Facility profile · CCN 245429
Tweeten Lutheran Health Care Center
28 federal citations on record , including 2 at the Immediate Jeopardy level, and 2 federal enforcement actions totaling $120,876.
Record summary
Federal record · Q1 202628
Total citations
25
Last 3 years
5
Actual harm+
2
Federal penalties
$120,876
Total fines
1
Overall ★ rating
Most common violation categories here
Most common F-tags at this facility
Citation history
28 on record| Survey | F-Tag | Violation | Severity | Source |
|---|---|---|---|---|
| Dec 19, 2025 | F732 | Post nurse staffing information every day. | C | Complaint |
| Dec 19, 2025 | F727 | Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | F | Complaint |
| Dec 19, 2025 | F689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | Complaint |
| Dec 19, 2025 | F686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | Complaint |
| Dec 19, 2025 | F658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | Complaint |
| Dec 19, 2025 | F657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | Complaint |
| Dec 19, 2025 | F655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | Complaint |
| Dec 19, 2025 | F609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Complaint |
| Dec 19, 2025 | F607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | D | Complaint |
| Jul 18, 2025 | F760 | Ensure that residents are free from significant medication errors. | J | Complaint |
| Jan 9, 2025 | F887 | Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. | D | Standard |
| Jan 9, 2025 | F880 | Provide and implement an infection prevention and control program. | F | Standard |
| Jan 9, 2025 | F812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | Standard |
| Jan 9, 2025 | F645 | PASARR screening for Mental disorders or Intellectual Disabilities | D | Standard |
| Dec 2, 2024 | F757 | Ensure each resident’s drug regimen must be free from unnecessary drugs. | D | Complaint |
| Dec 2, 2024 | F692 | Provide enough food/fluids to maintain a resident's health. | G | Complaint |
| Dec 2, 2024 | F656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Complaint |
| Nov 21, 2024 | F880 | Provide and implement an infection prevention and control program. | D | Complaint |
| Nov 21, 2024 | F610 | Respond appropriately to all alleged violations. | D | Complaint |
| Nov 21, 2024 | F609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Complaint |
| Oct 26, 2023 | F761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | Standard |
| Oct 26, 2023 | F755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | Standard |
| Oct 26, 2023 | F554 | Allow residents to self-administer drugs if determined clinically appropriate. | D | Standard |
| Jul 11, 2023 | F908 | Keep all essential equipment working safely. | D | Complaint |
| May 25, 2023 | F689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | Complaint |
| May 4, 2022 | F880 | Provide and implement an infection prevention and control program. | D | Standard |
| May 4, 2022 | F760 | Ensure that residents are free from significant medication errors. | D | Standard |
| May 4, 2022 | F552 | Ensure that residents are fully informed and understand their health status, care and treatments. | G | Standard |
Federal enforcement history
Federal regulators have imposed 2 enforcement actions against this facility, including 1 civil money penalties totaling $120,876 and 1 payment-denial actions spanning 5 days.
| Date | Type | Fine | Payment denial |
|---|---|---|---|
| Nov 21, 2024 | Payment Denial | — | Dec 28, 2024 · 5 days |
| May 25, 2023 | Fine | $120,876 | — |
About this record
A citation is a finding by a state survey team working under federal contract. It is not a court
judgment. The description above is drawn verbatim from federal public datasets. Facilities have
the right to appeal findings through an Informal Dispute Resolution (IDR/IIDR) process.
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