A list of the most recent deficiencies for Mount Vernon Health Care 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? |
|---|---|---|---|---|
| Keep residents' personal and medical records private and confidential. | Health | 2023-09-26 | 2023-10-09 | Y |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2023-09-26 | 2023-10-09 | Y |
| Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | Health | 2023-06-02 | 2023-09-01 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2023-06-26 | 2023-07-07 | N |
| PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2023-06-02 | 2023-06-28 | N |
| Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | Health | 2023-06-02 | 2023-06-15 | N |
| Assess the resident when there is a significant change in condition | Health | 2023-06-02 | 2023-06-15 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-06-02 | 2023-06-15 | 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 | 2023-06-02 | 2023-06-15 | 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 | 2023-06-02 | 2023-06-15 | N |
| Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2022-07-26 | 2023-03-06 | N |
| Install proper backup exit lighting. | Fire Safety | 2022-07-26 | 2022-08-26 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2022-07-26 | 2022-08-26 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2022-07-26 | 2022-08-26 | N |
| Install smoke barrier doors that can resist smoke for at least 20 minutes. | Fire Safety | 2022-07-26 | 2022-08-26 | N |
| Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | Health | 2022-07-28 | 2022-08-19 | N |
| Ensure that each resident is free from medications that restrain them, unless needed for medical treatment. | Health | 2022-07-28 | 2022-08-19 | N |
| Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | Health | 2022-07-28 | 2022-08-19 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-07-28 | 2022-08-19 | N |
| Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. | Health | 2022-07-28 | 2022-08-19 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-07-28 | 2022-08-19 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-07-28 | 2022-08-19 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2022-07-28 | 2022-08-19 | N |
| Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | Health | 2022-07-28 | 2022-08-19 | N |
| Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia. | Health | 2022-07-28 | 2022-08-19 | 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 | 2022-07-28 | 2022-08-19 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2022-07-28 | 2022-08-19 | N |
| Ensure that residents are free from significant medication errors. | Health | 2022-07-28 | 2022-08-19 | 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 | 2022-07-28 | 2022-08-19 | N |
| Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | Health | 2022-07-28 | 2022-08-19 | N |
| Develop and implement policies and procedures for flu and pneumonia vaccinations. | Health | 2022-07-28 | 2022-08-19 | N |
| Protect each resident from the wrongful use of the resident's belongings or money. | Health | 2022-07-01 | 2022-07-22 | Y |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2022-07-01 | 2022-07-01 | Y |
| Conduct risk assessment and an All-Hazards approach. | Fire Safety | 2021-09-28 | 2021-10-18 | N |
| Create arrangements with other facilities to receive patients. | Fire Safety | 2021-09-28 | 2021-10-18 | N |
| Provide a means of sharing information on occupancy/needs. | Fire Safety | 2021-09-28 | 2021-10-18 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2021-09-28 | 2021-10-18 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2021-09-28 | 2021-10-18 | N |
| Install smoke barrier doors that can resist smoke for at least 20 minutes. | Fire Safety | 2021-09-28 | 2021-10-18 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2021-09-28 | 2021-10-18 | N |
| Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2021-09-28 | 2021-10-18 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2021-09-30 | 2021-10-14 | 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 | 2021-09-30 | 2021-10-14 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2021-09-30 | 2021-10-14 | N |
| Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | Health | 2021-09-30 | 2021-10-14 | N |
| Post nurse staffing information every day. | Health | 2021-09-30 | 2021-10-14 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2021-09-30 | 2021-10-14 | N |
| Perform COVID19 testing on residents and staff. | Health | 2021-09-30 | 2021-10-14 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2021-04-21 | 2021-04-28 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2021-03-03 | 2021-03-15 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2021-03-03 | 2021-03-15 | Y |
