Inspection Reports for Valparaiso Senior Village
74 E. Journey Way, Valparaiso, IN 46383, IN, 46383
Back to Facility ProfileDeficiencies per Year
16
12
8
4
0
Severe
High
Moderate
Low
Unclassified
Census Over Time
Inspection Report
Complaint Investigation
Census: 97
Deficiencies: 3
Jan 30, 2025
Visit Reason
This visit was conducted for the investigation of Complaint IN00447319 regarding allegations of failure to notify the Physician or Nurse Practitioner of laboratory test results in a timely manner and improper medication management.
Findings
The facility failed to ensure timely notification of a low TSH lab result to the NP, failed to document why a resident's antidepressant medication was stopped abruptly, and failed to notify the NP when the resident's blood pressure was out of parameters as ordered. Documentation and communication deficiencies were noted related to Resident B's care.
Complaint Details
Complaint IN00447319 was investigated and the state deficiency related to the allegations was cited at R0241.
Deficiencies (3)
| Description |
|---|
| Failure to ensure the Physician or Nurse Practitioner was notified of a laboratory test result in a timely manner. |
| Failure to ensure a resident's antidepressant medication was not stopped abruptly without indication. |
| Failure to notify the Nurse Practitioner when a resident's blood pressure was out of parameters per physician's orders. |
Report Facts
Residential Census: 97
Blood Pressure readings out of parameters: 18
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jamie Srnec | Director of Nursing | Interviewed regarding lack of documentation and notification to NP about lab results and blood pressure readings. |
Inspection Report
Complaint Investigation
Census: 94
Deficiencies: 2
Oct 24, 2024
Visit Reason
This visit was conducted for the investigation of Complaint IN00443260, which involved allegations related to medication administration and transfer/discharge paperwork.
Findings
The facility failed to ensure the correct dosage of insulin was administered to a resident during medication administration and failed to complete transfer/discharge paperwork for three residents discharged to the hospital.
Complaint Details
Complaint IN00443260 was substantiated with state deficiencies cited at R0243 and R0354 related to medication administration and clinical records noncompliance.
Deficiencies (2)
| Description |
|---|
| Failed to ensure the correct dosage of insulin was administered per Physician's Orders during medication administration for Resident D. |
| Failed to ensure transfer/discharge paperwork was completed for residents discharged to the hospital for 3 of 3 residents reviewed (Residents B, E, and F). |
Report Facts
Residential Census: 94
Units of insulin administered incorrectly: 4
Additional units of insulin administered: 2
Residents reviewed for hospitalization transfer paperwork: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| JAclyn Wolski | Laboratory Director or Provider/Supplier Representative | Signed the report |
| LPN 1 | Nurse involved in medication administration error for Resident D | |
| Administrator | Interviewed regarding missing transfer/discharge paperwork |
Inspection Report
Complaint Investigation
Census: 87
Deficiencies: 0
Jul 18, 2024
Visit Reason
This visit was conducted for the investigation of Complaint IN00434259.
Findings
No deficiencies related to the allegations in Complaint IN00434259 were cited. The facility was found to be in compliance with 410 IAC 16.2-5 regarding the complaint investigation.
Complaint Details
Complaint IN00434259 was investigated and found to have no deficiencies related to the allegations.
Report Facts
Residential Census: 87
Inspection Report
Complaint Investigation
Census: 84
Deficiencies: 13
Apr 24, 2024
Visit Reason
This visit was for a State Residential Licensure Survey including the investigation of complaints IN00426987, IN00429218, and IN00433132.
Findings
The facility was found deficient in multiple areas including resident rights violations related to abuse and discrimination, incomplete transfer and discharge paperwork, failure to report a COVID-19 outbreak, insufficient staff CPR and first aid certifications, lack of annual HVAC inspection, incomplete pet vaccination records, incomplete resident evaluations and service plans, poor kitchen sanitation, incomplete clinical records including medication administration and infection control deficiencies, and failure to maintain annual health statements for residents.
Complaint Details
This visit included investigation of complaints IN00426987 (no deficiencies cited), IN00429218 (deficiencies cited related to medication administration and clinical records), and IN00433132 (deficiencies cited related to resident rights and abuse).
