Deficiency Records for Vasona Creek Healthcare Center

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Updated as of April 01, 2024

A list of the most recent deficiencies for Vasona Creek 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?
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Health 2024-02-09 2024-03-04 Y
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Health 2024-02-09 2024-03-04 Y
Provide and implement an infection prevention and control program. Health 2024-02-09 2024-03-04 Y
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. Health 2024-01-11 2024-02-02 Y
Ensure services provided by the nursing facility meet professional standards of quality. Health 2024-01-11 2024-02-02 Y
Ensure services provided by the nursing facility meet professional standards of quality. Health 2023-12-27 2024-01-12 Y
Plan the resident's discharge to meet the resident's goals and needs. Health 2023-12-11 2024-01-08 Y
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Health 2023-12-11 2024-01-08 Y
Ensure services provided by the nursing facility meet professional standards of quality. Health 2023-12-28 2023-12-29 Y
Provide safe, appropriate dialysis care/services for a resident who requires such services. Health 2023-12-07 2023-12-20 Y
Respond appropriately to all alleged violations. Health 2023-11-16 2023-12-04 Y
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. Health 2023-11-15 2023-12-01 Y
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. Health 2023-11-06 2023-11-14 Y
Allow resident to participate in the development and implementation of his or her person-centered plan of care. Health 2023-10-12 2023-11-10 Y
Ensure services provided by the nursing facility meet professional standards of quality. Health 2023-09-29 2023-10-25 Y
Provide and implement an infection prevention and control program. Health 2023-07-12 2023-08-10 Y
Ensure services provided by the nursing facility meet professional standards of quality. Health 2023-05-01 2023-05-08 Y
Ensure that residents are fully informed and understand their health status, care and treatments. Health 2023-03-03 2023-04-07 Y
Plan the resident's discharge to meet the resident's goals and needs. Health 2023-03-03 2023-04-07 Y
Provide safe, appropriate pain management for a resident who requires such services. Health 2023-03-03 2023-04-07 Y
Provide medically-related social services to help each resident achieve the highest possible quality of life. Health 2023-03-03 2023-04-07 Y
Provide medically-related social services to help each resident achieve the highest possible quality of life. Health 2023-02-06 2023-02-24 Y
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Health 2023-02-06 2023-02-24 Y
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Health 2023-02-06 2023-02-24 Y
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. Health 2023-02-13 2023-02-23 Y
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2023-01-19 2023-02-17 Y
Provide or get specialized rehabilitative services as required for a resident. Health 2023-01-19 2023-02-17 Y
Provide and implement an infection prevention and control program. Health 2023-01-19 2023-02-17 Y
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Health 2023-01-13 2023-01-23 Y
Develop and implement policies and procedures to prevent abuse, neglect, and theft. Health 2022-11-01 2022-11-29 Y
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Health 2022-07-05 2022-07-29 Y
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 2022-07-05 2022-07-29 Y
Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy. Health 2022-06-02 2022-06-16 Y
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Health 2021-11-22 2022-01-20 N
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. Health 2021-11-22 2022-01-20 N
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. Health 2021-11-22 2022-01-20 N
Ensure each resident receives an accurate assessment. Health 2021-11-22 2022-01-20 N
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Health 2021-11-22 2022-01-20 N
Provide appropriate treatment and care according to orders, resident?s preferences and goals. Health 2021-11-22 2022-01-20 N
Provide safe, appropriate dialysis care/services for a resident who requires such services. Health 2021-11-22 2022-01-20 N
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Health 2021-11-22 2022-01-20 N
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. Health 2021-11-22 2022-01-20 N
Ensure medication error rates are not 5 percent or greater. Health 2021-11-22 2022-01-20 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 2021-11-22 2022-01-20 N
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Health 2021-11-22 2022-01-20 N
Provide and implement an infection prevention and control program. Health 2021-11-22 2022-01-20 N
