Deficiency Records for Baya Pointe Nursing and Rehabilitation Center
Updated as of April 01, 2024
A list of the most recent deficiencies for Baya Pointe Nursing and Rehabilitation 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? |
|---|---|---|---|---|
| Meet other general requirements. | Fire Safety | 2023-09-14 | 2023-10-14 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2023-07-07 | 2023-07-31 | Y |
| Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2023-07-07 | 2023-07-31 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-07-07 | 2023-07-31 | Y |
| Administer the facility in a manner that enables it to use its resources effectively and efficiently. | Health | 2023-07-07 | 2023-07-31 | Y |
| Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | Health | 2023-07-07 | 2023-07-31 | 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 | 2023-01-12 | 2023-02-21 | N |
| Provide and implement an infection prevention and control program. | Health | 2023-01-12 | 2023-02-21 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2023-01-10 | 2023-02-21 | N |
| Have properly sized and located compartments to protect residents from smoke. | Fire Safety | 2023-01-10 | 2023-02-21 | 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 | 2021-07-09 | 2021-08-09 | N |
| Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | Health | 2021-07-09 | 2021-08-09 | 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 | 2021-07-09 | 2021-08-09 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2019-11-25 | 2019-12-25 | N |
| Install proper backup exit lighting. | Fire Safety | 2019-11-25 | 2019-12-25 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2019-11-25 | 2019-12-25 | 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 | 2019-11-25 | 2019-12-25 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2019-11-25 | 2019-12-25 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2019-11-25 | 2019-12-25 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2019-11-25 | 2019-12-25 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2019-11-25 | 2019-12-25 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2019-11-25 | 2019-12-25 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2019-11-25 | 2019-12-25 | N |
| Ensure that testing and maintenance of electrical equipment is performed. | Fire Safety | 2019-11-25 | 2019-12-25 | N |
| Ensure that personnel concerned with handling of medical gases and cylinders are trained on the risk. | Fire Safety | 2019-11-25 | 2019-12-25 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2019-11-22 | 2019-12-16 | N |
| Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | Health | 2019-11-22 | 2019-12-16 | N |
| Provide safe, appropriate pain management for a resident who requires such services. | Health | 2019-11-22 | 2019-12-16 | N |
| Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | Health | 2019-11-22 | 2019-12-16 | 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 | 2019-11-22 | 2019-12-16 | N |
