Deficiencies per Year
20
15
10
5
0
Severe
High
Moderate
Low
Unclassified
Inspection Report
Complaint Investigation
Deficiencies: 20
Dec 11, 2024
Visit Reason
State-compiled facility inspection summary page showing multiple inspections from 2012 to 2024 including complaint and standard inspections with deficiency history.
Findings
Across multiple inspections, the facility had several Class 3 and Level 2 deficiencies primarily related to resident care supervision, staff training, medication management, risk management, and emergency plan approval. Several complaint investigations found no deficiencies, while others cited issues that were later corrected.
Complaint Details
Multiple complaint investigations are included, some with no deficiencies cited and others with Class 3 and Level 2 deficiencies related to resident care, training, medication, and risk management.
Severity Breakdown
Class 3: 16
2: 3
Deficiencies (20)
| Description | Severity |
|---|---|
| A0025 — RESIDENT CARE - SUPERVISION: The facility failed to notify a licensed physician timely when a resident exhibited signs of dementia or cognitive impairment. | 2 |
| A0081 — TRAINING - STAFF IN-SERVICE: New employees did not complete required preservice orientation training before interacting with residents. | Class 3 |
| A0081 — TRAINING - STAFF IN-SERVICE: New employees did not complete required preservice orientation training before interacting with residents. | Class 3 |
| A0082 — TRAINING - HIV/AIDS: Facility employees failed to complete required HIV/AIDS education course within 30 days of employment. | Class 3 |
| A0086 — TRAINING - ADRD: Facility staff did not receive required Alzheimer's Disease and Related Disorders training. | Class 3 |
| A0090 — TRAINING - DO NOT RESUSCITATE ORDERS: Facility staff failed to receive required training on Do Not Resuscitate Orders policies and procedures. | Class 3 |
| A0052 — MEDICATION - ASSISTANCE WITH SELF-ADMIN: Facility failed to properly assist residents with self-administration of medication. | Class 3 |
| A0165 — RISK MGMT & QA: Facility failed to establish or maintain an adequate internal risk management and quality assurance program. | Class 3 |
| A0181 — EMERGENCY PLAN APPROVAL: Facility failed to submit emergency plan for review and approval to local emergency management agency as required. | Class 3 |
| A0028 — RESIDENT CARE - ACTIVITIES OF DAILY LIVING: Facility failed to provide adequate supervision or assistance with activities of daily living. | Class 3 |
| A0032 — RESIDENT CARE - ELOPEMENT STANDARDS: Facility failed to identify and supervise residents at risk for elopement. | 2 |
| A0055 — MEDICATION - STORAGE AND DISPOSAL: Facility failed to properly store and dispose of medications. | Class 3 |
| A0079 — STAFFING STANDARDS - LEVELS: Facility failed to maintain minimum required staff hours per week. | Class 3 |
| A0165 — RISK MGMT & QA; ADVERSE INCIDENT REPORT: Facility failed to maintain adequate risk management and quality assurance program including adverse incident reporting. | 2 |
| A0025 — RESIDENT CARE - SUPERVISION: The facility failed to notify a licensed physician timely when a resident exhibited signs of dementia or cognitive impairment. | Class 3 |
| A0028 — RESIDENT CARE - ACTIVITIES OF DAILY LIVING: Facility failed to provide adequate supervision or assistance with activities of daily living. | Class 3 |
| A0030 — RESIDENT CARE - RIGHTS & FACILITY PROCEDURES: Facility failed to post Resident Bill of Rights or maintain grievance procedures as required. | Class 3 |
| A0055 — MEDICATION - STORAGE AND DISPOSAL: Facility failed to properly store and dispose of medications. | Class 3 |
| A0056 — MEDICATION - LABELING AND ORDERS: Facility failed to ensure medications were properly labeled and dispensed according to regulations. | Class 3 |
| A0093 — FOOD SERVICE - DIETARY STANDARDS: Facility failed to meet nutritional standards for therapeutic diets. | Class 3 |
Report Facts
Inspections on page: 46
Inspection Report
Complaint Investigation
Deficiencies: 0
Dec 11, 2024
Visit Reason
State-compiled facility profile showing multiple inspections from 2012 to 2024 with deficiency history and inspection statuses.
Findings
Across all inspections, the facility had a mix of deficiency outcomes including cited deficiencies, corrected deficiencies, and many inspections with no deficiencies noted. The most recent inspections from 2024 are pending.
Report Facts
Inspections on page: 63
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