Deficiencies (last 9 years)
Deficiencies (over 9 years)
2.8 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
53% better than Kansas average
Kansas average: 6 deficiencies/yearDeficiencies per year
12
9
6
3
0
Occupancy
Latest occupancy rate
62% occupied
Based on a August 2024 inspection.
Occupancy rate over time
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Mar 4, 2026
Visit Reason
The resurvey was conducted with attached complaints 193267, 192974, 192913, 191896, 191175, and 190348 at the assisted living facility.
Findings
The resurvey conducted on 03/04/2026 resulted in a finding of no deficiency citations.
Inspection Report
Re-Inspection
Deficiencies: 0
Date: Mar 4, 2026
Visit Reason
The resurvey was conducted as a follow-up to multiple attached complaints at the assisted living facility.
Findings
The resurvey on 03/04/2026 resulted in a finding of no deficiency citations.
Inspection Report
Re-Inspection
Deficiencies: 0
Date: Sep 18, 2024
Visit Reason
An offsite revisit survey was conducted to verify correction of all previous deficiencies cited on 2024-08-22.
Findings
All deficiencies have been corrected as of the compliance date of 2024-09-17 and no new noncompliance was found. The facility is in compliance with all regulations surveyed.
Inspection Report
Re-Inspection
Census: 32
Deficiencies: 11
Date: Aug 22, 2024
Visit Reason
Re-Licensure Survey with complaint investigations conducted on August 19-22, 2024.
Complaint Details
The inspection included complaint investigations KS00176426, KS185916, KS00188342, KS188515, and KS00189151.
Findings
The facility had multiple deficiencies including failure to notify legal representatives of resident condition changes, incomplete signatures on service agreements, inadequate health care services for residents with weight loss, improper delegation of nursing tasks, medication administration errors, improper medication labeling and storage, lack of dementia training for staff, failure to conduct quarterly emergency plan reviews, and incomplete tuberculosis testing documentation.
Deficiencies (11)
K.A.R. 26-39-103(h)(1)(A) Resident Right Notification of Changes: The facility failed to ensure designated staff informed the resident's legal representative of behavior changes and new medication orders for one resident.
KAR 26-41-202(h) NSA Signatures: The facility failed to ensure all involved in the development of the Negotiated Service Agreement signed it for one resident.
KAR 26-41-204(a) Health Care Services: The facility failed to ensure licensed nurses provided or coordinated necessary health care services for two residents with unplanned weight loss.
KAR 26-41-204(e) Delegation of Duties: The administrator failed to ensure two newly hired Certified Medication Aides were properly trained and delegated nursing procedures for blood glucose checks.
KAR 26-41-205(d) Facility Administration of Medications: The operator failed to ensure insulin administration was done by qualified staff; CMAs improperly held insulin pens against resident skin during injection.
KAR 26-41-205(d)(4) Delegation of Medication Administration: The administrator failed to ensure five newly hired CMAs were trained and delegated the procedure of preparing and dialing insulin pens.
KAR 26-41-205(g)(3) Over the Counter Drugs: The facility failed to ensure all over-the-counter medications were labeled with the resident's full name on both the package and container.
KAR 26-41-205(h) Medication Storage: The facility failed to date insulin pens when first put into use, risking administration beyond manufacturer expiration.
KAR 26-41-103(c) Staff Development on Dementia: The facility failed to provide orientation and in-service education on dementia treatment and responses for five newly hired staff.
KAR 26-41-104(d)(3) Disaster and Emergency Preparedness: The facility failed to conduct quarterly reviews of the emergency management plan with all employees and residents.
K.A.R 26-41-207(c) Infection Control Policies: The facility failed to ensure tuberculosis skin test records included dates of reading results and failed to ensure timely two-step TB testing for new employees.
Report Facts
Resident census: 32
Weight loss: 10.2
Weight loss percentage: 5.4
Weight loss: 31.4
Weight loss percentage: 25
Units remaining: 150
Units remaining: 80
Units remaining: 180
Units remaining: 70
Units remaining: 150
Units remaining: 50
Inspection Report
Renewal
Deficiencies: 0
Date: Aug 19, 2024
Visit Reason
The document is a Plan of Correction related to a Re-Licensure Survey with complaint investigations conducted at the facility on August 19, 20, 21, and 22, 2024.
