Deficiency Records for Woodland Manor
Updated as of August 01, 2020
This is not the most recent data for Woodland Manor. For the most recent information, click here.
A list of the most recent deficiencies for Woodland Manor. 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? |
|---|---|---|---|---|
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2019-09-04 | 2019-09-05 | Y |
| Conduct testing and exercise requirements. | Fire Safety | 2019-07-29 | 2019-08-28 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2019-07-29 | 2019-08-28 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2019-07-29 | 2019-08-28 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2019-07-29 | 2019-08-28 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2019-07-29 | 2019-08-28 | N |
| Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. | Fire Safety | 2019-07-29 | 2019-08-28 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2019-07-29 | 2019-08-28 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2019-07-29 | 2019-08-28 | N |
| Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged. | Health | 2019-06-17 | 2019-07-17 | 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 | 2019-06-17 | 2019-07-17 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2019-06-17 | 2019-07-17 | 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 | 2019-06-17 | 2019-07-17 | N |
| Provide or obtain dental services for each resident. | Health | 2019-06-17 | 2019-07-17 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2019-06-17 | 2019-07-17 | N |
| Provide and implement an infection prevention and control program. | Health | 2019-06-17 | 2019-07-17 | N |
| Develop and implement policies and procedures for flu and pneumonia vaccinations. | Health | 2019-06-17 | 2019-07-17 | N |
| Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | Health | 2019-06-17 | 2019-07-17 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2019-06-17 | 2019-07-17 | Y |
| Provide appropriate foot care. | Health | 2019-06-17 | 2019-07-17 | Y |
| Ensure each resident must receive and the facility must provide necessary behavioral health care and services. | Health | 2019-06-17 | 2019-07-17 | Y |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2019-06-17 | 2019-07-17 | Y |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2019-03-05 | 2019-04-04 | Y |
| Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | Health | 2018-12-18 | 2019-01-11 | Y |
| 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 | 2018-12-18 | 2019-01-11 | Y |
| Post nurse staffing information every day. | Health | 2018-12-18 | 2019-01-11 | Y |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2018-12-18 | 2019-01-11 | Y |
| Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | Health | 2018-12-18 | 2019-01-11 | Y |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2018-08-28 | 2018-09-27 | Y |
| Provide and implement an infection prevention and control program. | Health | 2018-08-28 | 2018-09-27 | Y |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2018-07-10 | 2018-09-05 | N |
| Establish policies and procedures for sheltering. | Fire Safety | 2018-07-10 | 2018-08-17 | N |
| Establish roles under a Waiver declared by secretary. | Fire Safety | 2018-07-10 | 2018-08-17 | N |
| Provide primary/alternate means for communication. | Fire Safety | 2018-07-10 | 2018-08-17 | N |
| Establish methods for sharing information. | Fire Safety | 2018-07-10 | 2018-08-17 | N |
| Provide a means of sharing information on occupancy/needs. | Fire Safety | 2018-07-10 | 2018-08-17 | N |
| Provide family notifications of emergency plan. | Fire Safety | 2018-07-10 | 2018-08-17 | N |
| Have corridors or aisles that are unobstructed and are at least 8 feet in width. | Fire Safety | 2018-07-10 | 2018-08-17 | 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 | 2018-07-10 | 2018-08-17 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2018-07-10 | 2018-08-17 | N |
| Follow proper procedures when the fire alarm was out of service for more than 4 hours. | Fire Safety | 2018-07-10 | 2018-08-17 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2018-07-10 | 2018-08-17 | N |
| Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours. | Fire Safety | 2018-07-10 | 2018-08-17 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2018-07-10 | 2018-08-17 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2018-07-10 | 2018-08-17 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2018-07-10 | 2018-08-17 | N |
