Spiritrust Lutheran the Village at Luther Ridge

A resident's bed enabler bar had an uncovered opening, creating a potential entrapment hazard.

Unattended and unlocked plant food containers were accessible to residents in a courtyard storage container.

A resident's annual medical evaluation did not indicate if their needs could be met safely at the facility.

The weekly menu for the following week was not posted in a conspicuous place.

Medications were not stored properly, including a blister pack with a hole exposing medication and loose pills found in a medication cart.

A direct care staff member did not receive required training in topics including DME/RASP, personal care service needs, and safe management techniques.

Staff member did not receive annual training regarding Resident Rights and the Older Adult Protective Services Act.

Hot water temperatures in several areas, including common bathrooms and a resident bedroom, exceeded the 120°F limit.

Discrepancy found between a resident's glucometer reading and the Medication Administration Record (MAR) documentation.

Failure to follow prescriber's orders as a blood sugar reading was not recorded, resulting in the Humalog insulin not being administered.

A direct care staff person did not have a high school diploma, GED, or active registry status on the Pennsylvania nurse aide registry.

Prescription medications were found unlocked, unattended, and accessible in resident rooms.

An expired medication pen was found in the home's medication cart.

Medication delivery logs containing resident information were left unlocked and accessible in an unattended nurse station drawer.

The first aid kit in the white Toyota van was missing antiseptic.

Multiple glucometer readings for two residents were incorrectly documented in the Medication Administration Record (MAR).

The resident's support plan failed to document how specific medical needs, including medications for depression, glaucoma, and edema, would be met.