Complaint Details
The visit included complaint investigations identified by KS00176426, KS185916, KS00188342, KS188515, and KS00189151.
Findings
The Plan of Correction addresses findings from the Re-Licensure Survey and multiple complaint investigations conducted during the specified dates.
Inspection Report
Re-Inspection
Deficiencies: 1
Date: Jan 22, 2024
Visit Reason
This revisit inspection was conducted to verify that previously reported deficiencies have been corrected.
Findings
The report confirms that the deficiency identified under regulation 26-41-101 (f) (1) was corrected as of the revisit date.
Deficiencies (1)
Regulation 26-41-101 (f) (1) deficiency was corrected as of 2024-01-22.
Inspection Report
Abbreviated Survey
Census: 36
Deficiencies: 1
Date: Dec 27, 2023
Visit Reason
The visit was an abbreviated survey with review of facility report #184740 at an assisted living facility to assess compliance with regulations related to resident safety and protection.
Findings
The facility failed to protect ten residents at risk for elopement by not securing all exit doors, resulting in one cognitively impaired resident exiting unsupervised and being found outside after approximately five hours. Immediate jeopardy was identified and later removed after corrective actions were implemented.
Deficiencies (1)
KAR 26-41-101(f)(1)(B) Staff failed to protect residents from neglect by not securing all exit doors, allowing a cognitively impaired resident to exit unsupervised and be found outside after several hours.
Report Facts
Resident census: 36
Residents at risk for elopement: 10
Residents marked for wandering: 9
Resident R1's elopement duration: 5
Resident R1's body temperature: 86.7
Temperature at time of elopement: 24
Wind speed at time of elopement: 6
Temperature at time resident found: 25
Wind speed at time resident found: 12
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Administrative Staff A | Provided statements about door security, staff actions, and confirmed wandering residents | |
| Certified Nurse Aide C | CNA | Reported inability to locate resident R1 and participated in search |
| Certified Medication Aide D | CMA | Assisted in searching for resident R1 and reported findings |
| Certified Medication Aide F | CMA | Reported frequency of resident R1 checks during day shift |
| Certified Nurse Aide E | CNA | Entered resident R1's apartment during rounds prior to elopement |
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Dec 27, 2023
Visit Reason
The document is a plan of correction responding to findings from an abbreviated survey conducted at an assisted living facility on December 27, 2023.
Findings
The plan of correction addresses findings identified during an abbreviated survey and review of facility report #184740 at the assisted living facility.
Inspection Report
Follow-Up
Deficiencies: 1
Date: Nov 30, 2023
Visit Reason
This revisit inspection was conducted to verify that previously cited deficiencies have been corrected by the facility.
Findings
The report confirms that the previously reported deficiency under regulation 26-41-101 (f)(1) was corrected as of the revisit date.
Deficiencies (1)
Regulation 26-41-101 (f)(1) deficiency was corrected as of 11/30/2023.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Nov 7, 2023
Visit Reason
The document represents a plan of correction submitted in response to an abbreviated survey conducted at the assisted living facility on 11/07/2023.
Findings
The plan of correction addresses findings from an abbreviated survey and review of facility report #183800 conducted on 11/07/2023.
Inspection Report
Abbreviated Survey
Census: 34
Deficiencies: 1
Date: Nov 7, 2023
Visit Reason
An abbreviated survey was conducted to review the facility's compliance with regulations, including a review of a facility report related to resident safety and elopement risks.
Findings
The facility failed to protect four cognitively impaired residents at risk for elopement due to inadequate staff elopement training and unsecured exit doors. One resident eloped through an unsecured door and was found outside after approximately 45 minutes. The facility's alarm systems were insufficiently monitored and tested, and staff training and policies were lacking.
Deficiencies (1)
KAR 26-41-101(f)(1)(B) The administrator failed to protect four cognitively impaired residents at risk for elopement by not providing adequate staff elopement training and failing to secure all exit doors, resulting in one resident leaving the facility unsupervised.
Report Facts
Resident census: 34
Resident sample size: 4
Elopement duration: 45
Exit doors: 5
Elopement Risk Assessment score: 35
Elopement Risk Assessment score: 60
Elopement Risk Assessment score: 40
Elopement Risk Assessment score: 13
Inspection Report
Re-Inspection
Deficiencies: 0
Date: Nov 17, 2022
Visit Reason
An offsite revisit survey was conducted to verify correction of all previous deficiencies cited on 2022-10-26.
