Above average — CMS composite of the measures below.
The next survey window likely opens around October 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Heartland Care And Rehabilitation Center during CMS and state inspections, most recent first.
Failure to Maintain Rooms and Shower Areas in Good Repair: A resident room bathroom door could not be opened, a shower room had multiple broken, cracked, and missing tiles, and two other resident areas had holes in the walls. Staff said repair needs were reported on maintenance logs or directly to maintenance, and the Administrator expected the building to be in good repair and issues addressed in a timely manner.
Infection control practices were not maintained during catheter care for two residents and blood sugar checks for two residents. Staff did not wear gowns for EBP during catheter care, one RN cleaned a suprapubic catheter incorrectly by wiping toward the insertion site with the same washcloth area, and an RN brought a shared test strip container into resident rooms during fingerstick glucose checks. After removing gloves, the RN did not perform hand hygiene before removing blood-soiled test strips from the glucometer.
The facility failed to follow physician orders for four residents, resulting in missed weight documentation and insulin administration. A resident with heart failure had multiple missed daily weight checks, while another with diabetes had numerous missed insulin administrations and blood sugar checks. Staff interviews revealed confusion over responsibilities, contributing to these deficiencies.
The facility failed to follow physician's orders for oxygen administration with BIPAP for two residents. One resident with respiratory issues had no oxygen bled into the BIPAP as ordered, and staff removed the nasal cannula at night. Another resident with similar orders also lacked the necessary adapter for oxygen bleeding, leading to concerns about inadequate air supply. The ADON was unaware of these orders, and the DON expected staff to ensure proper BIPAP setup.
A facility failed to maintain a medication error rate below five percent, resulting in an 11% error rate. A resident with diabetes received insulin without proper pen priming, as required by manufacturer guidelines. Interviews revealed a lack of staff education on this procedure, despite facility policy expectations.
A facility failed to ensure proper labeling and storage of medications, as a resident was found to have ophthalmic solutions at their bedside without a physician's order. The resident self-administered the medications, and there was no assessment of their ability to do so. Interviews with the ADON and DON confirmed that medications should not be at the bedside without an order.
The facility failed to maintain an accurate accounting system for the resident trust fund petty cash box, resulting in a $5.90 discrepancy. The Human Resources/Business Office Manager acknowledged the error, and the Administrator was aware of the issue, noting that reconciliation was attempted almost daily.
Failure to Maintain Rooms and Shower Areas in Good Repair
Penalty
Summary
The facility failed to provide a clean, comfortable, and homelike environment. Observation of a resident room showed the bathroom door could not be opened, and the resident stated the bathroom door could not open and needed to be fixed. Observation of the shower room showed eight broken tiles with pieces missing on the left side of the shower floor, approximately 15 cracked tiles throughout the shower floor, and two missing tiles around the drain. Observation of another resident room showed two 1-inch holes in the wall above the toilet tissue holder in the bathroom. Observation of a separate resident room showed two 1-inch holes in the wall above the name plate outside the room. During interviews, the Maintenance Director said staff either told him/her in person or wrote repair requests on maintenance logs, and noted the tiles were old and some doors swell during humid conditions. Other staff stated repair needs were written on maintenance logs or reported to maintenance staff, and the Administrator said the building was expected to be in good repair and issues addressed in a timely manner.
Infection Control Failures During Catheter Care and Blood Sugar Checks
Penalty
Summary
The facility failed to maintain proper infection control practices during catheter care for two residents and blood sugar checks for two residents. Resident #59 had diagnoses of neuromuscular dysfunction of the bladder and retention of urine, with orders for urinary catheter care each shift and enhanced barrier precautions (EBP) twice a day. During observation of catheter care, a CNA and an RN did not put on gowns before entering the room and performing the resident’s catheter care. Resident #7 had diagnoses of unspecified hydronephrosis and retention of urine, with orders for daily suprapubic catheter site care and EBP twice a day. During observation, an RN did not put on a gown and wiped the catheter from approximately four inches outward and toward the insertion site with a washcloth, then used the same area of the washcloth to wipe the insertion site. During blood sugar checks for two residents, RN B carried the entire container of test strips used by multiple residents into each resident’s room. RN B performed hand hygiene, put on gloves, and completed the blood sugar checks, but after removing the gloves did not perform hand hygiene before removing the blood-soiled test strips from the glucometer. The facility’s policies reviewed included EBP, catheter care, obtaining a fingerstick glucose level, and standard precautions, and interviews with RN A, RN B, the DON, and the Administrator confirmed that gowns were expected for high-contact care on EBP, catheter care should be performed from the insertion site outward, the test strip container should not be brought into resident rooms, and gloves should be worn when removing soiled test strips.
