EBEN EZER LUTHERAN CARE CENTER
BRUSH, CO · 125 beds · Non profit - Corporation
Red Flags
- ⚠ This facility has a substantiated finding of abuse
- ⚠ 4 citation(s) where residents suffered actual harm
Green Flags
No positive signals identified yet.
Quick Facts
Violation Timeline
December 2, 2025
1 deficiencyFreedom from Abuse, Neglect, and Exploitation Deficiencies
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Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
August 14, 2024
6 deficiencyiesResident Assessment and Care Planning Deficiencies
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Ensure services provided by the nursing facility meet professional standards of quality.
Quality of Life and Care Deficiencies
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Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies
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Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Nursing and Physician Services Deficiencies
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Observe each nurse aide's job performance and give regular training.
Nutrition and Dietary Deficiencies
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Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Infection Control Deficiencies
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Provide and implement an infection prevention and control program.
March 1, 2023
3 deficiencyiesQuality of Life and Care Deficiencies
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Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Pharmacy Service Deficiencies
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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.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
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Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
November 17, 2021
3 deficiencyiesQuality of Life and Care Deficiencies
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Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies
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Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
Pharmacy Service Deficiencies
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Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Staffing
A nurse checks on each resident roughly every 5.6 hours on average.
Fines & Penalties
- Fine Mar 1, 2023$26,832
Ownership
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EBEN EZER LUTHERAN CARE CENTER
OPERATIONAL/MANAGERIAL CONTROL
Since since 01/01/1966
Organization -
BASS, SONYOU
CORPORATE DIRECTOR
Since since 07/01/2024
Individual -
CHAPIN, ROBERT
CORPORATE DIRECTOR
Since since 07/01/2024
Individual -
FRASIER, MARK
CORPORATE DIRECTOR
Since since 07/01/2024
Individual -
LEE, MICHAEL
CORPORATE DIRECTOR
Since since 07/01/2024
Individual -
LEFEVER, TRAVIS
CORPORATE DIRECTOR
Since since 07/01/2024
Individual -
SCHAEFER, ROGER
CORPORATE DIRECTOR
Since since 07/01/2024
Individual -
TEKRONEY, MICHAEL
CORPORATE DIRECTOR
Since since 07/01/2024
Individual -
THISTLE, JENNIFER
CORPORATE DIRECTOR
Since since 07/01/2024
Individual -
VANNOY, DOUGLAS
CORPORATE DIRECTOR
Since since 07/01/2024
Individual -
HERGENRETER, SHELLY
CORPORATE OFFICER
Since since 07/06/2005
Individual -
MASON, LESLIE
CORPORATE OFFICER
Since since 06/03/2011
Individual -
HERGENRETER, SHELLY
W-2 MANAGING EMPLOYEE
Since since 09/01/2007
Individual -
MASON, LESLIE
W-2 MANAGING EMPLOYEE
Since since 06/03/2011
Individual