Envive of Lawrenceburg: No Call Light for Months - IN
The man had a stroke. He has weakness on one side of his body, uses a wheelchair, and needs help getting dressed. He is cognitively intact, meaning he understood exactly what his situation was, and he described it plainly to inspectors during a September 22 complaint inspection: no call light, ever, not once since he moved in.
The facility gave him a bell to ring instead. He eventually lost track of where it was. And on the nights he did have it, it didn't matter. He was in the last room at the end of the hallway, and no matter how hard he rang, staff couldn't hear it.
One night he couldn't get out of bed. He needed to vomit. He had no call light, no bell within reach, no way to summon anyone. He yelled.
When he could get himself to the bathroom, he used the call light in there. That was his system.
A registered nurse who walked through his room with inspectors that morning confirmed what Resident C had already said: no call light was plugged into the wall above his bed. She pointed to where it should have been. She asked him directly whether he had ever had one. He told her he had not.
The maintenance supervisor, interviewed later that morning, said he knew. The room had originally been configured as a single room, he explained, so a second call light outlet was never installed. He knew there was no call light. He said it as a fact, not an apology.
The facility's own records made the timeline worse. The administrator produced an email chain on the afternoon of the inspection. The first email was dated July 22, two months earlier, and asked whether call light boxes were on backorder. The next email in the chain was dated the morning of the inspection itself, September 22, a follow-up asking about the order. A reply came that afternoon: the boxes were shipping that day. There were no emails between July and September. Two months, no follow-up, no resolution, no call light.
The administrator told inspectors that afternoon that Resident C now had a functioning call light. The old call light for the room had been hooked up.
Inspectors went back to check.
At 3:30 in the afternoon, they watched Resident C press his call light button while lying in bed. The light above his room door did not illuminate. There was no sound. He then hit the bell that had been placed on his bedside table three times and dropped it on the floor. No staff came.
The administrator's explanation was that the light associated with his call light was actually above a stairwell beside his room, not above his door like every other room. She also acknowledged there was no audible alert at the nurses' station when he pressed it, unlike the other call lights in the building.
So even the fix wasn't a fix. The light was in the wrong place. There was no sound. Staff responding to call lights throughout the facility would have no way of knowing he had pressed his.
The facility's own call light policy, revised in August 2024, states that call lights must be plugged in and functioning at all times, accessible to residents when in bed, and that defective call lights must be reported to a nurse supervisor promptly.
Resident C spent months in a room where none of that was true. He has hypertension, depression, and the lasting effects of a stroke. He needs moderate help with basic tasks. On the night he was sick and couldn't move, the facility's answer to how he would reach someone was: he would have to yell and hope.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Envive of Lawrenceburg from 2025-09-22 including all violations, facility responses, and corrective action plans.
Download the official CMS inspection PDF from Medicare.gov
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: September 23, 2026 · Our methodology
ENVIVE OF LAWRENCEBURG in LAWRENCEBURG, IN was cited for violations during a health inspection on September 22, 2025.
He has weakness on one side of his body, uses a wheelchair, and needs help getting dressed.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.