Implement a program that monitors antibiotic use. Health 2021-11-22 2022-01-20 N
Report COVID19 data to residents and families. Health 2021-11-22 2022-01-20 N
Ensure resident rooms hold no more than 4 residents; for new construction after November 28, 2016, rooms hold no more than 2 residents. Health 2021-11-22 2022-01-20 N
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. Health 2021-11-22 2022-01-20 N
Use approved construction type or materials. Fire Safety 2021-11-23 2021-12-10 N
Properly install and monitor supervisory attachments on automatic sprinkler systems. Fire Safety 2021-11-23 2021-12-10 N
Inspect, test, and maintain automatic sprinkler systems. Fire Safety 2021-11-23 2021-12-10 N
Properly select, install, inspect, or maintain portable fire extinguishes. Fire Safety 2021-11-23 2021-12-10 N
Install corridor and hallway doors that block smoke. Fire Safety 2021-11-23 2021-12-10 N
Install smoke barrier doors that can resist smoke for at least 20 minutes. Fire Safety 2021-11-23 2021-12-10 N
Have simulated fire drills held at unexpected times. Fire Safety 2021-11-23 2021-12-10 N
Meet requirements for the use of electrical equipment. Fire Safety 2021-11-23 2021-12-10 N
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. Health 2021-08-18 2021-09-17 Y
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Health 2021-06-30 2021-07-23 Y
Ensure services provided by the nursing facility meet professional standards of quality. Health 2021-06-18 2021-07-17 Y
Provide emergency officials' contact information. Fire Safety 2019-07-17 2019-08-09 N
Conduct testing and exercise requirements. Fire Safety 2019-07-17 2019-08-09 N
Install corridor and hallway doors that block smoke. Fire Safety 2019-07-17 2019-08-09 N
Have generator or other power source capable of supplying service within 10 seconds. Fire Safety 2019-07-17 2019-08-09 N
Ensure proper usage of power strips and extension cords. Fire Safety 2019-07-17 2019-08-09 N
Keep residents' personal and medical records private and confidential. Health 2019-05-10 2019-06-04 N
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Health 2019-05-10 2019-06-04 N
Honor each resident's preferences, choices, values and beliefs. Health 2019-05-10 2019-06-04 N
Provide appropriate treatment and care according to orders, resident?s preferences and goals. Health 2019-05-10 2019-06-04 N
Provide appropriate pressure ulcer care and prevent new ulcers from developing. Health 2019-05-10 2019-06-04 N
Provide safe and appropriate respiratory care for a resident when needed. Health 2019-05-10 2019-06-04 N
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Health 2019-05-10 2019-06-04 N
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. Health 2019-05-10 2019-06-04 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 2019-05-10 2019-06-04 N
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Health 2019-05-10 2019-06-04 N
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Health 2019-05-10 2019-06-04 N
Provide and implement an infection prevention and control program. Health 2019-05-10 2019-06-04 N
Ensure resident rooms hold no more than 4 residents; for new construction after November 28, 2016, rooms hold no more than 2 residents. Health 2019-05-10 2019-06-04 N
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. Health 2019-05-10 2019-06-04 N
Have approved installation, maintenance and testing program for fire alarm systems. Fire Safety 2018-06-29 2018-07-11 N
Inspect, test, and maintain automatic sprinkler systems. Fire Safety 2018-06-29 2018-07-11 N
Properly select, install, inspect, or maintain portable fire extinguishes. Fire Safety 2018-06-29 2018-07-11 N
Install corridor and hallway doors that block smoke. Fire Safety 2018-06-29 2018-07-11 N
Ensure proper usage of power strips and extension cords. Fire Safety 2018-06-29 2018-07-11 N
Reasonably accommodate the needs and preferences of each resident. Health 2018-04-19 2018-05-31 N
Develop and implement policies and procedures to prevent abuse, neglect, and theft. Health 2018-04-19 2018-05-31 N
Provide appropriate treatment and care according to orders, resident?s preferences and goals. Health 2018-04-19 2018-05-31 N
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2018-04-19 2018-05-31 N
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Health 2018-04-19 2018-05-31 N
Ensure medication error rates are not 5 percent or greater. Health 2018-04-19 2018-05-31 N
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Health 2018-04-19 2018-05-31 N
Ensure resident rooms hold no more than 4 residents; for new construction after November 28, 2016, rooms hold no more than 2 residents. Health 2018-04-19 2018-05-31 N
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. Health 2018-04-19 2018-05-31 N