A list of the most recent deficiencies for Marshall Health Care and Rehab. 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? |
|---|---|---|---|---|
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2023-04-05 | 2023-05-08 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-04-05 | 2023-05-08 | N |
| Ensure that residents are fully informed and understand their health status, care and treatments. | Health | 2023-04-05 | 2023-05-05 | N |
| PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2023-04-05 | 2023-05-05 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2023-04-05 | 2023-05-05 | 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 | 2023-04-05 | 2023-05-05 | 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 | 2023-04-05 | 2023-05-05 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-04-05 | 2023-05-05 | N |
| Develop and maintain an Emergency Preparedness Program (EP). | Fire Safety | 2023-04-04 | 2023-05-03 | N |
| Conduct risk assessment and an All-Hazards approach. | Fire Safety | 2023-04-04 | 2023-05-03 | N |
| Establish staff and initial training requirements. | Fire Safety | 2023-04-04 | 2023-05-03 | N |
| Conduct testing and exercise requirements. | Fire Safety | 2023-04-04 | 2023-05-03 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2023-04-04 | 2023-05-03 | 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 | 2023-04-04 | 2023-05-03 | 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 | 2023-04-04 | 2023-05-03 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2023-04-04 | 2023-05-03 | N |
| Construct fire resistant interior walls. | Fire Safety | 2023-04-04 | 2023-05-03 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2023-04-04 | 2023-05-03 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2023-04-04 | 2023-05-03 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2023-04-04 | 2023-05-03 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2023-04-04 | 2023-05-03 | N |
| Have restrictions on the use of flammable curtains. | Fire Safety | 2023-04-04 | 2023-05-03 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2023-04-04 | 2023-05-03 | N |
| Ensure that any exit in an area undergoing construction, repair, or improvements shall be inspected daily to ensure its ability to be used instantly in case of emergency. | Fire Safety | 2023-04-04 | 2023-05-03 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2023-04-04 | 2023-05-03 | N |
| Meet requirements for the use of electrical equipment. | Fire Safety | 2023-04-04 | 2023-05-03 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2023-04-04 | 2023-05-03 | 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 | 2022-11-29 | 2022-12-23 | Y |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2022-11-29 | 2022-12-23 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-11-29 | 2022-12-16 | Y |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2022-04-20 | 2022-04-20 | Y |
| Keep residents' personal and medical records private and confidential. | Health | 2022-04-20 | 2022-04-19 | Y |
| Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2022-04-20 | 2022-04-19 | Y |
| Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | Health | 2021-12-15 | 2022-01-16 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2021-12-15 | 2022-01-16 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2021-12-15 | 2022-01-16 | N |
| Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit. | Health | 2021-12-15 | 2022-01-16 | N |
| Ensure that the resident and his/her doctor meet face-to-face at all required visits. | Health | 2021-12-15 | 2022-01-16 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2021-12-15 | 2022-01-16 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2021-12-15 | 2022-01-16 | N |
| Establish staff and initial training requirements. | Fire Safety | 2021-12-13 | 2021-12-21 | N |
| Conduct testing and exercise requirements. | Fire Safety | 2021-12-13 | 2021-12-21 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2021-12-13 | 2021-12-21 | N |
| Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | Health | 2020-01-29 | 2020-02-18 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2020-01-29 | 2020-02-18 | N |
| Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. | Health | 2020-01-29 | 2020-02-18 | N |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2020-01-29 | 2020-02-18 | N |
