Inspection Reports for Life Care Center of Valparaiso
3405 N CAMPBELL RD, IN, 46385
Back to Facility ProfileDeficiencies per Year
12
9
6
3
0
Moderate
Low
Census Over Time
Census
Capacity
Inspection Report
Complaint Investigation
Census: 97
Deficiencies: 0
Apr 3, 2025
Visit Reason
The visit was conducted for the investigation of Complaint IN00456403.
Findings
No deficiencies related to the complaint allegations were cited. The facility was found to be in compliance with relevant regulations.
Complaint Details
Complaint IN00456403 was investigated and found to have no deficiencies related to the allegations.
Report Facts
Census Bed Type - SNF/NF: 83
Census Bed Type - SNF: 14
Total Census: 97
Census Payor Type - Medicare: 22
Census Payor Type - Medicaid: 53
Census Payor Type - Other: 22
Inspection Report
Life Safety
Census: 86
Capacity: 110
Deficiencies: 3
Dec 9, 2024
Visit Reason
A Life Safety Code Recertification and State Licensure Survey was conducted by the Indiana Department of Health in accordance with 42 CFR 483.90(a) and NFPA 101 standards.
Findings
The facility was found not in compliance with Life Safety Code requirements, including issues with the kitchen hood manual activation pull station height, lack of semi-annual fire alarm system inspection documentation, and use of non-medical grade power strips in resident rooms.
Severity Breakdown
SS=E: 2
SS=F: 1
Deficiencies (3)
| Description | Severity |
|---|---|
| Failed to maintain kitchen extinguishing system manual activation pull station between 42 and 48 inches above the floor as required by NFPA 96. | SS=E |
| Failed to maintain fire alarm system with required semi-annual visual inspections as per NFPA 72. | SS=F |
| Failed to ensure power strips in 2 resident rooms met UL rating of 1363A or 60601-1 as required by NFPA 99. | SS=E |
Report Facts
Facility capacity: 110
Census: 86
Deficiencies cited: 3
Power strips non-compliant: 2
Medical grade surge protectors ordered: 40
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Amber Janeczko | Executive Director | Named in relation to exit conference and plan of correction |
| Maintenance Director | Interviewed regarding deficiencies and corrective actions | |
| Maintenance Supervisor | Responsible for monitoring corrective actions and audits |
Inspection Report
Life Safety
Deficiencies: 0
Dec 9, 2024
Visit Reason
The visit was conducted as a Life Safety Code Recertification and State Licensure Survey.
Findings
Life Care Center of Valparaiso was found in compliance with Medicare/Medicaid participation requirements, Life Safety from Fire regulations, and the 2012 Edition of the NFPA 101 Life Safety Code, Chapter 19, Existing Health Care Occupancies, and 410 IAC 16.2.
Inspection Report
Annual Inspection
Census: 89
Capacity: 89
Deficiencies: 6
Nov 1, 2024
Visit Reason
This visit was for a Recertification and State Licensure Survey conducted from October 28 to November 1, 2024.
Findings
The facility was found deficient in multiple areas including failure to develop and implement comprehensive care plans for residents, failure to ensure proper treatment and monitoring of skin conditions, failure to ensure adaptive devices were used as ordered, improper catheter management, and inadequate infection control practices related to glucometer cleaning and Enhanced Barrier Precautions for a resident with MDRO.
