ElderGrade

Inspection citations at Ivy At Deer Lodge

38 citations on record, 6 of which inspectors scored at actual harm or immediate jeopardy. Each one is the state surveyor's own finding, not our summary.

Reading the scope & severity code

A–C

No harm, minimal potential

D–F

No harm, potential for harm

G–I

Actual harm to a resident

J–L

Immediate jeopardy

The letter also encodes how many residents were affected — isolated, a pattern, or widespread. Full explainer.

Citations by survey year

Year Citations Involving harm or jeopardy
2025 6 2
2024 17 3
2023 15 1
D December 3, 2025 Tag F0658 Corrected Dec 2025

Resident Assessment and Care Planning Deficiencies

Ensure services provided by the nursing facility meet professional standards of quality.

No actual harm, potential for more than minimal harm

D December 3, 2025 Tag F0657 Complaint investigation Corrected Dec 2025

Resident Assessment and Care Planning Deficiencies

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

No actual harm, potential for more than minimal harm

D December 3, 2025 Tag F0554 Corrected Dec 2025

Resident Rights Deficiencies

Allow residents to self-administer drugs if determined clinically appropriate.

No actual harm, potential for more than minimal harm

F December 3, 2025 Tag F0880 Corrected Dec 2025

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

No actual harm, potential for more than minimal harm

G December 3, 2025 Tag F0745 Complaint investigation Corrected Dec 2025

Quality of Life and Care Deficiencies

Provide medically-related social services to help each resident achieve the highest possible quality of life.

Actual harm to a resident

G December 3, 2025 Tag F0689 Complaint investigation Corrected Dec 2025

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Actual harm to a resident

J November 25, 2024 Tag F0697 Complaint investigation Corrected Dec 2024

Quality of Life and Care Deficiencies

Provide safe, appropriate pain management for a resident who requires such services.

Immediate jeopardy to resident health or safety

J November 25, 2024 Tag F0600 Complaint investigation Corrected Dec 2024

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Immediate jeopardy to resident health or safety

K November 25, 2024 Tag F0686 Complaint investigation Corrected Dec 2024

Quality of Life and Care Deficiencies

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

Immediate jeopardy to resident health or safety

B October 10, 2024 Tag F0625 Corrected Nov 2024

Resident Rights Deficiencies

Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.

No actual harm, minimal potential

B October 10, 2024 Tag F0565 Corrected Nov 2024

Resident Rights Deficiencies

Honor the resident's right to organize and participate in resident/family groups in the facility.

No actual harm, minimal potential

D October 10, 2024 Tag F0623 Corrected Nov 2024

Resident Rights Deficiencies

Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

No actual harm, potential for more than minimal harm

E October 10, 2024 Tag F0761 Corrected Nov 2024

Pharmacy Service Deficiencies

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.

No actual harm, potential for more than minimal harm

F October 10, 2024 Tag F0812 Corrected Nov 2024

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

No actual harm, potential for more than minimal harm

D September 19, 2024 Tag F0849 Complaint investigation Corrected Oct 2024

Administration Deficiencies

Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.

No actual harm, potential for more than minimal harm

D September 19, 2024 Tag F0684 Complaint investigation Corrected Oct 2024

Quality of Life and Care Deficiencies

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

No actual harm, potential for more than minimal harm

D September 19, 2024 Tag F0563 Complaint investigation Corrected Oct 2024

Resident Rights Deficiencies

Honor the resident's right to receive visitors of his or her choosing, at the time of his or her choosing.

No actual harm, potential for more than minimal harm

E September 19, 2024 Tag F0584 Complaint investigation Corrected Oct 2024

Resident Rights Deficiencies

Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

No actual harm, potential for more than minimal harm

E September 19, 2024 Tag F0555 Complaint investigation Corrected Oct 2024

Resident Rights Deficiencies

Honor the resident's right to choose his or her attending physician.

No actual harm, potential for more than minimal harm

E July 17, 2024 Tag F0726 Complaint investigation Corrected Aug 2024

Nursing and Physician Services Deficiencies

Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.

No actual harm, potential for more than minimal harm

E July 17, 2024 Tag F0610 Complaint investigation Corrected Aug 2024

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Respond appropriately to all alleged violations.

No actual harm, potential for more than minimal harm

E July 17, 2024 Tag F0600 Complaint investigation Corrected Aug 2024

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

No actual harm, potential for more than minimal harm

E July 17, 2024 Tag F0582 Complaint investigation Corrected Aug 2024

Resident Rights Deficiencies

Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.

No actual harm, potential for more than minimal harm

B November 8, 2023 Tag F0695 Corrected Dec 2023

Quality of Life and Care Deficiencies

Provide safe and appropriate respiratory care for a resident when needed.

No actual harm, minimal potential

B November 8, 2023 Tag F0582 Corrected Dec 2023

Resident Rights Deficiencies

Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.

No actual harm, minimal potential

D November 8, 2023 Tag F0692 Corrected Dec 2023

Quality of Life and Care Deficiencies

Provide enough food/fluids to maintain a resident's health.

No actual harm, potential for more than minimal harm

D November 8, 2023 Tag F0656 Corrected Dec 2023

Resident Assessment and Care Planning Deficiencies

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

No actual harm, potential for more than minimal harm

E November 8, 2023 Tag F0806 Corrected Dec 2023

Nutrition and Dietary Deficiencies

Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.

No actual harm, potential for more than minimal harm

E November 8, 2023 Tag F0660 Corrected Dec 2023

Resident Assessment and Care Planning Deficiencies

Plan the resident's discharge to meet the resident's goals and needs.

No actual harm, potential for more than minimal harm

E November 8, 2023 Tag F0584 Corrected Dec 2023

Resident Rights Deficiencies

Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

No actual harm, potential for more than minimal harm

E November 8, 2023 Tag F0578 Corrected Dec 2023

Resident Rights Deficiencies

Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.

No actual harm, potential for more than minimal harm

F November 8, 2023 Tag F0867 Corrected Dec 2023

Administration Deficiencies

Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.

No actual harm, potential for more than minimal harm

F November 8, 2023 Tag F0801 Corrected Dec 2023

Nutrition and Dietary Deficiencies

Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.

No actual harm, potential for more than minimal harm

D August 2, 2023 Tag F0726 Complaint investigation Corrected Sep 2023

Nursing and Physician Services Deficiencies

Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.

No actual harm, potential for more than minimal harm

D August 2, 2023 Tag F0657 Complaint investigation Corrected Sep 2023

Resident Assessment and Care Planning Deficiencies

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

No actual harm, potential for more than minimal harm

E August 2, 2023 Tag F0839 Complaint investigation Corrected Sep 2023

Administration Deficiencies

Employ staff that are licensed, certified, or registered in accordance with state laws.

No actual harm, potential for more than minimal harm

E August 2, 2023 Tag F0729 Complaint investigation Corrected Sep 2023

Nursing and Physician Services Deficiencies

Verify that a nurse aide has been trained; and if they haven't worked as a nurse aide for 2 years, receive retraining.

No actual harm, potential for more than minimal harm

G August 2, 2023 Tag F0689 Complaint investigation Corrected Sep 2023

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Actual harm to a resident

Citations are published by CMS from state survey agency findings. A citation describes what an inspector observed on a specific date; homes are required to submit a correction plan, and many findings are resolved long before you read them. Ask the administrator what happened and what changed.