Perry Lutheran Home
Inspection Findings
F-Tag F0684
F 0684 Level of Harm - Actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
Re-check the blood glucose within 15 minutes, or sooner, if resident condition warrants.If the blood glucose remains low (<70), administer another 15-gram dose of carbohydrates and notify the physician. Follow any orders/instructions. Repeat until blood sugar is noted to be >70. 4. Once stabilized, the resident should receive a snack (such as, peanut butter sandwich and 8 ounces skim milk) or the next scheduled meal if within 30 minutes. 5. Update the physician and family of hypoglycemic episode and corrective measures unless otherwise directed by physician orders or as directed by family. If the resident is unresponsive and/or unable to swallow:1. Test the blood glucose. If below 70, recheck the blood glucose2. If the blood glucose remains below 70 and is unresponsive, give Glucagon 1mg. IM or SQ x1 dose, as ordered 3. Monitor the resident closely and assess level of consciousness and vital signs4. Repeat the blood glucose in 15 minutes 5. If blood glucose remains <70 and the resident is not able or willing to consume nutrition, call 911 and transfer to the hospital. 6. If the blood glucose is <70 and the resident is responsive and able to swallow follow the interventions in Process A. 7. Notify the physician and family of episode and interventions 8.
Document series of events in the Progress Notes- Provide follow up documentation as deemed necessary.
If at any time family/responsible party requests transfer to ER, call for ambulance and notify physician.
Review of the facility policy Medication and Treatment Orders, dated 2024, documented orders need to be written completely and followed as ordered.
Event ID:
Facility ID:
If continuation sheet
Perry Lutheran Home in Perry, IA inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
Frequently Asked Questions
- What is an F-tag violation?
- F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
- Were these violations corrected?
- Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
- How often do nursing home inspections happen?
- CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
- What should families do about these violations?
- Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in Perry, IA, (5) Report new concerns to state authorities.
- Where can I see the full inspection report?
- Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from Perry Lutheran Home or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.