Deficiencies (13)
| Description |
|---|
| Facility failed to ensure a resident was treated with consideration and respect by a staff member for 1 of 1 residents reviewed for abuse (Resident C). |
| Facility failed to ensure transfer and discharge paperwork was completed and documented for 2 of 8 resident records reviewed (Residents 4 and 5). |
| Facility failed to report a COVID-19 outbreak to the State Agency affecting 14 residents. |
| Facility failed to ensure there was one staff member with current CPR and first aid certificates scheduled for multiple shifts reviewed. |
| Facility failed to ensure the heating and ventilation system was inspected annually. |
| Facility failed to ensure pets were up to date on vaccinations for 2 of 4 pet vaccination records reviewed (Room 403). |
| Facility failed to record weights upon admission and ensure medication self-administration evaluation was completed for 2 of 8 residents reviewed (Residents 2 and 3). |
| Facility failed to update a Service Plan related to elopement after a resident eloped for 1 of 8 resident records reviewed (Resident 5). |
| Facility failed to maintain proper kitchen sanitation including low dishwasher temperatures, uncovered dry food storage bins, food touching freezer ceiling, improper thermometer cleaning, and inadequate sanitation bucket levels. |
| Facility failed to ensure clinical records were complete and accurate related to lack of monitoring a resident on antibiotics and medications not signed out as administered for 2 of 8 records reviewed (Residents 5 and B). |
| Facility failed to ensure infection control guidelines were implemented including lack of physician orders, family notification, and monitoring for COVID-19 positive residents, and failure to adhere to work restriction guidelines for a COVID-19 positive staff member. |
| Facility failed to ensure infection control measures were followed related to opening a medication capsule with bare hands during medication pass. |
| Facility failed to ensure residents had annual signed health statements indicating no evidence of tuberculosis in an infectious stage for 3 of 8 residents reviewed (Residents C, 4, and 5). |
Report Facts
Residents tested positive for COVID-19: 14
Residents present: 84
Deficiency completion dates: 6
Staff shifts without CPR certification: 5
Staff shifts without first aid certification: 8
Sanitation bucket ppm levels: 150
Sanitation bucket ppm levels: 200
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| CNA 1 | Reported inappropriate conversation by Activity Director about Resident C | |
| Activity Director | Named in resident abuse and discrimination findings related to Resident C | |
| Director of Nursing | Director of Nursing | Interviewed regarding multiple deficiencies including transfer paperwork, staff certifications, infection control, and clinical records |
| QMA 1 | Observed opening medication capsule with bare hands during medication pass | |
| Cook 1 | Observed during kitchen sanitation inspection | |
| Dietary Director | Interviewed regarding kitchen sanitation and dishwasher temperature |
Inspection Report
Complaint Investigation
Census: 80
Deficiencies: 1
Jan 16, 2024
Visit Reason
This visit was conducted for the investigation of complaints IN00416830 and IN00419837. Complaint IN00416830 resulted in a state deficiency citation, while complaint IN00419837 had no deficiencies related to the allegations.
Findings
The facility failed to ensure clinical records were accurate and complete, specifically lacking documentation of a medication administration error and failure to administer medication as ordered for 2 of 3 residents reviewed. The Director of Nursing acknowledged the lack of documentation and the facility implemented corrective actions including staff education and weekly audits.
Complaint Details
Complaint IN00416830 was substantiated with a state deficiency cited at R0349. Complaint IN00419837 was not substantiated with no deficiencies cited.
Deficiencies (1)
| Description |
|---|
| Failure to ensure clinical records were accurate and complete related to lack of documentation of a medication administration error and medication not administered as ordered for 2 of 3 residents. |
Report Facts
Residential Census: 80
Medication administration omissions: 21
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jaclyn Wolski | Laboratory Director or Provider/Supplier Representative | Signed the report |
| Director of Nursing | Named in relation to findings regarding failure to document medication errors and medication administration |
Inspection Report
Complaint Investigation
Census: 83
Deficiencies: 0
Aug 4, 2023
Visit Reason
This visit was for the investigation of Complaint IN00407150.
Findings
No deficiencies related to the allegations were cited. The facility was found to be in compliance with 410 IAC 16.2-5 regarding the complaint investigation.
Complaint Details
Complaint IN00407150 was investigated and found to have no related deficiencies.
Report Facts
Residential Census: 83
Inspection Report
Complaint Investigation
Census: 47
Deficiencies: 0
Aug 31, 2022
Visit Reason
This visit was for the Investigation of Complaint IN00383684.
Findings
Complaint IN00383684 was substantiated, but no deficiencies related to the allegations were cited. The facility was found to be in compliance with 410 IAC 16.2-5 regarding the complaint investigation.
Complaint Details
Complaint IN00383684 - Substantiated. No deficiencies related to the allegations are cited.
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