Severity Breakdown
SS=D: 6
Deficiencies (6)
| Description | Severity |
|---|---|
| Failed to ensure a comprehensive care plan was developed and in place for a resident with a history of MDROs. | SS=D |
| Failed to ensure care plans were implemented and/or updated for residents with skin discolorations and lesions. | SS=D |
| Failed to ensure residents received necessary treatment and services related to monitoring and assessment of skin discolorations and lesions. | SS=D |
| Failed to ensure palm protectors and/or splints were in place as ordered for residents with contractures. | SS=D |
| Failed to ensure an indwelling suprapubic catheter tubing and collection bag was kept off the floor. | SS=D |
| Failed to ensure infection control measures were in place related to a glucometer used for multiple residents and not cleaned and sanitized after each use, and failure to place a resident with MDRO on Enhanced Barrier Precautions as ordered. | SS=D |
Report Facts
Census: 89
Total Capacity: 89
Deficiencies cited: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Amber Janeczko | Executive Director | Signed plan of correction and referenced in report |
| RN 1 | Registered Nurse | Observed not sanitizing glucometer between resident uses |
| LPN 1 | Licensed Practical Nurse | Interviewed regarding Enhanced Barrier Precautions for Resident 71 |
| Director of Nursing | Director of Nursing | Provided multiple interviews regarding care plans, adaptive devices, and infection control |
| Infection Prevention Nurse | Infection Prevention Nurse | Interviewed about Enhanced Barrier Precautions and care plan for Resident 71 |
| CNA 1 | Certified Nursing Assistant | Interviewed about application of palm protectors |
Inspection Report
Renewal
Deficiencies: 0
Nov 1, 2024
Visit Reason
Paper compliance review to the Recertification and State Licensure survey completed on 11/1/24.
Findings
Life Care Center of Valparaiso was found to be in compliance with 42 CFR Part 483, Subpart B and 410 IAC 16.2-3.1 in regard to the paper compliance review to the Recertification and State Licensure survey.
Inspection Report
Complaint Investigation
Census: 87
Deficiencies: 0
Apr 18, 2024
Visit Reason
This visit was conducted for the investigation of Complaint IN00428373 at Life Care Center of Valparaiso.
Findings
No deficiencies related to the allegations in Complaint IN00428373 were cited. The facility was found to be in compliance with relevant regulations.
Complaint Details
Complaint IN00428373 was investigated and found to have no deficiencies related to the allegations.
Report Facts
Census: 87
Census Bed Type: 72
Census Bed Type: 15
Census Payor Type: 11
Census Payor Type: 60
Census Payor Type: 16
Inspection Report
Complaint Investigation
Census: 100
Deficiencies: 0
Feb 7, 2024
Visit Reason
This visit was for the Investigation of Complaint IN00427495.
Findings
No deficiencies related to the allegations are cited. The facility was found to be in compliance with 42 CFR Part 483, Subpart B and 410 IAC 16.2-3.1 in regard to the complaint investigation.
Complaint Details
Complaint IN00427495 - No deficiencies related to the allegations are cited.
Report Facts
Census Bed Type - SNF/NF: 82
Census Bed Type - SNF: 18
Census Bed Type - Total: 100
Census Payor Type - Medicare: 18
Census Payor Type - Medicaid: 61
Census Payor Type - Other: 21
Census Payor Type - Total: 100
Inspection Report
Census: 96
Capacity: 110
Deficiencies: 0
Nov 6, 2023
Visit Reason
An Emergency Preparedness Survey and a Life Safety Code Recertification and State Licensure Survey were conducted by the Indiana Department of Health in accordance with 42 CFR 483.73 and 42 CFR 483.90(a).
Findings
The facility was found in compliance with Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers, as well as Life Safety Code requirements including fire safety and sprinkler systems. The facility is a one-story, fully sprinklered Type II (111) construction with monitored fire alarm systems and hard-wired smoke detectors.
Report Facts
Facility capacity: 110
Census: 96
Inspection Report
Annual Inspection
Census: 99
Capacity: 99
Deficiencies: 7
Oct 25, 2023
Visit Reason
This visit was for a Recertification and State Licensure Survey conducted on October 19, 20, 23, 24, and 25, 2023.
Findings
The facility was found deficient in several areas including failure to make state survey results easily accessible to residents, inadequate monitoring and treatment of a resident's skin condition, lack of physician orders for adaptive devices, improper oxygen administration, unsanitary kitchen conditions, failure to promote antibiotic stewardship, and improper administration of PRN medications by a Qualified Medication Aide without nurse authorization.
