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Complaint Investigation

Saint Therese At Oxbow Lake

August 7, 2024 · Brooklyn Park, MN · 9751 Regent Avenue North
Citations 1
CMS Rating 3/5
Beds 64
Provider ID 245619
Healthcare Facility
Saint Therese At Oxbow Lake
Brooklyn Park, MN  ·  View full profile →
Source Document
Official CMS Inspection Report (Medicare.gov)  ·  18 pages
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

SAINT THERESE AT OXBOW LAKE in BROOKLYN PARK, MN — inspection on August 7, 2024.

Found 1 citation. 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

FF689
Minimal harm or she was unable to bear her own weight. R1 was incontinent of bowel and bladder and was prescribed an Few two to six months; however, no fractures related to these falls. affected

During observation and interview on 8/6/24 at 10:53 a.m., R3 sat in her w/c. R3's w/c was without adaptive devices and a soft-touched call light was near her.

Her bedroom and bathroom environment lacked such devices as a Reacher to assist with picking up things from the floor which would help her obtain things from her closet. In addition, the environment lacked CALL TO NOT FALL sign(s).

During observation and interview on 8/6/24 at 10:41 a.m., R2 sat in his wheelchair. R2's w/c had anti-lock and anti-tip devices. R2's environment was observed which lacked fall mitigation signs and/or devices.

When interviewed via telephone on 8/6/24 at 11:55 a.m., R1, R2, and R3's medical provider (MD) stated individualized fall interventions should be implemented upon admission, if considered a fall risk, and then right after the first fall these should be reviewed and adjusted.

After further discussion of R1, R2, and R3 care plan interventions, MD indicated he would have thought staff would have initiated more specific interventions, adding, That is someone's job to put those precautions in place.

245619

Form Approved OMB

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.

Building 245619 B.

Wing 08/07/2024

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Saint Therese at Oxbow Lake 9751 Regent Avenue North Brooklyn Park, MN 55443

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 BROOKLYN PARK, MN, (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 SAINT THERESE AT OXBOW LAKE 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.