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Complaint Investigation

Lincolnshire Health & Rehabilitation Center

Inspection Date: November 24, 2025
Total Violations 2
Facility ID 155650
Location MERRILLVILLE, IN
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Inspection Findings

F-Tag F0684

Quality of Life and Care Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0684 Level of Harm - Minimal harm or potential for actual harm

indicated, . Weekly skin checks will be conducted by the licensed nurse. This will be documented in the resident's Electronic Medical Record (EMR). Daily, during routine care, the Certified Nursing Assistant (CNA) will observe the resident's skin. When abnormalities are noted this will be communicated to the licensed nurse .

Residents Affected - Some

This citation relates to Intake 2585462. 3.1-37(a)

FORM CMS-2567 (02/99) Previous Versions Obsolete

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

11/24/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Lincolnshire Health & Rehabilitation Center

8380 Virginia St Merrillville, IN 46410

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

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F-Tag F0694

Quality of Life and Care Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0694

Provide for the safe, appropriate administration of IV fluids for a resident when needed.

Level of Harm - Minimal harm or potential for actual harm

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on

record review and interview, the facility failed to ensure an intravenous (IV) access site was assessed upon admission and removed in a timely manner for 1 of 1 resident reviewed for parenteral/IV fluids. (Resident D)Finding includes:The closed record for Resident D was reviewed on 11/19/25 at 3:22 p.m. Diagnoses included, but were not limited to, aortocoronary bypass graft, atherosclerotic heart disease, and type 2 diabetes mellitus. The Medicare 5-day Minimum Data Set (MDS) assessment, dated 8/9/25, indicated the resident had moderate cognitive impairment. The admission Nursing Assessment, dated 8/3/25, indicated

the resident did not have an IV (intravenous) present. The After Visit Summary from the hospital, dated 8/3/25, had no documentation related to an IV access site. A Nurse's Note, dated 8/3/25 at 12:40 p.m., indicated the resident had multiple areas of small bruising related to IV insertion. The note did not indicate if

the IV access was still present. A Nurse's Note, dated 8/4/25 at 9:49 p.m., indicated the resident had multiple small bruising related to IV insertion. Again, the note did not indicate if the IV access was still present. A Physician's Progress note, dated 8/5/25 at 2:36 a.m., indicated the resident had a peripheral IV line from the hospital that the hospital did not remove. A Physician's Order, dated 8/6/25, indicated it was okay to remove the peripheral IV site. A Nurse's Note, dated 8/6/25 at 3:22 p.m., indicated the resident had

a peripheral IV line from the hospital that the hospital did not remove. The hospital stated it was to come out there. The IV was removed per the physician's order and family was notified. A Physician's Discharge summary, dated [DATE REDACTED] at 7:45 a.m., indicated the resident had draining and discomfort to her surgical area and she was discharged to the hospital for evaluation based on the resident's request. The resident was admitted to the facility on [DATE REDACTED] with a peripheral IV line in from the hospital that the hospital did not remove. The IV was removed on 8/6/25 while in the facility. During an interview on 11/24/25 at 11:02 a.m.,

the Director of Nursing (DON) indicated the IV was an oversight on the admission assessment and it should have documented as being present. The facility policy titled, PICC (peripherally inserted central catheter) Line Maintenance, was provided by the Nurse Consultant on 11/24/25 at 4:02 p.m. and identified as current. The policy indicated the IV site should be checked for at least each shift for signs of infection, infiltration, or other complications. This citation relates to Intake 2585462.3.1-47(a)(2)

Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

Event ID:

Facility ID:

If continuation sheet

📋 Inspection Summary

LINCOLNSHIRE HEALTH & REHABILITATION CENTER in MERRILLVILLE, IN inspection on recent inspection.

Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.

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

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 MERRILLVILLE, 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 LINCOLNSHIRE HEALTH & REHABILITATION CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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