Deficiency Records for Aspen Hill Rehabiliation and Healthcare Center
Updated as of April 01, 2024
A list of the most recent deficiencies for Aspen Hill Rehabiliation and Healthcare Center. 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? |
|---|---|---|---|---|
| Keep residents' personal and medical records private and confidential. | Health | 2024-01-25 | 2024-03-05 | 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 | 2024-01-25 | 2024-03-05 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2024-01-25 | 2024-03-05 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2024-01-25 | 2024-03-05 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2024-01-25 | 2024-03-05 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2024-01-25 | 2024-03-05 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2024-01-25 | 2024-03-05 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2024-01-25 | 2024-03-05 | 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 | 2024-01-25 | 2024-03-05 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2024-01-25 | 2024-03-05 | N |
| Provide for the safe, appropriate administration of IV fluids for a resident when needed. | Health | 2024-01-25 | 2024-03-05 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2024-01-25 | 2024-03-05 | N |
| Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | Health | 2024-01-25 | 2024-03-05 | 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 | 2024-01-25 | 2024-03-05 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2024-01-25 | 2024-03-05 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2024-01-25 | 2024-03-05 | 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 | 2024-01-25 | 2024-03-05 | N |
| Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | Health | 2024-01-25 | 2024-03-05 | N |
| Dispose of garbage and refuse properly. | Health | 2024-01-25 | 2024-03-05 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2024-01-25 | 2024-03-05 | N |
| Provide and implement an infection prevention and control program. | Health | 2024-01-25 | 2024-03-05 | N |
| Implement a program that monitors antibiotic use. | Health | 2024-01-25 | 2024-03-05 | N |
| Meet other general requirements. | Fire Safety | 2024-02-06 | 2024-03-05 | N |
| Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. | Health | 2023-09-19 | 2023-10-27 | Y |
| Have an externally vented heating system. | Fire Safety | 2022-12-06 | 2023-01-13 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-12-06 | 2022-12-23 | N |
| Have elevators that firefighters can control in the event of a fire. | Fire Safety | 2022-12-06 | 2022-12-13 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2022-11-17 | 2022-12-09 | 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 | 2022-11-17 | 2022-12-09 | 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 | 2022-11-17 | 2022-12-09 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2022-11-17 | 2022-12-09 | N |
| Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | Health | 2022-11-17 | 2022-12-09 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-11-17 | 2022-12-09 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2022-11-17 | 2022-12-09 | 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 | 2022-11-17 | 2022-12-09 | N |
| Provide care or services that was trauma informed and/or culturally competent. | Health | 2022-11-17 | 2022-12-09 | N |
| Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame. | Health | 2022-11-17 | 2022-12-09 | N |
| Let each resident or the resident's legal representative access or purchase copies of all the resident's records. | Health | 2022-08-31 | 2022-09-22 | Y |
| Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. | Health | 2021-11-16 | 2021-12-22 | Y |
| Meet other general requirements. | Fire Safety | 2021-05-04 | 2021-06-18 | 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 | 2021-05-04 | 2021-05-25 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2021-05-04 | 2021-05-25 | 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 | 2021-04-20 | 2021-05-17 | N |
| Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | Health | 2021-04-20 | 2021-05-17 | N |
| Ensure each resident receives an accurate assessment. | Health | 2021-04-20 | 2021-05-17 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2021-04-20 | 2021-05-17 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2021-04-20 | 2021-05-17 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2021-04-20 | 2021-05-17 | 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 | 2021-04-20 | 2021-05-17 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2021-04-20 | 2021-05-17 | N |
| Provide and implement an infection prevention and control program. | Health | 2021-04-20 | 2021-05-17 | N |
