Deficiency Records for Adrian Bay Rehab and Nursing Center
Updated as of June 01, 2019
This is not the most recent data for Adrian Bay Rehab and Nursing Center. For the most recent information, click here.
A list of the most recent deficiencies for Adrian Bay Rehab and Nursing 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? |
|---|---|---|---|---|
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2018-11-19 | 2018-12-26 | N |
| Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2018-11-19 | 2018-12-26 | N |
| Be properly staffed | Fire Safety | 2018-11-19 | 2018-12-26 | N |
| Ensure that sources of ignition are removed from patients receiving respiratory therapy. | Fire Safety | 2018-11-19 | 2018-12-26 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2018-11-16 | 2018-12-26 | N |
| Post a list of names, addresses, and telephone numbers of all pertinent State agencies and advocacy groups and a statement that the resident may file a complaint with the State Survey Agency. | Health | 2018-11-16 | 2018-12-26 | 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 | 2018-11-16 | 2018-12-26 | N |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2018-11-16 | 2018-12-26 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2018-11-16 | 2018-12-26 | N |
| Respond appropriately to all alleged violations. | Health | 2018-11-16 | 2018-12-26 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2018-11-16 | 2018-12-26 | N |
| Notify the resident or the resident?s representative in writing how long the nursing home will hold the resident?s bed in cases of transfer to a hospital or therapeutic leave. | Health | 2018-11-16 | 2018-12-26 | N |
| Assess the resident when there is a significant change in condition | Health | 2018-11-16 | 2018-12-26 | 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 | 2018-11-16 | 2018-12-26 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2018-11-16 | 2018-12-26 | N |
| Provide appropriate foot care. | Health | 2018-11-16 | 2018-12-26 | N |
| Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | Health | 2018-11-16 | 2018-12-26 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2018-11-16 | 2018-12-26 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2018-11-16 | 2018-12-26 | N |
| Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install | Health | 2018-11-16 | 2018-12-26 | N |
| Provide or obtain dental services for each resident. | Health | 2018-11-16 | 2018-12-26 | N |
| Implement a program that monitors antibiotic use. | Health | 2018-11-16 | 2018-12-26 | 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 | 2018-11-16 | 2018-12-26 | N |
| Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | Health | 2018-11-01 | 2018-12-03 | Y |
| Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards. | Health | 2018-11-01 | 2018-12-03 | Y |
| Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2018-10-03 | 2018-10-12 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2018-08-22 | 2018-09-15 | Y |
| Provide safe, appropriate pain management for a resident who requires such services. | Health | 2018-08-22 | 2018-09-15 | Y |
| Store, cook, and serve food in a safe and clean way. | Health | 2017-08-03 | 2017-10-23 | N |
| Have a program that investigates, controls and keeps infection from spreading. | Health | 2017-08-03 | 2017-10-23 | Y |
| Have a fire alarm with audible and visual signals that transmits the alarm automatically to notify emergency forces in event of fire. | Fire Safety | 2017-08-08 | 2017-09-28 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2017-08-08 | 2017-09-28 | N |
| Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards. | Health | 2017-08-03 | 2017-09-11 | N |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2017-08-03 | 2017-09-11 | N |
| Keep accurate, complete and organized clinical records on each resident that meet professional standards. | Health | 2017-08-03 | 2017-09-11 | N |
| Allow residents to easily view the results of the nursing home's most recent inspection. | Health | 2017-08-03 | 2017-09-11 | Y |
| Provide housekeeping and maintenance services. | Health | 2017-08-03 | 2017-09-11 | Y |
| Post nurse staffing information/data on a daily basis. | Health | 2017-08-03 | 2017-09-11 | Y |
| 1) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. | Health | 2017-03-29 | 2017-06-16 | Y |
| Develop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property. | Health | 2017-03-29 | 2017-06-16 | Y |
| Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. | Health | 2017-03-29 | 2017-06-16 | Y |
| Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. | Health | 2016-06-10 | 2016-08-18 | Y |
| An approved automatic sprinkler system connected to the fire alarm system. | Fire Safety | 2016-06-08 | 2016-07-08 | N |
| Automatic sprinkler systems that have been maintained in working order. | Fire Safety | 2016-06-08 | 2016-07-08 | N |
| Portable fire extinguishers. | Fire Safety | 2016-06-08 | 2016-07-08 | N |
| Properly protected cooking facilities. | Fire Safety | 2016-06-08 | 2016-07-08 | N |
| Properly installed electrical wiring and equipment. | Fire Safety | 2016-06-08 | 2016-07-08 | N |
| 1) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. | Health | 2016-06-10 | 2016-07-08 | Y |
| Develop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property. | Health | 2016-06-10 | 2016-07-08 | Y |
| Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2016-06-10 | 2016-07-08 | N |
| Provide necessary care and services to maintain or improve the highest well being of each resident . | Health | 2016-06-10 | 2016-07-08 | N |
| Ensure residents maintain acceptable nutritional status. | Health | 2016-06-10 | 2016-07-08 | N |
| Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses. | Health | 2016-06-10 | 2016-07-08 | N |
| Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. | Health | 2016-06-10 | 2016-07-08 | N |
| Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%. | Health | 2016-06-10 | 2016-07-08 | N |
| Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards. | Health | 2016-06-10 | 2016-07-08 | N |
| Have a program that investigates, controls and keeps infection from spreading. | Health | 2016-06-10 | 2016-07-08 | N |
| Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home. | Health | 2016-06-10 | 2016-07-08 | Y |
| Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature. | Health | 2016-06-10 | 2016-07-08 | Y |
| Store, cook, and serve food in a safe and clean way. | Health | 2016-06-10 | 2016-07-08 | Y |
