Deficiencies per Year
4
3
2
1
0
Unclassified
Inspection Report
Renewal
Capacity: 38
Deficiencies: 0
Sep 18, 2023
Visit Reason
The inspection was conducted as a renewal inspection to review licensing activity and compliance with public health code and administrative rules regulating home for the aged facilities.
Findings
The facility was found to be in compliance with all applicable rules and statutes, and renewal of the license was recommended.
Inspection Report
Complaint Investigation
Capacity: 38
Deficiencies: 2
Aug 14, 2023
Visit Reason
The investigation was initiated due to a complaint alleging that Resident A was found with maggots in an ear wound.
Findings
The investigation confirmed that Resident A was found with live maggots in a left ear lesion. The facility failed to provide appropriate assistance or supervised care, placing Resident A at great risk. Additionally, the facility did not appoint a competent administrator as required, with the prior administrator resigning and no interim administrator properly appointed.
Complaint Details
The complaint alleged that Resident A was found with maggots in an ear wound. The violation was substantiated based on interviews, on-site investigation, and documentation review.
Deficiencies (2)
| Description |
|---|
| Failure to provide appropriate assistance or supervised care to Resident A, resulting in maggots in a skin lesion on the left ear. |
| Failure to appoint a competent administrator responsible for operating the home in accordance with established policies. |
Report Facts
Capacity: 38
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Percell Smith | Interim Administrator | Interviewed during investigation; acting facility administrator for one week at time of investigation |
| Mary North | Administrator | Named as authorized representative; no direct findings related to her |
| Holly Jenkins | Former Administrator | Resigned in August 2023; facility failed to submit required change of administrator form |
Inspection Report
Original Licensing
Capacity: 38
Deficiencies: 0
Sep 8, 2009
Visit Reason
The document is an addendum to the original licensing study report to modify the facility license due to a legal entity name change for the licensee.
Findings
The licensee name was changed from Alterra Healthcare Corporation to Brookdale Senior Living Communities, Inc. effective 2/17/2009, with no other changes noted.
Report Facts
Facility capacity: 38
Effective date of name change: Feb 17, 2009
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Beth Mell | Authorized Representative | Requested the license modification due to legal entity name change |
| Sara Henthorn | Administrator | Named as facility administrator |
| Patricia J. Sjo | Licensing Staff | Prepared the addendum report |
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