Deficiency Records for St Joseph's Rehabilitation and Residence
Updated as of April 01, 2024
A list of the most recent deficiencies for St Joseph's Rehabilitation and Residence. 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? |
|---|---|---|---|---|
| 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 | 2023-06-15 | 2023-07-31 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2023-06-15 | 2023-07-31 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-06-15 | 2023-07-31 | N |
| Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2023-06-15 | 2023-07-31 | 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 | 2023-06-15 | 2023-07-31 | N |
| Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. | Health | 2023-06-15 | 2023-07-31 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-06-15 | 2023-07-31 | N |
| Develop and maintain an Emergency Preparedness Program (EP). | Fire Safety | 2023-06-13 | 2023-07-24 | N |
| Conduct testing and exercise requirements. | Fire Safety | 2023-06-13 | 2023-07-24 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2023-06-13 | 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 | 2023-06-13 | 2023-07-24 | N |
| Have a complete alarm system manually initiated and initiated by fire sprinkler system connection. | Fire Safety | 2023-06-13 | 2023-07-24 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2023-06-13 | 2023-07-24 | N |
| Have properly sized and located compartments to protect residents from smoke. | Fire Safety | 2023-06-13 | 2023-07-24 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2023-06-13 | 2023-07-24 | N |
| Meet requirements for the installation and maintenance of electrical systems. | Fire Safety | 2023-06-13 | 2023-07-24 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-10-11 | 2022-11-04 | Y |
| Use approved construction type or materials. | Fire Safety | 2021-08-17 | 2021-09-30 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2021-08-17 | 2021-09-30 | N |
| Have properly located and lighted "Exit" signs. | Fire Safety | 2021-08-17 | 2021-09-30 | 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 | 2021-08-17 | 2021-09-30 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2021-08-17 | 2021-09-30 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2021-08-17 | 2021-09-30 | N |
| Have restrictions on the use of highly flammable decorations. | Fire Safety | 2021-08-17 | 2021-09-30 | N |
| Meet other general requirements. | Fire Safety | 2019-07-08 | 2019-08-27 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2019-07-08 | 2019-08-27 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2019-07-08 | 2019-08-27 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2019-07-08 | 2019-08-27 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2019-07-08 | 2019-08-27 | N |
| Meet requirements for the use of electrical equipment. | Fire Safety | 2019-07-08 | 2019-08-27 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2019-07-11 | 2019-08-22 | N |