Failure to Follow Physician Orders for Resident Care
Penalty
Summary
The facility failed to adhere to physician's orders for four residents, leading to deficiencies in care. Resident #5, diagnosed with chronic obstructive pulmonary disorder, respiratory failure, pneumonia, major depressive disorder, and heart failure, had orders for daily weights to monitor heart failure. However, there were multiple instances of missed weight documentation over September and October 2024. Similarly, Resident #9, with diagnoses including acquired kidney absence and COPD, had orders for weekly weights, but several opportunities were missed in the same period. Resident #19, diagnosed with dementia, hypothyroidism, and hyperlipidemia, also had missed weekly weight documentation, indicating a pattern of non-compliance with physician orders. Resident #68, with conditions such as anemia, orthostatic hypotension, diabetes mellitus, and dementia, had orders for insulin administration and blood sugar checks before meals and at bedtime. The Medication Administration Record showed numerous missed opportunities for insulin administration and blood sugar checks over three months. Interviews with staff revealed a lack of clarity and responsibility regarding the completion and documentation of these tasks, contributing to the deficiencies. The Director of Nursing and the Administrator acknowledged the expectation for staff to follow physician orders, highlighting a systemic issue in the facility's adherence to prescribed care protocols.
Failure to Follow Oxygen Administration Orders with BIPAP
Penalty
Summary
The facility failed to adhere to physician's orders for oxygen administration with the use of a bilevel positive airway pressure (BIPAP) device for two residents. Resident #5, who was diagnosed with acute and chronic respiratory failure, pneumonia, heart failure, chronic obstructive pulmonary disease (COPD), and morbid obesity, had a physician's order for BIPAP with oxygen bled in at bedtime. However, observations on two separate days showed that there was no connector piece to bleed in oxygen, and no oxygen was attached to the BIPAP. The resident reported that staff removed the oxygen and nasal cannula when applying the BIPAP mask, and he/she relied on staff to manage the BIPAP setup. Similarly, Resident #75, with diagnoses including dyspnea, hypoxemia, respiratory failure, lymphedema, and pneumonia, had orders for oxygen to be bled in with the BIPAP at bedtime. Observations revealed that the BIPAP was not equipped with an adapter to allow for oxygen to be bled in, and no oxygen was attached. The resident expressed concerns about the BIPAP not operating correctly and experiencing shortness of breath when attempting to use the nasal cannula with the BIPAP mask. The Assistant Director of Nursing (ADON) was unaware of the order to bleed in oxygen for both residents, despite having cared for them during night shifts. The Director of Nursing (DON) and the Administrator expected staff to follow physician orders and ensure proper BIPAP setup and monitoring.
Medication Error Rate Exceeds Acceptable Threshold
Penalty
Summary
The facility failed to maintain a medication error rate of less than five percent, resulting in an error rate of 11% during the administration of medications. This deficiency was identified through observation, interview, and record review, affecting one resident outside the sample of four residents. The facility's policy on insulin administration, dated 2001, requires that only appropriately licensed or certified personnel draw and administer insulin, and that the type, dosage, strength, and method of administration be verified before administration. However, the facility did not adhere to these guidelines, as evidenced by the failure to prime insulin pens before administration, which is a necessary step to ensure accurate dosing. The deficiency involved a resident with diabetes who had physician orders for insulin glargine and Humalog. On two separate occasions, a registered nurse (RN) administered these insulins without priming the pens, contrary to the manufacturer's guidelines. Interviews with the Assistant Director of Nursing (ADON) and the RN revealed a lack of education and practice regarding the priming of insulin pens. The Director of Nursing (DON) acknowledged the expectation for nursing staff to prime insulin pens prior to administration, indicating a gap between policy and practice within the facility.
Failure to Ensure Proper Medication Labeling and Storage
Penalty
Summary
The facility failed to ensure that drugs and biologicals were labeled and stored according to accepted professional principles. Specifically, the facility did not have a policy regarding residents keeping medications at the bedside or self-administering them. This was observed in the case of a resident who had ophthalmic solutions, Muro and Pataday, at their bedside without a physician's order. The resident's Physician Order Sheet did not document an order for self-administration or bedside storage of these medications, and there was no assessment of the resident's ability to self-administer them. Interviews with the resident and facility staff, including the Assistant Director of Nursing (ADON) and the Director of Nursing (DON), confirmed that the resident was self-administering the eye drops and keeping them at the bedside. Both the ADON and DON stated that they would not expect residents to have medications at the bedside without a physician's order. The facility census at the time was 74, and this deficiency had the potential to affect all residents.
Discrepancy in Resident Trust Fund Accounting
Penalty
Summary
The facility failed to maintain an accurate accounting system for the resident trust fund petty cash box, which is a requirement for managing residents' personal funds. The facility's policy, revised in March 2021, mandates that the facility acts as a fiduciary for residents' funds, ensuring proper safeguarding, management, and accounting without levying service charges. Additionally, the facility's admission packet outlines that funds less than $50.00 can be maintained in a petty cash fund, and a complete and separate accounting system must be established according to generally accepted accounting principles. During an observation of the resident petty cash box count, a discrepancy was noted between the actual cash counted and the balance listed in the facility's maintained resident petty cash log. The Human Resources/Business Office Manager (BOM) counted $526.65, while the log showed a balance of $532.55, resulting in a $5.90 discrepancy. The BOM acknowledged an error in the count and mentioned attempts to reconcile the cash box daily, though it was not always possible. The Administrator was aware of the discrepancy, noting that the cash box was reconciled almost daily.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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| Fountainbleau Lodge | 1.1 mi | ★★★★★ | 7 | 0 |
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| Lutheran Home, The | 3.9 mi | ★★★★★ | 0 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.