Bethany On The Lake LLC

Penalties

• Mar 26, 2026 — Fine ($19,330)

Inspection findings

1. Mar 26, 2026 Health · 3 findings
   • Serious Scope/severity I Complaint

     F0600 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.

     Corrected Mar 13, 2026 · CMS health inspection

   • Not serious Scope/severity D Complaint

     F0609 Freedom from Abuse, Neglect, and Exploitation Deficiencies

     Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

     Corrected Apr 15, 2026 · CMS health inspection

   • Severity not stated

     H54348641C Substantiated complaint (MDH Office of Health Facility Complaints)

     MDH substantiated this complaint. The finding and its severity are in MDH's investigation report (linked).

     Statement of deficiencies (PDF)

2. Aug 13, 2025 Health · 7 findings
   • Not serious Scope/severity C

     F0577 Resident Rights Deficiencies

     Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.

     Corrected Sep 3, 2025 · CMS health inspection

   • Not serious Scope/severity E

     F0689 Quality of Life and Care Deficiencies

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

     Corrected Sep 3, 2025 · CMS health inspection

   • Not serious Scope/severity D

     K0321 Smoke Deficiencies

     Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

     Corrected Sep 30, 2025 · CMS fire safety

   • Not serious Scope/severity F

     K0345 Smoke Deficiencies

     Have approved installation, maintenance and testing program for fire alarm systems.

     Corrected Sep 5, 2025 · CMS fire safety

   • Not serious Scope/severity D

     K0364 Smoke Deficiencies

     Install properly constructed windows in hallway walls or doors.

     Corrected Sep 5, 2025 · CMS fire safety

   • Not serious Scope/severity D

     K0374 Smoke Deficiencies

     Install smoke barrier doors that can resist smoke for at least 20 minutes.

     Corrected Sep 5, 2025 · CMS fire safety

   • Not serious Scope/severity D

     K0761 Miscellaneous Deficiencies

     To conduct inspection, testing and maintenance of fire doors by qualified individuals.

     Corrected Sep 5, 2025 · CMS fire safety

3. Jan 22, 2025 MDH complaint investigation · 1 finding
   • Severity not stated

     H54344340C Substantiated complaint (MDH Office of Health Facility Complaints)

     MDH substantiated this complaint. The finding and its severity are in MDH's investigation report (linked).

     Statement of deficiencies (PDF)

4. Jan 10, 2025 Health · 1 finding
   • Serious Scope/severity J Complaint

     F0689 Quality of Life and Care Deficiencies

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

     Corrected Jan 7, 2025 · CMS health inspection

5. Dec 19, 2024 MDH complaint investigation · 1 finding
   • Severity not stated

     H54341681C Substantiated complaint (MDH Office of Health Facility Complaints)

     MDH substantiated this complaint. The finding and its severity are in MDH's investigation report (linked).

     Statement of deficiencies (PDF)

6. Dec 12, 2024 Health · 1 finding
   • Not serious Scope/severity D Complaint

     F0622 Resident Rights Deficiencies

     Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.

     Corrected Dec 26, 2024 · CMS health inspection

7. Jun 5, 2024 Health · 5 findings
   • Not serious Scope/severity D

     F0641 Resident Assessment and Care Planning Deficiencies

     Ensure each resident receives an accurate assessment.

     Corrected Jun 26, 2024 · CMS health inspection

   • Not serious Scope/severity D

     F0655 Resident Assessment and Care Planning Deficiencies

     Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted

     Corrected Jun 26, 2024 · CMS health inspection

   • Not serious Scope/severity D

     F0658 Resident Assessment and Care Planning Deficiencies

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

     Corrected Jun 26, 2024 · CMS health inspection

   • Not serious Scope/severity D

     K0321 Smoke Deficiencies

     Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

     Corrected Jun 25, 2024 · CMS fire safety

   • Not serious Scope/severity E

     K0324 Smoke Deficiencies

     Provide properly protected cooking facilities.

     Corrected Jun 25, 2024 · CMS fire safety

8. Apr 27, 2023 Health · 1 finding
   • Not serious Scope/severity F

     F0921 Environmental Deficiencies

     Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.

     Corrected May 10, 2023 · CMS health inspection

9. Mar 11, 2022 MDH complaint investigation · 1 finding
   • Severity not stated

     H5434037C Substantiated complaint (MDH Office of Health Facility Complaints)

     MDH substantiated this complaint. The finding and its severity are in MDH's investigation report (linked).

     Statement of deficiencies (PDF)

Owners and managers (as published by CMS)

• HALPERT, MARC — 5% or greater indirect ownership interest, 28%, since 12/29/2017
• HALPERT, MARC — corporate officer, NOT APPLICABLE, since 12/29/2017
• JAFFA, NOAM — corporate director, NOT APPLICABLE, since 12/29/2017
• JAFFA, NOAM — 5% or greater indirect ownership interest, 10%, since 12/29/2017
• LEGUM, JOSHUA — 5% or greater indirect ownership interest, 28%, since 12/29/2017
• LEGUM, JOSHUA — contracted managing employee, NOT APPLICABLE, since 12/29/2017
• STERN, WILLIAM — 5% or greater indirect ownership interest, 19%, since 12/29/2017
• STERN, WILLIAM — corporate officer, NOT APPLICABLE, since 12/29/2017
• JCA HOLDINGS LLC — 5% or greater direct ownership interest, 15%, since 12/29/2017
• MONARCH HEALTHCARE OPERATING V LLC — operational/managerial control, NOT APPLICABLE, since 12/29/2017
• NIJ LLC — 5% or greater direct ownership interest, 10%, since 12/29/2017
• SPARTAN HEALTHCARE LLC — 5% or greater direct ownership interest, 28%, since 12/29/2017
• WBS HOLDINGS LLC — 5% or greater direct ownership interest, 19%, since 12/29/2017
• YAZOMA HOLDINGS, LLC — 5% or greater direct ownership interest, 28%, since 12/29/2017