Severity Breakdown
C: 1
D: 5
E: 1
Deficiencies (7)
| Description | Severity |
|---|---|
| Failed to have the results of the State survey findings easily accessible for all residents to review. | C |
| Failed to ensure residents received necessary treatment and services related to monitoring and assessment of a scabbed area on the skin for 1 of 3 residents reviewed. | D |
| Failed to ensure a Physician's Order was in place for a palm protector for 1 of 1 residents reviewed for range of motion. | D |
| Failed to ensure residents received proper treatment and care related to oxygen administration flow rate for 1 of 1 residents reviewed for respiratory care. | D |
| Failed to ensure a sanitary kitchen related to built up burnt food debris and grease on stove top and convection oven. | E |
| Failed to promote antibiotic stewardship by ensuring appropriate use of antibiotic therapy and monitoring for 1 of 1 residents reviewed for urinary tract infections. | D |
| Failed to ensure a QMA received prior authorization from a licensed nurse before administering PRN medication to a resident for 1 of 5 residents reviewed. | D |
Report Facts
Census residents: 99
Total licensed capacity: 99
Survey dates: 5
Residents with Medicare: 19
Residents with Medicaid: 61
Residents with Other payor: 19
Antibiotic therapy duration: 3
Antibiotic therapy duration: 7
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Amber Janeczko | Executive Director | Named in plan of correction and correspondence |
| LPN 1 | Interviewed regarding PRN medication administration | |
| Assistant Director of Nursing | Interviewed regarding palm protector order and antibiotic stewardship | |
| Director of Nursing | Interviewed regarding skin integrity, oxygen administration, antibiotic stewardship, and PRN medication administration | |
| Activities Director | Interviewed regarding location of state survey results | |
| Dietary Manager | Interviewed regarding kitchen sanitation and cleaning procedures | |
| Cook 1 | Interviewed regarding convection oven condition | |
| RN 1 | Interviewed regarding oxygen flow rate |
Inspection Report
Renewal
Deficiencies: 0
Oct 25, 2023
Visit Reason
Paper compliance review to the Recertification and State Licensure survey.
Findings
Life Care Center of Valparaiso was found to be in compliance with 42 CFR Part 483, Subpart B and 410 IAC 16.2-3.1 regarding the paper compliance review to the Recertification and State Licensure survey.
Inspection Report
Complaint Investigation
Census: 95
Deficiencies: 0
Jun 1, 2023
Visit Reason
This visit was conducted for the investigation of Complaint IN00409387.
Findings
No deficiencies related to the complaint allegations were cited. The facility was found to be in compliance with applicable regulations.
Complaint Details
Complaint IN00409387 was investigated and found to have no deficiencies related to the allegations.
Report Facts
Census Bed Type - SNF/NF: 78
Census Bed Type - SNF: 17
Census Total: 95
Census Payor Type - Medicare: 18
Census Payor Type - Medicaid: 54
Census Payor Type - Other: 23
Census Payor Type - Total: 95
Inspection Report
Complaint Investigation
Census: 89
Deficiencies: 0
May 17, 2023
Visit Reason
This visit was conducted for the investigation of Complaint IN00396504 at Life Care Center of Valparaiso.
Findings
No deficiencies related to the allegations in Complaint IN00396504 were cited. The facility was found to be in compliance with relevant regulations.
Complaint Details
Investigation of Complaint IN00396504 found no deficiencies related to the allegations.
Report Facts
Census: 89
Census Bed Type: 74
Census Bed Type: 15
Census Payor Type: 17
Census Payor Type: 52
Census Payor Type: 20
Inspection Report
Re-Inspection
Census: 93
Capacity: 110
Deficiencies: 0
Feb 6, 2023
Visit Reason
A Post Survey Revisit (PSR) to the Life Safety Code Recertification and State Licensure Survey conducted on 12/19/22 was performed to verify compliance with prior deficiencies.
