Inspection Report
Routine
Deficiencies: 18
Sep 30, 2024
Visit Reason
State-compiled facility profile showing multiple inspections from 2012 to 2024 with deficiency history and enforcement classifications.
Findings
Across multiple inspections, the facility had several Class 3 and Class 4 deficiencies primarily related to staff training, background screening, admissions, medication records, and resident care. Some inspections found no deficiencies.
Complaint Details
Complaint investigations occurred on 11/19/2021, 3/16/2020, 2/2/2015, and 12/4/2014 with no deficiencies cited in most complaint inspections except one Class 3 deficiency on 2/2/2015 related to admissions continued residency.
Severity Breakdown
Class 3: 15
Class 4: 2
Unclassified: 3
Deficiencies (18)
| Description | Severity |
|---|---|
| A0083 — TRAINING - FIRST AID AND CPR: A staff member who has completed courses in First Aid and CPR and holds a currently valid card documenting completion of such courses must be in the facility at all times. | Class 3 |
| CZ814 — BACKGROUND SCREENING CLEARINGHOUSE: Requirements related to fingerprint enrollment and national screening for employees with breaks in service. | Unclassified |
| CZ815 — BACKGROUND SCREENING; PROHIBITED OFFENSES: Level 2 background screening requirements for certain employees including licensees and administrators. | Unclassified |
| CZ816 — BACKGROUND SCREENING-COMPLIANCE ATTESTATION: Requirement for level 2 background rescreening every 5 years following licensure or employment. | Unclassified |
| AN276 — LNS - NURSING SERVICES: Requirements for nursing services provided under a limited nursing services license. | Class 3 |
| AN278 — LNS - RECORDS: Maintenance of records for residents receiving limited nursing services including nursing progress notes and assessments. | Class 3 |
| A0054 — MEDICATION - RECORDS: Requirements for maintaining original labeled medication containers or medication listings and daily medication observation records. | Class 3 |
| A0078 — STAFFING STANDARDS - STAFF: Newly hired staff must submit a health care provider statement documenting no communicable disease symptoms within 30 days of employment. | Class 3 |
| A0161 — RECORDS - STAFF: Maintenance of personnel records including background screening and training documentation. | Class 3 |
| CZ816 — BACKGROUND SCREENING-COMPLIANCE ATTESTATION: Level 2 background rescreening every 5 years as a condition of retaining license or employment. | Class 4 |
| A0008 — ADMISSIONS - HEALTH ASSESSMENT: Requirement for medical examination within 60 days prior to admission to the facility. | Class 3 |
| A0010 — ADMISSIONS - CONTINUED RESIDENCY: Responsibility for determining appropriateness of admission and continued residency based on assessments. | Class 3 |
| A0031 — RESIDENT CARE - THIRD PARTY SERVICES: Residents or representatives may arrange and pay for third party services independently. | Class 3 |
| A0086 — TRAINING - ADRD: Training requirements for staff providing care to residents with Alzheimer's Disease and Related Disorders. | Class 3 |
| A0030 — RESIDENT CARE - RIGHTS & FACILITY PROCEDURES: Posting and provision of Resident Bill of Rights and grievance procedures. | Class 3 |
| A0053 — MEDICATION - ADMINISTRATION: Licensed staff must be available to administer medications according to provider orders and document unusual reactions. | Class 3 |
| A0162 — RECORDS - RESIDENT: Maintenance of resident records including demographic data and emergency contacts. | Class 3 |
| A0091 — TRAINING - DOCUMENTATION & MONITORING: Documentation of training certificates including program details and trainee participation. | Class 4 |
Report Facts
Inspections on page: 26
Inspection Report
Deficiencies: 3
Sep 30, 2024
Visit Reason
State-compiled facility profile showing multiple inspections from 2012 to 2024 with deficiency history and inspection statuses.
Findings
The facility has undergone numerous inspections over the years with a mix of no deficiencies, deficiencies cited, and deficiencies corrected across various inspection types including standard, complaint, and monitor visits.
Deficiencies (3)
| Description |
|---|
| Deficiencies Cited |
| Deficiencies Corrected |
| No Deficiencies |
Report Facts
Inspections on page: 29
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