Grand Valley Health Care Center

In the surveyor’s words

From the most serious findings on record at Grand Valley Health Care Center, in the surveyor’s own words.

• Immediate jeopardy, isolatedF805Jan 2, 2026

  Based on observation, interview, and record review, the facility failed to:1. Ensure one of seven (7) sampled residents (Resident 56), who had an order for modified liquid consistency (liquids that have been thickened [drinks such as water, juice, coffee, modified with powders or gels to be easier and safer to swallow] to a specific level to improve swallowing safety per the International Dysphagia Diet Standardization Initiative [IDDSI - framework that provides a common terminology to describe food textures and drink thickness]), was not provided thin (water-like) liquids. The facility failed to: a. […]

• Actual harm, isolatedF600Jan 21, 2025

  Based on interview and record review, the facility failed to protect the resident's right to be free from physical abuse (deliberately aggressive or violent behavior with the intention to cause harm) for one of four sampled residents (Resident 1) when on 1/8/2025, Resident 2 punched Resident 1 in the face several times with a fist (a person's hand when the fingers are bent in toward the palm and held there tightly). This deficient practice resulted in Resident 1 being subjected to physical abuse by Resident 2 while under the care of the facility. […]

• Actual harm, isolatedF711Jul 25, 2024

  Based on interview and record review, the facility failed to ensure that the primary care physician (Primary Medical Doctor 1 [PMD 1]) for one of four sampled residents (Resident 1), who had a history of hypothyroidism (a condition where the thyroid gland doesn't release enough thyroid hormone [plays a role in regulating weight, energy levels, growth and metabolism] into the bloodstream), reviewed Resident 1's General Acute Care Hospital 1 (GACH 1) progress notes, including medications essential to Resident 1's medical treatment. […]

• Actual harm, isolatedF600May 1, 2023

  Based on observation, interview, and record review, the facility failed to protect resident ' s right to be free from physical abuse (deliberately aggressive or violent behavior with the intention to cause harm) by: 1. Resident 1 for one of two sampled residents (Resident 2). On 4/28/2023, Resident 1 threw a water pitcher (container) which hit Resident 2 ' s head. 2. Resident 2 for one of two sampled residents (Resident 1). On 4/28/2023, Resident 2 threw his cane which hit Resident 1 ' s head. […]

• No harm, potential for more than minimal, patternF583Jan 2, 2026

  Based on observation, interview, and record review, the facility failed to ensure the confidential personal information of residents were protected by failing to ensure documents (diet tickets) containing protected information ([PHI]- any health information that can be used to identify specific individual which must remain confidential to prevent harmful consequences) were shredded prior to disposing in the waste container. This failure had the potential to violate 80 of 82 residents' rights for privacy and confidentiality of personal and medical records. Findings: During an observation on 12/30/2025 at 3:36 p.m. of the dishwashing process with Dietary Aide 2 (DA 2), observed DA 2 sorting food and diet tickets from the soiled residents' tray in different trash containers. […]