Life Care Center Of The Willows
Inspection Findings
F-Tag F0842
F 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
maximal assistance for toileting hygiene, and was frequently incontinent of bowel and bladder. A Care Plan, dated 1/19/24, indicated the resident had occasional urinary incontinence. Interventions included, but were not limited to, assist with toileting and pericare as needed.The CNA (Certified Nursing Assistant) Task, B&B - Bowel and Bladder Elimination, indicated CNAs were to document at least every shift (3 times a day) incontinence care provided. Documentation included whether the resident was incontinent or continent of bowel and bladder. The task was reviewed for the previous 30 days and indicated there was no documentation of incontinence care provided during the following shifts: - Day shift: 9/1, 9/4, 9/8, 9/10, 9/13, and 9/14/25- Evening shift: 9/10, 9/12, 9/16, 9/20, 9/21, 9/24, and 9/25/25- Night shift: 9/3, 9/4, 9/10, 9/12, 9/13, 9/14, 9/15, 9/16, 9/19, 9/20, 9/23, and 9/27/25 During an interview on 9/29/25 at 2:45 p.m., the Regional Nurse Consultant indicated the CNAs were supposed to chart incontinence care at least three times a day on the CNA Tasks. She had no further information to provide.A facility policy titled, Critical Notes, received on 9/29/25 at 2:55 p.m. and noted as current from the Regional Nurse Consultant, indicated, Incontinence management, urinary, long-term care.perform hand hygiene, put on gloves and other personal protective equipment.clean the perineal area.remove personal protective equipment, perform hand hygiene, and document the procedure.This citation relates to Intake 2595565.3.1-50(a)(2)
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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
09/29/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Life Care Center of the Willows
1000 Elizabeth Dr Valparaiso, IN 46383
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)
F-Tag F0921
F 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some
FORM CMS-2567 (02/99) Previous Versions Obsolete
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and
the public. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
observation and interview, the facility failed to ensure the residents' environment was clean and in good repair related to dirty and discolored vents, exposed electrical wiring, and a broken baseboard heating cover for 3 of 3 units and the dining room. (East Hall, Center Hall, [NAME] Hall, and Dining Room) Findings include: During an Environmental Tour on 9/29/25 at 8:55 a.m., the following was observed: 1. East Halla.
The ceiling vents were dirty and discolored throughout the hallway. 2. Center Hall a. The ceiling vents were dirty and discolored throughout the hallway.b. There was exposed electrical wiring in the hallway across from room [ROOM NUMBER].c. There were exposed electrical wiring hanging from a ceiling tile in the center hallway. 3. [NAME] Halla. The ceiling vents were dirty and discolored throughout the hallway. 4.
Dining Room a. The vents in the dining room were dirty and discolored.b. The baseboard heating unit cover was not attached. During an interview on 9/29/25 at 9:49 a.m., the Maintenance Director indicated he was aware of the exposed wiring. The covers had been knocked off somehow about a week ago and he had not replaced the covers yet. He had told housekeeping to dust the vents throughout the facility and was in the process of replacing the vents in the kitchen at the time. The rest of the vents throughout the facility were in need of power washing or replacing. This citation relates to Intake 2595565. 3.1-19(f)
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LIFE CARE CENTER OF THE WILLOWS in VALPARAISO, IN 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 VALPARAISO, 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 LIFE CARE CENTER OF THE WILLOWS or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.