A list of the most recent deficiencies for Sligo Creek Healthcare. 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? |
|---|---|---|---|---|
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2020-11-20 | 2020-12-21 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2020-11-20 | 2020-12-21 | 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 | 2020-11-20 | 2020-12-21 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2020-11-20 | 2020-12-21 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2020-11-20 | 2020-12-21 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2020-11-20 | 2020-12-21 | 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 | 2020-11-24 | 2020-12-21 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2020-11-24 | 2020-12-21 | N |
| Develop and maintain an Emergency Preparedness Program (EP). | Fire Safety | 2019-05-21 | 2019-06-26 | N |
| Establish emergency prep training and testing. | Fire Safety | 2019-05-21 | 2019-06-26 | N |
| Establish staff and initial training requirements. | Fire Safety | 2019-05-21 | 2019-06-26 | N |
| Conduct testing and exercise requirements. | Fire Safety | 2019-05-21 | 2019-06-26 | N |
| Meet requirements for the installation and maintenance of electrical systems. | Fire Safety | 2019-05-21 | 2019-06-26 | N |
| Ensure that testing and maintenance of electrical equipment is performed. | Fire Safety | 2019-05-21 | 2019-06-26 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2019-05-10 | 2019-06-14 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2019-05-10 | 2019-06-14 | 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 | 2019-05-10 | 2019-06-14 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2019-05-10 | 2019-06-14 | N |
| Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2019-05-10 | 2019-06-14 | 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 | 2019-05-10 | 2019-06-14 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2019-05-10 | 2019-06-14 | N |
| Have a policy regarding use and storage of foods brought to residents by family and other visitors. | Health | 2019-05-10 | 2019-06-14 | N |
| Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations and emergencies. | Health | 2019-05-10 | 2019-06-14 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2019-05-10 | 2019-06-14 | N |
| Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | Health | 2018-05-15 | 2018-06-22 | N |
| Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2018-05-15 | 2018-06-22 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2018-05-15 | 2018-06-22 | N |
| Respond appropriately to all alleged violations. | Health | 2018-05-15 | 2018-06-22 | N |
| Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | Health | 2018-05-15 | 2018-06-22 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2018-05-15 | 2018-06-22 | 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 | 2018-05-15 | 2018-06-22 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2018-05-15 | 2018-06-22 | N |
| Ensure that the resident and his/her doctor meet face-to-face at all required visits. | Health | 2018-05-15 | 2018-06-22 | 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 | 2018-05-15 | 2018-06-22 | 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 | 2018-05-15 | 2018-06-22 | N |
| Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs. | Health | 2018-05-15 | 2018-06-22 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2018-05-15 | 2018-06-22 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2018-05-16 | 2018-06-10 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2018-05-16 | 2018-06-10 | N |
