to develop a person-centered baseline care plan including chronic pain for a newly admitted resident.
Failed to ensure low air loss mattress was set correctly and offloading boots applied to prevent pressure ulcers.
Failed to provide appropriate care to maintain and/or improve range of motion for resident with contractures.
Failed to secure oxygen storage rooms and follow nothing by mouth (NPO) orders, risking resident safety.
Failed to ensure dialysis physician orders were in the medical record and care plans directed dialysis care.
Failed to provide trauma-informed care by assessing trauma triggers and implementing individualized interventions.
Failed to provide consistent dementia-related behavioral interventions to promote resident well-being.
Failed to ensure accurate reconciliation of controlled drugs at shift changes and maintain count sheets.
Failed to keep medication carts locked and secured with cognitively impaired and independently mobile residents on the hall.
Failed to follow sanitary dietary standards related to storage, preparation, and meal service in the kitchen.
Failed to ensure coordinated hospice care plans reflecting hospice services and contact information.
Failed to ensure nurse aides completed required 12 hours of in-service education including dementia care and abuse prevention.
Report Facts
Residents reviewed for dignity: 5
Residents reviewed for assistive device needs: 4
Residents reviewed for abuse and neglect: 3
Residents reviewed for hospitalization and discharge: 3
Residents reviewed for baseline care plans: 26
Residents reviewed for pressure ulcer care: 4
Residents reviewed for dialysis care: 26
Residents reviewed for trauma-informed care: 3
Residents reviewed for dementia care: 2
Residents reviewed for pharmaceutical services: 26
Residents reviewed for food safety: 107
Residents reviewed for hospice services: 2
CNAs reviewed for in-service training: 5
Missing narcotic shift count signatures: 9
Oxygen cylinders in storage room: 21
Oxygen E-tanks in storage room: 32
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Administrative Nurse D | Provided statements on meal service, abuse training, assistive device use, baseline care plans, mattress monitoring, dialysis care, trauma-informed care, medication reconciliation, medication cart security, hospice care, and nurse aide training. | |
| Certified Nurse Aide O | CNA | Provided statements on meal service timing, assistive device use, ice chip monitoring, pressure ulcer care, hospice services, and nurse aide training. |
| Licensed Nurse K | LN | Provided statements on meal service, assistive device use, mattress settings, ice chip orders, dialysis orders, trauma-informed care, dementia care, medication reconciliation, and hospice care. |
| Dietary Staff BB | Provided statements on dishwasher issues and food storage violations. | |
| Certified Nurse Aide XX | CNA | Witnessed verbal abuse incident involving dietary staff and resident. |
| Certified Nurse Aide YY | CNA | Witnessed verbal abuse incident involving dietary staff and resident. |
| Certified Nurse Aide UU | CNA | Witnessed sexual abuse incident involving resident R16. |
| Licensed Nurse G | LN | Provided statements on oxygen storage room security and hospice care. |
| Licensed Nurse H | LN | Provided statements on medication cart security. |
| Administrative Staff A | Provided statements on sexual abuse incident and hospice care. | |
| Administrative Staff B | Provided statements on meal service timing and dishwasher issues. | |
| Certified Nurse Aide M | CNA | Provided statements on oxygen storage room security. |
| Certified Nurse Aide WW | CNA | Provided statements on abuse training and sexual behavior supervision. |
Inspection Report
Routine
Census: 102
Deficiencies: 13
Date: Jan 23, 2024
Visit Reason
The inspection was conducted as a routine regulatory survey of Azria Health Olathe nursing home to assess compliance with federal regulations related to resident care, safety, and facility operations.
Findings
The facility was found deficient in multiple areas including failure to ensure dignified care and dining, failure to provide required Medicaid/Medicare notices, failure to protect resident privacy, failure to timely report suspected neglect, failure to provide timely transfer notifications, inadequate assistance with activities of daily living, failure to follow physician orders for daily weights, failure to prevent accidents related to improper use of Hoyer lift and wheelchair safety pads, failure to provide appropriate dementia care and supervision, failure to follow dietary and food safety standards, and failure to implement proper infection control practices.
Deficiencies (13)
Failure to ensure a dignified care environment and dignity during dining, including use of disposable silverware and dishware.
Failure to issue required Skilled Nursing Facility Advance Beneficiary Notification forms with complete information.
Failure to secure and protect privacy and confidentiality of resident medical records.
Failure to timely report a preventable accident involving a resident fall from a Hoyer lift as potential neglect.
