Deficiency Records for The Pavilion

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Updated as of August 01, 2024

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Deficiency Records for The Pavilion

A list of the most recent deficiencies for The Pavilion. The list is based on the information provided by CMS from both standard inspections and from complaints filed by residents.

A list of the most recent deficiencies for The Pavilion. 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?
Provide safe and appropriate respiratory care for a resident when needed. Health 2024-06-13 2024-07-01 N
Provide care or services that was trauma informed and/or culturally competent. Health 2024-06-13 2024-07-01 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 2024-06-13 2024-07-01 N
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Health 2024-06-13 2024-07-01 N
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Fire Safety 2023-04-03 2023-05-17 N
Have approved installation, maintenance and testing program for fire alarm systems. Fire Safety 2023-04-03 2023-05-12 N
Implement emergency and standby power systems. Fire Safety 2023-04-03 2023-04-27 N
Have generator or other power source capable of supplying service within 10 seconds. Fire Safety 2023-04-03 2023-04-27 N
Provide properly protected cooking facilities. Fire Safety 2023-04-03 2023-04-14 N
Inspect, test, and maintain automatic sprinkler systems. Fire Safety 2023-04-03 2023-04-14 N
Properly select, install, inspect, or maintain portable fire extinguishes. Fire Safety 2023-04-03 2023-04-14 N
Have simulated fire drills held at unexpected times. Fire Safety 2023-04-03 2023-04-14 N
Have an enclosure around a vertical opening shaft. Fire Safety 2020-01-30 2020-02-17 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 2020-01-30 2020-02-17 N
Inspect, test, and maintain automatic sprinkler systems. Fire Safety 2020-01-30 2020-02-17 N
Have generator or other power source capable of supplying service within 10 seconds. Fire Safety 2020-01-30 2020-02-17 N
Ensure services provided by the nursing facility meet professional standards of quality. Health 2019-12-06 2020-01-10 N

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