Deficiency Records for Lutheran Convalescent Home
Updated as of July 01, 2021
This is not the most recent data for Lutheran Convalescent Home. For the most recent information, click here.
A list of the most recent deficiencies for Lutheran Convalescent Home. 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 appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2020-10-21 | 2020-12-04 | Y |
| Provide and implement an infection prevention and control program. | Health | 2020-07-20 | 2020-09-11 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2019-09-13 | 2019-10-25 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2019-09-13 | 2019-10-25 | N |
| Meet other general requirements that are deficient. | Fire Safety | 2019-09-13 | 2019-10-25 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2019-09-13 | 2019-10-25 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2018-10-11 | 2018-11-20 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2018-10-11 | 2018-11-20 | N |
| Install smoke barrier doors that can resist smoke for at least 20 minutes. | Fire Safety | 2018-10-11 | 2018-11-20 | N |
| Have restrictions on the use of portable space heaters. | Fire Safety | 2018-10-11 | 2018-11-20 | N |
| Meet other general requirements that are deficient. | Fire Safety | 2018-10-11 | 2018-11-20 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2018-10-11 | 2018-11-20 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2018-10-11 | 2018-11-20 | N |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2018-10-11 | 2018-11-20 | N |
| Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death. | Health | 2018-10-11 | 2018-10-18 | N |
| Follow proper procedures when the fire alarm was out of service for more than 4 hours. | Fire Safety | 2017-11-14 | 2017-12-29 | N |
| Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours. | Fire Safety | 2017-11-14 | 2017-12-29 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2017-11-14 | 2017-12-29 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2017-11-14 | 2017-12-29 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2017-11-14 | 2017-12-29 | N |
| Let residents refuse treatment, refuse to take part in an experiment, or formulate advance directives. | Health | 2017-11-14 | 2017-12-29 | N |
| Develop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property. | Health | 2017-11-14 | 2017-12-29 | N |
| Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. | Health | 2017-11-14 | 2017-12-29 | N |
| Have a program that investigates, controls and keeps infection from spreading. | Health | 2017-11-14 | 2017-12-29 | N |
