A list of the most recent deficiencies for Millcroft Living. 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? |
|---|---|---|---|---|
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-10-19 | 2023-12-06 | N |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2023-10-19 | 2023-12-06 | Y |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2023-10-19 | 2023-12-06 | 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 | 2023-10-19 | 2023-12-06 | Y |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2023-10-19 | 2023-12-06 | Y |
| Ensure that nurse aides who have worked more than 4 months, are trained and competent; and nurse aides who have worked less than 4 months are enrolled in appropriate training. | Health | 2023-10-19 | 2023-12-06 | Y |
| Observe each nurse aide's job performance and give regular training. | Health | 2023-10-19 | 2023-12-06 | Y |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2023-10-19 | 2023-12-06 | Y |
| Ensure that residents are free from significant medication errors. | Health | 2023-10-19 | 2023-12-06 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2022-09-16 | 2022-10-28 | Y |
| Ensure each resident receives an accurate assessment. | Health | 2022-09-16 | 2022-10-28 | Y |
| Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | Health | 2022-09-16 | 2022-10-28 | Y |
| Provide or arrange emergency care by a doctor 24 hours a day. | Health | 2022-09-16 | 2022-10-28 | Y |
| Ensure that residents are free from significant medication errors. | Health | 2022-09-16 | 2022-10-28 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2022-09-16 | 2022-10-28 | Y |
| Provide and implement an infection prevention and control program. | Health | 2021-09-13 | 2021-11-01 | N |
| Perform COVID19 testing on residents and staff. | Health | 2021-09-13 | 2021-11-01 | N |
| Reasonably accommodate the needs and preferences of each resident. | Health | 2021-03-31 | 2021-05-28 | N |
| The resident has the right to receive notices in a format and a language he or she understands. | Health | 2021-03-31 | 2021-05-28 | N |
| Allow residents to easily view the nursing home's survey results and communicate with advocate agencies. | Health | 2021-03-31 | 2021-05-28 | N |
| Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | Health | 2021-03-31 | 2021-05-28 | N |
| Ensure each resident receives an accurate assessment. | Health | 2021-03-31 | 2021-05-28 | N |
| 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 | 2021-03-31 | 2021-05-28 | N |
| Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | Health | 2021-03-31 | 2021-05-28 | N |
| Provide and implement an infection prevention and control program. | Health | 2021-03-31 | 2021-05-28 | N |
| Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | Health | 2019-03-22 | 2019-05-22 | N |
| Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | Health | 2019-03-22 | 2019-05-22 | N |
| Reasonably accommodate the needs and preferences of each resident. | Health | 2019-03-22 | 2019-05-06 | N |
| Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | Health | 2019-03-22 | 2019-05-06 | 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 | 2019-03-22 | 2019-05-06 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2019-03-22 | 2019-05-06 | N |
| Ensure each resident receives an accurate assessment. | Health | 2019-03-22 | 2019-05-06 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2019-03-22 | 2019-05-06 | 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 | 2019-03-22 | 2019-05-06 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2019-03-22 | 2019-05-06 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2019-03-22 | 2019-05-06 | N |
| Provide safe, appropriate pain management for a resident who requires such services. | Health | 2019-03-22 | 2019-05-06 | N |
| Provide medically-related social services to help each resident achieve the highest possible quality of life. | Health | 2019-03-22 | 2019-05-06 | N |
| Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | Health | 2019-03-22 | 2019-05-06 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2019-03-22 | 2019-05-06 | N |
