Deficiency Records for The Green House Cottages of Belle Meade
Updated as of March 01, 2024
A list of the most recent deficiencies for The Green House Cottages of Belle Meade. The list is based on the information provided by CMS from both standard inspections and from complaints filed by residents.
| Deficiency | Type of Deficiency | Deficiency Date | Date Corrected | Resulted from a Complaint? |
|---|---|---|---|---|
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2023-02-03 | 2023-03-04 | N |
| Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | Health | 2023-02-03 | 2023-02-27 | N |
| Ensure each resident receives an accurate assessment. | Health | 2023-02-03 | 2023-02-27 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-02-03 | 2023-02-27 | N |
| Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | Health | 2023-02-03 | 2023-02-27 | N |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2023-02-03 | 2023-02-27 | N |
| Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | Health | 2023-02-03 | 2023-02-27 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-02-03 | 2023-02-27 | N |
| Have a plan that describes the process for conducting QAPI and QAA activities. | Health | 2023-02-03 | 2023-02-27 | N |
| Provide and implement an infection prevention and control program. | Health | 2023-02-03 | 2023-02-27 | N |
| 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. | Health | 2023-02-03 | 2023-02-27 | N |
| Ensure staff are vaccinated for COVID-19 | Health | 2023-02-03 | 2023-02-27 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2023-02-03 | 2023-02-27 | Y |
| Ensure staff are vaccinated for COVID-19 | Health | 2022-05-11 | 2022-06-03 | Y |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2022-02-02 | 2022-03-01 | Y |
| Report COVID19 data to residents and families. | Health | 2022-02-02 | 2022-03-01 | Y |
| Provide and implement an infection prevention and control program. | Health | 2021-10-07 | 2021-11-05 | Y |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2021-08-13 | 2021-09-12 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2021-08-13 | 2021-09-12 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2021-08-13 | 2021-09-12 | N |
| Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | Health | 2021-08-13 | 2021-09-12 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2021-08-13 | 2021-09-12 | N |
| Provide and implement an infection prevention and control program. | Health | 2021-08-13 | 2021-09-12 | N |
| Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. | Fire Safety | 2021-08-12 | 2021-09-12 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2021-08-12 | 2021-09-12 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2021-08-12 | 2021-09-12 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2021-08-12 | 2021-09-12 | N |
| Post a list of names, addresses, and telephone numbers of all pertinent State agencies and advocacy groups and a statement that the resident may file a complaint with the State Survey Agency. | Health | 2021-08-13 | 2021-08-13 | N |
| 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. | Health | 2021-08-13 | 2021-08-13 | N |
| Ensure each resident receives an accurate assessment. | Health | 2020-03-06 | 2020-04-06 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2020-03-06 | 2020-04-06 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2020-03-06 | 2020-04-06 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2020-03-06 | 2020-04-06 | N |
| 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. | Health | 2020-03-06 | 2020-04-06 | N |
| Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | Health | 2020-03-06 | 2020-04-06 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2020-03-06 | 2020-04-06 | N |
| Provide and implement an infection prevention and control program. | Health | 2020-03-06 | 2020-04-06 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2020-03-02 | 2020-04-06 | N |
| 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. | Health | 2020-03-06 | 2020-03-06 | N |
| Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. | Health | 2020-03-06 | 2020-03-06 | N |