Failure to provide timely written notification of facility-initiated transfers to resident or representative.
Failure to provide necessary assistance with eating and drinking as per care plan.
Failure to follow physician's order for daily weights to monitor for fluid overload.
Failure to ensure environment free from accident hazards including improper placement of wheelchair safety pads and improper use of Hoyer lift sling resulting in resident falls.
Failure to ensure catheter bag was kept below resident's bladder during Hoyer lift transfer.
Failure to provide appropriate dementia care and supervision to prevent wandering and use of other residents' beds.
Failure to follow nutritionally approved recipes during preparation of pureed meals.
Failure to follow sanitary dietary standards related to food preparation, service, storage, and cleaning of kitchen equipment and service areas.
Failure to ensure staff followed infection control practices including proper storage of oxygen tubing and sanitizing of Hoyer lift after each use.
Report Facts
Residents in sample: 22
Residents reviewed for dignity: 6
Residents reviewed for abuse/neglect: 3
Residents reviewed for falls: 10
Residents on pureed diets: 6
Days reviewed for weight documentation: 113
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Administrative Nurse D | Administrative Nurse | Provided statements regarding dignity, privacy, reporting, and care expectations |
| Licensed Nurse H | Licensed Nurse | Involved in medication administration, fall incident, and infection control statements |
| Certified Nurse Aide M | Certified Nurse Aide | Witnessed fall, feeding assistance, and infection control observations |
| Dietary Staff BB | Dietary Staff | Observed food preparation and kitchen sanitation issues |
| Licensed Nurse I | Licensed Nurse | Provided statements on dignity, feeding assistance, and dementia care |
Inspection Report
Routine
Census: 102
Deficiencies: 13
Date: Jan 23, 2024
Visit Reason
The inspection was a routine survey of Azria Health Olathe nursing home to assess compliance with regulatory requirements related to resident rights, care, safety, and infection control.
Findings
The facility failed to ensure dignified care, proper notification for Medicare coverage, privacy of medical records, timely reporting of neglect, proper transfer notifications, adequate assistance with activities of daily living, adherence to physician orders for daily weights, prevention of accidents, appropriate dementia care, safe food preparation and storage, and infection control practices. Several residents were at risk due to these deficiencies.
Deficiencies (13)
Failed to ensure a dignified care environment and dignity during dining related to use of disposable silverware and dishware.
Failed to issue CMS Skilled Nursing Facility Advance Beneficiary Notification form with required information for Medicare Part A discharged residents.
Failed to ensure staff secured and protected the privacy and confidentiality of a resident's medical record.
Failed to timely report a preventable accident as an allegation of potential neglect to the State Agency.
Failed to provide written notification of facility-initiated transfers to resident or representative.
Failed to provide necessary assistance to a resident for eating and drinking per care plan.
Failed to follow physician's order for daily weights to monitor for fluid overload.
Failed to ensure an environment free from accident hazards and adequate supervision to prevent accidents, including proper placement of Dycem pads and securement of Hoyer sling.
Failed to provide appropriate dementia care and supervision to prevent wandering into other residents' rooms and beds.
Failed to follow nutritionally approved recipes during preparation of pureed meals.
Failed to follow sanitary dietary standards related to food preparation, service, and storage, and failed to ensure sanitary cleaning of kitchen service areas and equipment.
Failed to ensure catheter bag was kept below resident's bladder during Hoyer transfer, increasing risk for infection.
Failed to ensure staff followed infection control practices including proper storage of oxygen tubing and sanitizing of shared equipment.
Report Facts
Residents in sample: 22
Residents on puree diet: 6
Residents reviewed for falls: 10
Days with missing daily weight: 12
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Administrative Nurse D | Administrative Nurse | Provided statements on dignity, privacy, reporting, and catheter care |
| Licensed Nurse H | Licensed Nurse | Provided statements on privacy, Hoyer lift use, catheter care, and infection control |
| Certified Nurse Aide M | Certified Nurse Aide | Provided statements on feeding assistance, infection control, and fall prevention |
| Dietary Staff BB | Dietary Staff | Observed preparing pureed meals and provided statements on food safety |
| Licensed Nurse I | Licensed Nurse | Provided statements on feeding assistance, dementia care, and privacy |
Inspection Report
Routine
Census: 99
Deficiencies: 14
Date: May 12, 2022
Visit Reason
Routine inspection of Azria Health Olathe nursing home to assess compliance with regulatory requirements including resident care, medication management, dementia care, dialysis care, food safety, and other areas.
