A list of the most recent deficiencies for Hamilton Grove. 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? |
---|---|---|---|---|
Install corridor and hallway doors that block smoke. | Fire Safety | 2023-04-26 | 2023-08-11 | N |
Conduct risk assessment and an All-Hazards approach. | Fire Safety | 2023-04-26 | 2023-07-24 | N |
Address subsistence needs for staff and patients. | Fire Safety | 2023-04-26 | 2023-07-24 | N |
Establish procedures for tracking staff and patients during an emergency. | Fire Safety | 2023-04-26 | 2023-07-24 | N |
Establish policies and procedures for volunteers. | Fire Safety | 2023-04-26 | 2023-07-24 | N |
Provide primary/alternate means for communication. | Fire Safety | 2023-04-26 | 2023-07-24 | N |
Provide family notifications of emergency plan. | Fire Safety | 2023-04-26 | 2023-07-24 | N |
Implement emergency and standby power systems. | Fire Safety | 2023-04-26 | 2023-07-24 | 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 | 2023-04-26 | 2023-07-24 | N |
Have exits that are accessible at all times. | Fire Safety | 2023-04-26 | 2023-07-24 | 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 | 2023-04-26 | 2023-07-24 | N |
Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2023-04-26 | 2023-07-24 | N |
Have simulated fire drills held at unexpected times. | Fire Safety | 2023-04-26 | 2023-07-24 | N |
Provide properly sized and located linen or trash receptacles. | Fire Safety | 2023-04-26 | 2023-07-24 | N |
Have restrictions on the use of portable space heaters. | Fire Safety | 2023-04-26 | 2023-07-24 | N |
Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2023-04-26 | 2023-07-24 | N |
Ensure proper usage of power strips and extension cords. | Fire Safety | 2023-04-26 | 2023-07-24 | N |
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2023-04-04 | 2023-06-06 | 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 | 2023-04-04 | 2023-06-06 | N |
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2023-04-04 | 2023-06-06 | 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 | 2023-04-04 | 2023-06-06 | N |
Provide activities to meet all resident's needs. | Health | 2023-04-04 | 2023-06-06 | N |
Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-04-04 | 2023-06-06 | N |
Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2023-04-04 | 2023-06-06 | N |
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-04-04 | 2023-06-06 | 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 | 2023-04-04 | 2023-06-06 | N |
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2023-04-04 | 2023-06-06 | N |
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-04-04 | 2023-06-06 | N |
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2022-07-06 | 2022-07-07 | Y |
Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2022-07-06 | 2022-07-07 | Y |
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2022-07-06 | 2022-07-07 | Y |
Respond appropriately to all alleged violations. | Health | 2022-07-06 | 2022-07-07 | Y |
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2022-04-26 | 2022-06-21 | Y |
The resident has the right to receive notices in a format and a language he or she understands. | Health | 2022-04-26 | 2022-06-21 | N |
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | Health | 2022-04-26 | 2022-06-21 | N |
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2022-04-26 | 2022-06-21 | 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 | 2022-04-26 | 2022-06-21 | N |
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2022-04-26 | 2022-06-21 | 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 | 2022-04-26 | 2022-06-21 | N |
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2022-04-26 | 2022-06-21 | N |
Notify the resident or the resident?s representative in writing how long the nursing home will hold the resident?s bed in cases of transfer to a hospital or therapeutic leave. | Health | 2022-04-26 | 2022-06-21 | N |
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-04-26 | 2022-06-21 | 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 | 2022-04-26 | 2022-06-21 | N |
Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2022-04-26 | 2022-06-21 | N |
Provide activities to meet all resident's needs. | Health | 2022-04-26 | 2022-06-21 | N |
Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-04-26 | 2022-06-21 | N |
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-04-26 | 2022-06-21 | 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 | 2022-04-26 | 2022-06-21 | 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 | 2022-04-26 | 2022-06-21 | N |
Provide safe and appropriate respiratory care for a resident when needed. | Health | 2022-04-26 | 2022-06-21 | N |
Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia. | Health | 2022-04-26 | 2022-06-21 | 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 | 2022-04-26 | 2022-06-21 | 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 | 2022-04-26 | 2022-06-21 | N |
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | Health | 2022-04-26 | 2022-06-21 | N |
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-04-26 | 2022-06-21 | N |
Conduct testing and exercise requirements. | Fire Safety | 2022-05-16 | 2022-06-15 | N |
Meet other general requirements. | Fire Safety | 2022-05-16 | 2022-06-15 | N |
Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2022-05-16 | 2022-06-15 | N |
Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2022-05-16 | 2022-06-15 | N |
Install a fire alarm system that can be heard throughout the facility. | Fire Safety | 2022-05-16 | 2022-06-15 | N |
Follow proper procedures when the fire alarm was out of service for more than 4 hours. | Fire Safety | 2022-05-16 | 2022-06-15 | N |
Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-05-16 | 2022-06-15 | N |
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours. | Fire Safety | 2022-05-16 | 2022-06-15 | N |
Have simulated fire drills held at unexpected times. | Fire Safety | 2022-05-16 | 2022-06-15 | N |
Provide and implement an infection prevention and control program. | Health | 2021-12-09 | 2022-01-03 | N |
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2021-04-02 | 2021-05-02 | Y |
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Health | 2021-04-02 | 2021-05-02 | Y |
Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2021-04-02 | 2021-05-02 | Y |
Provide safe, appropriate pain management for a resident who requires such services. | Health | 2021-04-02 | 2021-05-02 | Y |
Have corridors or aisles that are unobstructed and are at least 8 feet in width. | Fire Safety | 2020-03-09 | 2020-04-08 | N |
Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2020-03-09 | 2020-04-08 | N |
Follow proper procedures when the fire alarm was out of service for more than 4 hours. | Fire Safety | 2020-03-09 | 2020-04-08 | N |
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours. | Fire Safety | 2020-03-09 | 2020-04-08 | N |
Install corridor and hallway doors that block smoke. | Fire Safety | 2020-03-09 | 2020-04-08 | N |
To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2020-03-09 | 2020-04-08 | 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 | 2020-01-13 | 2020-02-12 | N |
PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2020-01-13 | 2020-02-12 | N |
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2020-01-13 | 2020-02-12 | N |
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2020-01-13 | 2020-02-12 | N |