Findings
All deficiencies have been corrected as of the compliance date of 2022-11-16, and no new noncompliance was found. The facility is in compliance with all regulations surveyed.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Oct 27, 2022
Visit Reason
The document is a plan of correction responding to findings from a licensure resurvey with attached complaints #175622, 173164, and 165275 conducted on 10/25/22, 10/26/22, and 10/27/22.
Findings
The plan of correction addresses citations identified during the licensure resurvey and complaint investigations conducted over three days in late October 2022.
Inspection Report
Licensure Resurvey With Complaint Investigation
Census: 35
Deficiencies: 6
Date: Oct 26, 2022
Visit Reason
Licensure resurvey with attached complaints #175622, 173164, and 165275 conducted on 10/25/22, 10/26/22, and 10/27/22.
Complaint Details
The inspection included complaint investigations for complaint numbers 175622, 173164, and 165275. The complaint related to failure to report abuse timely, improper medication storage and administration, inadequate staff training for non-English speakers, and unsafe facility conditions.
Findings
The facility failed to report an allegation of abuse within 24 hours, improperly stored medications including expired insulin pens, failed to provide employee education in a language understood by non-English speaking staff, failed to serve food at proper temperatures, failed to comply with tuberculosis testing guidelines for new employees, and failed to secure chemicals in common areas accessible to cognitively impaired residents.
Deficiencies (6)
K.A.R. 26-41-101 (f) (3) The facility failed to report an allegation of abuse to the department within 24 hours after notification regarding resident R112.
K.A.R. 26-41-205 (h) (1) (4) The facility failed to ensure medications were stored securely and administered before expiration, including an undated and unlabeled insulin pen for resident R114.
K.A.R. 26-41-103 (a) The facility failed to provide required employee education in a language understood by a non-English speaking employee, resulting in delayed reporting of witnessed abuse.
K.A.R. 26-41-206 (d) The facility failed to ensure food was served at proper temperatures and failed to document food temperatures prior to meal service.
K.A.R. 26-41-207 (b) (5-6) (c) The facility failed to comply with tuberculosis testing guidelines for newly hired employees LN F and CMA G.
K.A.R. 28-39-254 (a) The facility failed to maintain a safe environment by leaving unlocked chemicals accessible to cognitively impaired and independently mobile residents.
Report Facts
Resident census: 35
Number of cognitively impaired residents: 15
Date of inspection: Oct 26, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Operator B | Facility Operator | Confirmed failure to report abuse and acknowledged facility conditions. |
| Non-certified staff A | Housekeeper | Witnessed abuse but delayed reporting due to language barrier. |
| Regional Licensed Nurse C | Regional Licensed Nurse | Confirmed medication storage and TB testing deficiencies. |
| Certified Medication Aide E | Certified Medication Aide | Observed medication cart unlocked and unlabeled insulin pen. |
| Dietary staff D | Dietary Staff | Received abuse report from non-certified staff A via translator app. |
| Licensed Nurse F | Licensed Nurse | New hire lacking required two-step TB test documentation. |
| Certified Medication Aide G | Certified Medication Aide | New hire lacking proper TB test date and time documentation. |
Inspection Report
Abbreviated Survey
Deficiencies: 0
Date: Jul 29, 2020
Visit Reason
The facility underwent a special infection control survey for COVID-19 conducted on July 29, 2020.
Findings
The survey resulted in findings of no deficiency citations related to infection control.
Inspection Report
Complaint Investigation
Census: 33
Deficiencies: 2
Date: Dec 19, 2018
Visit Reason
The inspection was a resurvey with complaint investigation 126699 conducted at the assisted living facility on December 17-19, 2018.
Complaint Details
The visit was a resurvey with complaint investigation number 126699.
Findings
The facility failed to ensure that each individual involved in the development of the negotiated service agreement signed the agreement. Additionally, the clinical record for one resident lacked a medical care provider's order for each medication administered.
Deficiencies (2)
KAR 26-41-202(h) The facility failed to ensure each individual involved in the development of the negotiated service agreement signed the agreement for Resident #600.
KAR 26-41-205(k)(1) The facility failed to ensure the clinical record contained a medical care provider's order for each medication administered to Resident #600.
