A list of the most recent deficiencies for Lutheran Life Villages. The list is based on the information provided by CMS from both standard inspections and from complaints filed by residents.
| Deficiency | Type of Deficiency | Deficiency Date | Date Corrected | Resulted from a Complaint? |
|---|---|---|---|---|
| Provide care or services that was trauma informed and/or culturally competent. | Health | 2024-02-27 | 2024-03-08 | N |
| Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | Health | 2024-02-27 | 2024-03-08 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-02-20 | 2023-03-03 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2023-02-20 | 2023-03-03 | N |
| Provide safe, appropriate pain management for a resident who requires such services. | Health | 2023-02-20 | 2023-03-03 | N |
| Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. | Health | 2023-02-20 | 2023-03-03 | N |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2022-05-09 | 2022-05-27 | Y |
| Meet requirements for sections of health care facilities separated by fire resistive construction. | Fire Safety | 2022-04-11 | 2022-04-29 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2022-04-11 | 2022-04-29 | N |
| Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. | Fire Safety | 2022-04-11 | 2022-04-29 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2022-04-11 | 2022-04-29 | N |
| Have an externally vented heating system. | Fire Safety | 2022-04-11 | 2022-04-29 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2022-04-11 | 2022-04-29 | N |
| Have a battery powered remote alarm panel in a location accessible by operating personnel. | Fire Safety | 2022-04-11 | 2022-04-29 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2022-04-11 | 2022-04-29 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2022-04-11 | 2022-04-29 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-03-08 | 2022-03-30 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-03-08 | 2022-03-30 | N |
| Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | Health | 2022-03-08 | 2022-03-30 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2022-03-08 | 2022-03-30 | N |
| Provide and implement an infection prevention and control program. | Health | 2021-07-20 | 2021-08-06 | N |
