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Complaint Investigation

Oak Grove Christian Retirement Village

August 13, 2025 · Demotte, IN · 221 W Division St
Citations 3
CMS Rating 1/5
Beds 73
Provider ID 155667
Healthcare Facility
Oak Grove Christian Retirement Village
Demotte, IN  ·  View full profile →
Source Document
Official CMS Inspection Report (Medicare.gov)
Downloaded from CMS/Medicare.gov. Reflects what state inspectors documented and does not include the facility's plan of correction, which is submitted separately. Facilities may have taken corrective actions since this report was released.
Inspection Summary

OAK GROVE CHRISTIAN RETIREMENT VILLAGE in DEMOTTE, IN — inspection on August 13, 2025.

Found 3 citations. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

Inspection Findings

FF0684
Quality of Life and Care Deficiencies

Resident C's record was reviewed on 8/13/25 at 9:04 a.m.

Diagnoses included, but were not limited

Data Set assessment, dated 7/18/25, indicated the resident was moderately impaired for daily decision making. A Care Plan, dated 3/31/25, indicated the resident had an altered cardiovascular status related to congestive heart failure, hypertension (high blood pressure), and hyperlipidemia (high levels of fat/lipids in the blood).

Interventions included, but were not limited to, administer medications as ordered. A Physician's Order, dated 4/1/25, indicated metoprolol tartrate (blood pressure medication) 25 milligrams, 1 tablet by mouth twice a day.

Check blood pressure (bp) prior to administering the medication.

Hold the medication if bp is less than 100/50 or heart rate is less than

  • The June 2025 Medication Administration Record (MAR) indicated the medication was held on the
  • following dates and times: - Morning dose: 6/13/25 bp 101/55 and 6/19/25 no vital signs recorded - Bedtime dose: 6/14/25 bp 104/50 The July 2025 Medication Administration Record (MAR) indicated the medication was held on the following dates and times: - Bedtime dose: 7/2/25 bp 108/58 and 7/31/25 bp 106/68 The August 2025 Medication Administration Record (MAR) indicated the medication was held on the following dates and times: - Morning dose: 8/5/25 no vital signs recorded - Bedtime dose: 8/2/25 bp 117/50

During an interview on 8/13/25 at 2:15 p.m., the Director of Nursing indicated she had no further information to provide related to the medications being held when the vital signs were within the parameters to administer.

This citation relates to Complaint 2587154. 3.1-37(a) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided.

For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.

LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE

155667 08/13/2025

Oak Grove Christian Retirement Village 221 W Division St Demotte, IN 46310

155667 08/13/2025

Oak Grove Christian Retirement Village 221 W Division St Demotte, IN 46310

During an interview on 8/13/25 at 2:15 p.m., the Director of Nursing indicated she had no further information to provide.

This citation relates to Complaint 2587154. 3.1-50(a)(1) 3.1-50(a)(2)

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 DEMOTTE, IN, (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 OAK GROVE CHRISTIAN RETIREMENT VILLAGE or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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About This Inspection Report

Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.

Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.

Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.