Report Facts
Census: 33
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Licensed Staff B | Interviewed and confirmed lack of resident/legal representative signature on the negotiated service agreement and inability to obtain signed physician orders. |
Inspection Report
Renewal
Deficiencies: 0
Date: Nov 22, 2016
Visit Reason
The licensure resurvey of the assisted living facility was conducted on 11-21-16 and 11-22-16 to assess compliance for license renewal.
Findings
The inspection resulted in findings of no deficiency citations.
Inspection Report
Abbreviated Survey
Census: 36
Deficiencies: 2
Date: Jun 16, 2015
Visit Reason
An abbreviated survey with a complaint investigation was conducted at the assisted living facility on June 15-16, 2015.
Complaint Details
The visit included a complaint investigation (81542) regarding failure to report and investigate abuse, neglect, or exploitation allegations. The complaint was substantiated based on findings of unreported unwitnessed falls and incomplete incident documentation.
Findings
The facility failed to report and investigate allegations of abuse, neglect, or exploitation within 24 hours as required. Documentation of incidents, symptoms, and communication with residents' families was incomplete or missing.
Deficiencies (2)
KAR 26-41-101(f)(3) The operator failed to ensure each allegation of abuse, neglect, or exploitation was reported to the department within 24 hours and investigated. Two discharged residents had unreported unwitnessed falls resulting in injury.
KAR 26-41-105(f)(11) The operator failed to ensure documentation of all incidents, symptoms, and other indications of illness or injury including date, time, action taken, and results. One discharged resident's record lacked documentation of hospitalization outcome and family communication.
Report Facts
Resident census: 36
Discharged residents reviewed: 4
Employees mentioned
| Name | Title | Context |
|---|---|---|
| licensed staff B | Interviewed regarding failure to report and investigate resident #2's fall and injury | |
| licensed staff C | Signed medical record entry for resident #3's hospital transfer | |
| licensed staff D | Reported resident #2 lying on floor with injury | |
| licensed staff E | Found resident #2 lying on floor with injury | |
| licensed staff F | Documented resident #4's unwitnessed fall and injury | |
| licensed staff G | Documented resident #4's injuries | |
| administrative staff A | Interviewed regarding unreported injuries and communication failures |
Inspection Report
Renewal
Deficiencies: 0
Date: Oct 30, 2014
Visit Reason
The licensure resurvey of the facility was conducted on 10/29/2014 and 10/30/2014 to assess compliance for license renewal.
Findings
The inspection resulted in no deficiency citations being found at the facility.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: N046040 POC MINU11
Visit Reason
This document is a Plan of Correction related to a previous inspection or deficiency report for the facility identified as State ID N046040.
Findings
No deficiency records or findings are included in this Plan of Correction document.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: N046040 POC MINU12
Visit Reason
This document is a Plan of Correction related to a prior inspection or regulatory finding for the facility identified as ASPEN with State ID N046040.
Findings
No deficiency details or findings are included in this Plan of Correction document. It serves as a corrective action response to previously identified issues.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: N046040 POC 3UXQ11
Visit Reason
This document is a plan of correction related to a prior deficiency report for the facility.
Findings
No specific findings or deficiencies are detailed in this document. It serves as a placeholder or record for the plan of correction submission.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: N046040 POC QXVU11
Visit Reason
This document is a Plan of Correction related to a prior inspection event identified by Event ID QXVU11 for the facility with State ID N046040.
Findings
No deficiencies or findings are detailed in this document. It serves as a placeholder or administrative record for the Plan of Correction with no substantive content.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: N046040 POC UZZH11
Visit Reason
This document is a Plan of Correction related to a prior deficiency report for The Homestead of Olathe North.
Findings
No specific findings or deficiencies are detailed in this document. It serves as a placeholder or reference to the Plan of Correction process.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: N046040 POC 90PE11
Visit Reason
This document is a plan of correction submitted in response to deficiencies identified in a prior inspection report for the facility.
Findings
No specific findings are detailed in this document; it serves as a corrective action plan linked to a previous deficiency report.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: N046040 POC WVF611
Visit Reason
This document is a Plan of Correction related to a prior deficiency report for the facility 'the homestead of olathe north'.
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: N046040 POC XFY711
Visit Reason
This document is a Plan of Correction related to a prior inspection event identified as XFY711 for the facility with State ID N046040.
Findings
No deficiency details or findings are included in this Plan of Correction document. It only references the related deficiency report and provides contact information for assistance.
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