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Deficiency Records for The Orchards at Three Rivers
View the most recent health deficiencies and inspection results for The Orchards at Three Rivers. Stay informed about quality of care issues.
View the most recent health deficiencies and inspection results for The Orchards at Three Rivers. Stay informed about quality of care issues.
| 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 | 2026-03-05 | 2026-03-30 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2026-03-05 | 2026-03-30 | Y |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2025-12-23 | 2026-01-20 | Y |
| Ensure that residents are fully informed and understand their health status, care and treatments. | Health | 2025-12-23 | 2026-01-20 | Y |
| 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 | 2025-12-23 | 2026-01-20 | Y |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2025-12-23 | 2026-01-20 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2025-12-23 | 2026-01-20 | Y |
| Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | Health | 2025-12-23 | 2026-01-20 | Y |
| Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | Health | 2025-12-23 | 2026-01-20 | Y |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2025-12-23 | 2026-01-20 | Y |
| Administer the facility in a manner that enables it to use its resources effectively and efficiently. | Health | 2025-12-23 | 2026-01-20 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2025-11-25 | 2026-01-20 | Y |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2025-11-25 | 2025-11-26 | Y |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2025-11-25 | 2025-11-26 | Y |
| Respond appropriately to all alleged violations. | Health | 2025-11-25 | 2025-11-26 | Y |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2025-11-25 | 2025-11-26 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2025-11-25 | 2025-11-26 | Y |
| Ensure that the facility has sufficient staff members who possess the competencies and skills to meet the behavioral health needs of residents. | Health | 2025-11-25 | 2025-11-26 | Y |
| Reasonably accommodate the needs and preferences of each resident. | Health | 2025-10-30 | 2025-11-20 | Y |
| Provide activities to meet all resident's needs. | Health | 2025-10-30 | 2025-11-20 | Y |
| Observe each nurse aide's job performance and give regular training. | Health | 2025-10-30 | 2025-11-20 | Y |
| Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia. | Health | 2025-10-30 | 2025-11-20 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2025-10-30 | 2025-11-20 | Y |
| Have a plan that describes the process for conducting QAPI and QAA activities. | Health | 2025-10-30 | 2025-11-20 | Y |
| Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | Health | 2025-10-30 | 2025-11-20 | Y |
| Develop, implement, and/or maintain an effective training program for all new and existing staff members. | Health | 2025-10-30 | 2025-11-20 | Y |
| Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention. | Health | 2025-10-30 | 2025-11-20 | Y |
| Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. | Health | 2025-10-30 | 2025-10-31 | Y |
| Provide care by qualified persons according to each resident's written plan of care. | Health | 2025-08-04 | 2025-08-29 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2025-08-04 | 2025-08-29 | Y |
| Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2025-08-04 | 2025-08-29 | Y |
| 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 | 2025-08-04 | 2025-08-29 | Y |
| Administer the facility in a manner that enables it to use its resources effectively and efficiently. | Health | 2025-08-04 | 2025-08-29 | Y |
| Provide and implement an infection prevention and control program. | Health | 2025-08-04 | 2025-08-29 | Y |
| Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | Health | 2025-04-03 | 2025-04-18 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2025-04-03 | 2025-04-18 | Y |
| Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Health | 2025-04-03 | 2025-04-18 | Y |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2025-04-03 | 2025-04-18 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2025-04-03 | 2025-04-18 | Y |
| Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. | Health | 2025-04-03 | 2025-04-18 | Y |
| Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | Health | 2025-04-03 | 2025-04-18 | Y |
| Provide and implement an infection prevention and control program. | Health | 2025-04-03 | 2025-04-18 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2024-11-15 | 2024-12-13 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2024-11-15 | 2024-12-13 | N |
| Provide and implement an infection prevention and control program. | Health | 2024-11-15 | 2024-12-13 | N |
| Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. | Health | 2024-11-15 | 2024-12-13 | N |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2024-11-15 | 2024-12-13 | N |
| Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation. | Health | 2024-11-15 | 2024-12-13 | N |
| Provide behavior health training consistent with the requirements and as determined by a facility assessment. | Health | 2024-11-15 | 2024-12-13 | N |
| Conduct risk assessment and an All-Hazards approach. | Fire Safety | 2024-11-15 | 2024-12-13 | 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 | 2024-11-15 | 2024-12-13 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2024-11-15 | 2024-12-13 | N |
| Develop and maintain an Emergency Preparedness Program (EP). | Fire Safety | 2024-11-15 | 2024-12-13 | N |
| Conduct testing and exercise requirements. | Fire Safety | 2024-11-15 | 2024-12-13 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2024-11-15 | 2024-12-13 | 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 | 2024-11-15 | 2024-12-13 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2024-11-15 | 2024-12-13 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2024-11-15 | 2024-12-13 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2024-11-15 | 2024-12-13 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2024-11-15 | 2024-12-13 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2024-11-15 | 2024-12-13 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2024-06-13 | 2024-07-12 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2024-06-13 | 2024-07-12 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2024-06-13 | 2024-07-12 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2024-03-21 | 2024-04-09 | Y |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2023-10-04 | 2023-10-30 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2023-10-04 | 2023-10-30 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2023-10-04 | 2023-10-30 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2023-10-04 | 2023-10-30 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-10-04 | 2023-10-30 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2023-10-04 | 2023-10-30 | N |
| Provide and implement an infection prevention and control program. | Health | 2023-10-04 | 2023-10-30 | 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 | 2022-07-14 | 2022-08-11 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-07-14 | 2022-08-11 | N |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2022-07-14 | 2022-08-11 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-07-14 | 2022-08-11 | N |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2022-07-14 | 2022-08-11 | N |
| Have exits that are accessible at all times. | Fire Safety | 2022-07-14 | 2022-08-10 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2022-07-14 | 2022-08-10 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2022-07-14 | 2022-08-10 | N |