All citations for Luther Haven
State inspectors check nursing homes that take Medicare or Medicaid against federal rules, usually about once a year, and also look into complaints. Each rule a home did not meet is a citation.
Last standard health inspection on record
August 20, 2025
Showing 1 to 15 of 15 citations
No harm, with potential for more than minimal harm
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
The home gave a date the problem would be corrected (November 20, 2023).
No harm, with potential for more than minimal harm
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
The home gave a date the problem would be corrected (November 20, 2023).
No harm, with potential for more than minimal harm
Have a plan that describes the process for conducting QAPI and QAA activities.
The home gave a date the problem would be corrected (November 20, 2023).
No harm, with potential for more than minimal harm
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
The home gave a date the problem would be corrected (November 20, 2023).
No harm, with potential for more than minimal harm
Provide and implement an infection prevention and control program.
The home gave a date the problem would be corrected (November 20, 2023).
No harm, with potential for more than minimal harm
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
The home gave a date the problem would be corrected (February 28, 2024).
No harm, with potential for more than minimal harm
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
The home gave a date the problem would be corrected (February 28, 2024).
No harm, with potential for more than minimal harm
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
The home gave a date the problem would be corrected (November 20, 2023).
No harm, with potential for more than minimal harm
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
The home gave a date the problem would be corrected (November 20, 2023).
No harm, with potential for more than minimal harm
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.
The home gave a date the problem would be corrected (November 20, 2023).
No harm, with potential for more than minimal harm
Ensure medication error rates are not 5 percent or greater.
The home gave a date the problem would be corrected (November 20, 2023).
No harm, with potential for more than minimal harm
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.
The home gave a date the problem would be corrected (November 20, 2023).
No harm, with potential for more than minimal harm
Develop and implement policies and procedures for flu and pneumonia vaccinations.
The home gave a date the problem would be corrected (November 20, 2023).
No harm, with potential for more than minimal harm
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
The home gave a date the problem would be corrected (November 20, 2023).
No harm, with potential for minimal harm
Have simulated fire drills held at unexpected times.
The home gave a date the problem would be corrected (October 20, 2023).
Source: CMS Provider Information, Fire Safety Deficiencies, Health Deficiencies, Citation Code Look-up, data as of September 30, 2026. Inspection results describe the home at the time of each inspection.