Findings
The facility was found deficient in multiple areas including failure to notify resident's durable power of attorney of hospital transfer, failure to provide appropriate Medicare non-coverage notices, failure to provide timely written notification of transfers, inaccurate medication assessments, failure to remove discontinued care plan interventions, inconsistent bathing opportunities, inadequate activity programming, failure to implement individualized incontinence care, inadequate prosthesis care, failure to provide non-pharmacological pain interventions, failure to document dialysis fistula assessments, failure to provide adequate dementia care resulting in resident injuries and unsafe environment, failure to ensure pharmacist review of medication irregularities, and failure to properly store and label food items.
Deficiencies (14)
Failed to notify Resident 31's Durable Power of Attorney when transferred to hospital for change in mental status.
Failed to provide appropriate Medicare Non-Coverage notices to residents 66, 56, and 71.
Failed to provide timely written notification of hospital transfers to Resident 63 and family/DPOA.
Failed to ensure accurate assessment and documentation of anticoagulant medication use for Residents 2, 76, and 94.
Failed to remove discontinued intervention for Resident 39's care plan related to hand splint.
Failed to provide consistent bathing opportunities for Resident 298.
Failed to provide consistent activities for Resident 52 with cognitive impairment.
Failed to implement individualized incontinence care interventions for Residents 28, 86, and 298.
Failed to provide care and assistance consistent with professional standards for Resident 13's prosthesis.
Failed to provide non-pharmacological pain interventions for Resident 298.
Failed to document arteriovenous fistula assessment for thrill and bruit every day for Resident 71 receiving hemodialysis.
Failed to provide appropriate dementia care and services for Resident 248 resulting in multiple resident-to-resident altercations, injuries, and hospitalizations; facility placed in Immediate Jeopardy.
Failed to ensure Consultant Pharmacist identified and reported irregularities related to hypertensive medication administration for Resident 36 and bowel movement monitoring for Resident 81.
Failed to ensure food items were properly stored, labeled, and dated after opening and failed to label and date prepared drink pitchers.
Report Facts
Residents reviewed: 23
Residents on memory care unit: 18
Days hypertensive medication given outside parameters: 8
Days bowel movement charting missing: 6
Days incontinent occurrences: 60
Days incontinent occurrences: 119
Days incontinent occurrences: 13
Days bowel movement charting missing: 6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Licensed Nurse G | Licensed Nurse | Provided statements regarding notification procedures and dementia care |
| Administrative Nurse D | Administrative Nurse | Provided statements regarding notification procedures, dialysis care, dementia care, and pain management |
| Certified Nurse Aide O | Certified Nurse Aide | Provided statements regarding bathing and incontinence care |
| Licensed Nurse I | Licensed Nurse | Provided statements regarding bathing, incontinence care, and pain management |
| Consultant GG | Consultant Physical Therapist | Provided statements regarding prosthesis care |
| Social Services X | Social Services | Provided statements regarding dementia care and activity plans |
| Certified Nurse Aide M | Certified Nurse Aide | Witnessed resident altercations and provided statements regarding dementia care |
| Licensed Nurse H | Licensed Nurse | Provided statements regarding resident altercations and dementia care |
| Administrative Nurse F | Administrative Nurse | Provided statements regarding resident altercations and dementia care |
| Licensed Nurse J | Licensed Nurse | Provided statements regarding medication administration |
| Certified Nurse Aide P | Certified Nurse Aide | Provided statements regarding dialysis care and bowel movement alerts |
Inspection Report
Plan of Correction
Deficiencies: 1
Date: Feb 6, 2012
Visit Reason
This document is a Plan of Correction submitted in response to deficiencies identified in a prior inspection of the facility.
Findings
No Plan of Correction was required for the identified deficiency F0000 as noted in the document.
Deficiencies (1)
No POC required
Inspection Report
Renewal
Census: 115
Deficiencies: 2
Date: Feb 6, 2012
Visit Reason
The inspection was conducted as a Licensure Resurvey to assess compliance with regulatory requirements for the nursing facility.
Findings
The facility failed to have a certified dietary manager and did not provide a policy regarding this requirement. Additionally, the facility failed to maintain a safe environment by not having a Ground Fault Interrupter (GFI) for the Hydrocollator in the therapy room.
Deficiencies (2)
Facility failed to have a certified dietary manager over the dietary department and failed to provide a policy regarding the need for a certified dietary manager.
Facility failed to have a safe Ground Fault Interrupter (GFI) in the therapy room for the Hydrocollator.
Report Facts
Census: 115
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