| Provide a written emergency evacuation plan. | Fire Safety | 2018-07-10 | 2018-08-17 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2018-07-10 | 2018-08-17 | N |
| Have restrictions on the use of highly flammable decorations. | Fire Safety | 2018-07-10 | 2018-08-17 | N |
| Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | Health | 2018-06-29 | 2018-07-29 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2018-06-29 | 2018-07-29 | N |
| Assess the resident when there is a significant change in condition | Health | 2018-06-29 | 2018-07-29 | N |
| Ensure each resident receives an accurate assessment. | Health | 2018-06-29 | 2018-07-29 | N |
| Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | Health | 2018-06-29 | 2018-07-29 | 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 | 2018-06-29 | 2018-07-29 | N |
| Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | Health | 2018-06-29 | 2018-07-29 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2018-06-29 | 2018-07-29 | N |
| 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 | 2018-06-29 | 2018-07-29 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2018-06-29 | 2018-07-29 | 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 | 2018-06-29 | 2018-07-29 | N |
| Provide or obtain dental services for each resident. | Health | 2018-06-29 | 2018-07-29 | N |
| Provide and implement an infection prevention and control program. | Health | 2018-06-29 | 2018-07-29 | N |
| Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements. | Fire Safety | 2017-09-05 | 2017-09-27 | N |
| Have corridors or aisles that are unobstructed and are at least 8 feet in width. | Fire Safety | 2017-09-05 | 2017-09-27 | N |
| Have protected exits that allow the resident to escape the building. | Fire Safety | 2017-09-05 | 2017-09-27 | 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 | 2017-09-05 | 2017-09-27 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2017-09-05 | 2017-09-27 | N |
| Follow proper procedures when the fire alarm was out of service for more than 4 hours. | Fire Safety | 2017-09-05 | 2017-09-27 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2017-09-05 | 2017-09-27 | N |
| Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours. | Fire Safety | 2017-09-05 | 2017-09-27 | N |
| Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke. | Fire Safety | 2017-09-05 | 2017-09-27 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2017-09-05 | 2017-09-27 | N |
| Install smoke barrier doors that can resist smoke for at least 20 minutes. | Fire Safety | 2017-09-05 | 2017-09-27 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2017-09-05 | 2017-09-27 | N |
| Provide a written emergency evacuation plan. | Fire Safety | 2017-09-05 | 2017-09-27 | N |
| Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2017-09-05 | 2017-09-27 | N |
| Have restrictions on the use of highly flammable decorations. | Fire Safety | 2017-09-05 | 2017-09-27 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2017-09-05 | 2017-09-27 | N |
| Have proper fire barriers, ventilation and signs for the transfilling of oxygen. | Fire Safety | 2017-09-05 | 2017-09-27 | N |
| Ensure residents have the right to have a choice over activities, their schedules, and health care according to their interests, assessments, and plans of care. | Health | 2017-07-28 | 2017-08-27 | N |
| Provide necessary care and services to maintain or improve the highest well being of each resident . | Health | 2017-07-28 | 2017-08-27 | N |
| Ensure that residents receive proper treatment and assistive devices to maintain their vision and hearing. | Health | 2017-07-28 | 2017-08-27 | N |
| At least once a month, have a licensed pharmacist review each resident's medication(s) and report any irregularities to the attending doctor. | Health | 2017-07-28 | 2017-08-27 | N |
| Have a program that investigates, controls and keeps infection from spreading. | Health | 2017-07-28 | 2017-08-27 | N |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2017-07-28 | 2017-08-27 | N |
| Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. | Health | 2017-07-28 | 2017-08-27 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2017-07-18 | 2017-08-11 | Y |
| Provide timely notification to the resident before transfer or discharge. | Health | 2017-07-18 | 2017-08-11 | Y |
| Protect each resident from all abuse, physical punishment, and involuntary separation from others. | Health | 2017-07-18 | 2017-08-11 | Y |
| Provide care by qualified persons according to each resident's written plan of care. | Health | 2017-07-18 | 2017-08-11 | Y |
