A list of the most recent deficiencies for Creekside Healthcare Center. 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? |
|---|---|---|---|---|
| Honor the resident's right to receive visitors of his or her choosing, at the time of his or her choosing. | Health | 2022-08-22 | 2022-09-02 | Y |
| Ensure staff are vaccinated for COVID-19 | Health | 2022-08-22 | 2022-09-02 | Y |
| Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2022-05-05 | 2022-06-04 | N |
| Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Health | 2022-05-05 | 2022-06-04 | 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 | 2022-05-05 | 2022-06-04 | 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 | 2022-05-05 | 2022-06-04 | N |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2022-05-05 | 2022-06-04 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-05-05 | 2022-06-04 | N |
| Develop and implement policies and procedures for flu and pneumonia vaccinations. | Health | 2022-05-05 | 2022-06-04 | N |
| Provide primary/alternate means for communication. | Fire Safety | 2022-05-10 | 2022-05-23 | N |
| Use approved construction type or materials. | Fire Safety | 2022-05-10 | 2022-05-23 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2022-05-10 | 2022-05-23 | N |
| Have properly located and lighted "Exit" signs. | Fire Safety | 2022-05-10 | 2022-05-23 | 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 | 2022-05-10 | 2022-05-23 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2022-05-10 | 2022-05-23 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-05-10 | 2022-05-23 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2022-05-10 | 2022-05-23 | N |
| Meet requirements for the use of electrical equipment. | Fire Safety | 2022-05-10 | 2022-05-23 | N |
| Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2022-02-01 | 2022-03-02 | Y |
| Provide appropriate foot care. | Health | 2021-12-08 | 2022-01-14 | Y |
| Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. | Fire Safety | 2019-09-17 | 2019-10-11 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2019-09-17 | 2019-10-11 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2019-09-17 | 2019-10-11 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2019-09-17 | 2019-10-11 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2019-09-17 | 2019-10-11 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2019-09-17 | 2019-10-11 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2019-09-17 | 2019-10-11 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2019-09-17 | 2019-10-11 | 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 | 2019-08-15 | 2019-09-13 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2019-08-15 | 2019-09-13 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2019-08-15 | 2019-09-13 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2019-08-15 | 2019-09-13 | N |
| Conduct risk assessment and an All-Hazards approach. | Fire Safety | 2018-11-14 | 2018-12-11 | N |
| Use approved construction type or materials. | Fire Safety | 2018-11-14 | 2018-12-11 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2018-11-14 | 2018-12-11 | 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 | 2018-11-14 | 2018-12-11 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2018-11-14 | 2018-12-11 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2018-11-14 | 2018-12-11 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2018-11-14 | 2018-12-11 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2018-11-14 | 2018-12-11 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2018-11-14 | 2018-12-11 | N |
| Meet other general requirements that are deficient. | Fire Safety | 2018-11-14 | 2018-12-11 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2018-11-14 | 2018-12-11 | N |
| Ensure that any exit in an area undergoing construction, repair, or improvements shall be inspected daily to ensure its ability to be used instantly in case of emergency. | Fire Safety | 2018-11-14 | 2018-12-11 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2018-11-14 | 2018-12-11 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2018-11-14 | 2018-12-11 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2018-11-14 | 2018-12-11 | 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 | 2018-09-13 | 2018-12-10 | N |
| Ensure that residents are free from significant medication errors. | Health | 2018-09-13 | 2018-12-10 | N |
| 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. | Health | 2018-09-13 | 2018-12-10 | N |
| Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. | Health | 2018-09-13 | 2018-12-10 | N |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2018-09-13 | 2018-12-10 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2018-09-13 | 2018-12-10 | N |
| Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations and emergencies. | Health | 2018-09-13 | 2018-12-10 | N |
| Keep all essential equipment working safely. | Health | 2018-09-13 | 2018-12-10 | N |