Findings
At this Post Survey Revisit, Life Care Center Valparaiso was found in compliance with Requirements for Participation in Medicare/Medicaid, Life Safety from Fire, and the 2012 edition of the National Fire Protection Association (NFPA) 101, Life Safety Code.
Report Facts
Facility capacity: 110
Census: 93
Inspection Report
Life Safety
Census: 82
Capacity: 110
Deficiencies: 1
Dec 19, 2022
Visit Reason
An Emergency Preparedness Survey and a Life Safety Code Recertification and State Licensure Survey were conducted by the Indiana Department of Health in accordance with 42 CFR 483.73 and 42 CFR 483.90(a) respectively.
Findings
The facility was found in compliance with Emergency Preparedness Requirements but was found not in compliance with Life Safety Code Requirements due to combustible decorations exceeding allowed coverage on one corridor door. The Maintenance Director removed the decorations during the survey and implemented corrective actions including audits to prevent recurrence.
Severity Breakdown
SS=E: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Combustible decorations on one corridor door exceeded 30 percent coverage, violating Life Safety Code 18.7.5.6. | SS=E |
Report Facts
Facility capacity: 110
Census: 82
Deficiencies cited: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Amber Janeczko | Executive Director | Named in plan of correction and exit conference |
| Maintenance Director | Named in deficiency finding and corrective action |
Inspection Report
Annual Inspection
Census: 84
Capacity: 84
Deficiencies: 9
Oct 28, 2022
Visit Reason
This visit was for a Recertification and State Licensure Survey conducted from October 24 to 28, 2022.
Findings
The facility was found deficient in multiple areas including failure to provide activities meeting resident interests, inadequate skin and wound care, lack of proper care plans and physician orders for injury prevention devices, improper G-tube management, insufficient dementia care activities, unsanitary kitchen conditions, lapses in infection control practices, and antibiotic stewardship issues.
Severity Breakdown
SS=D: 8
SS=F: 1
Deficiencies (9)
| Description | Severity |
|---|---|
| Failed to ensure a dependent resident was provided activities to meet her interests. | SS=D |
| Failed to ensure skin discolorations were assessed and monitored for residents on anticoagulants and wound dressings were changed as ordered. | SS=D |
| Failed to ensure a resident with a pressure ulcer received appropriate care related to accurate measurement, staging and date assessed. | SS=D |
| Failed to ensure an injury prevention device had a care plan, Physician's order, or monitoring for a resident with a history of falls. | SS=D |
| Failed to ensure a resident with a gastronomy tube received appropriate treatment related to checking tube placement prior to use. | SS=D |
| Failed to ensure a resident with dementia was provided activities to meet his interests. | SS=D |
| Failed to ensure a sanitary kitchen related to built up food debris on the stove top and faulty dishwasher test strips. | SS=F |
| Failed to ensure infection control measures were implemented related to incontinence care and hand hygiene during care. | SS=D |
| Failed to promote antibiotic stewardship by ensuring appropriate use of antibiotic therapy and reducing antibiotic resistance. | SS=D |
Report Facts
Census: 84
Total Capacity: 84
Deficiencies cited: 9
Dishwasher wash temperature: 120
Dishwasher sanitizer level: 50
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Amber Janeczko | Executive Director | Signed plan of correction and referenced in report |
| Angel Sutton | Corporate Wound Nurse, RN, MSN | Provided education on wound care and staging |
Inspection Report
Renewal
Deficiencies: 0
Oct 28, 2022
Visit Reason
Paper compliance review to the Recertification and State Licensure survey.
Findings
Life Care Center of Valparaiso was found to be in compliance with 42 CFR Part 483, Subpart B and 410 IAC 16.2-3.1 regarding the paper compliance review to the Recertification and State Licensure survey.
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