Deficiency Records for Mission Point Nsg and Phy Rehab Ctr of Elmwood
Updated as of September 01, 2021
This is not the most recent data for Mission Point Nsg and Phy Rehab Ctr of Elmwood. For the most recent information, click here.
A list of the most recent deficiencies for Mission Point Nsg and Phy Rehab Ctr of Elmwood. 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 appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2021-05-11 | 2021-05-14 | Y |
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2021-05-11 | 2021-05-14 | Y |
Develop and maintain an Emergency Preparedness Program (EP). | Fire Safety | 2021-03-03 | 2021-04-16 | N |
Establish roles under a Waiver declared by secretary. | Fire Safety | 2021-03-03 | 2021-04-16 | N |
Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2021-03-03 | 2021-04-16 | N |
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements. | Fire Safety | 2021-03-03 | 2021-04-16 | N |
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector. | Fire Safety | 2021-03-03 | 2021-04-16 | 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 | 2021-03-03 | 2021-04-16 | N |
Provide properly protected cooking facilities. | Fire Safety | 2021-03-03 | 2021-04-16 | N |
Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2021-03-03 | 2021-04-16 | N |
Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2021-03-03 | 2021-04-16 | N |
Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke. | Fire Safety | 2021-03-03 | 2021-04-16 | N |
Have properly installed electrical wiring and gas equipment. | Fire Safety | 2021-03-03 | 2021-04-16 | N |
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2021-03-03 | 2021-04-16 | N |
Have simulated fire drills held at unexpected times. | Fire Safety | 2021-03-03 | 2021-04-16 | N |
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2021-03-03 | 2021-04-16 | N |
Have power receptacles that are properly grounded. | Fire Safety | 2021-03-03 | 2021-04-16 | N |
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. | Fire Safety | 2021-03-03 | 2021-04-16 | N |
Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2021-03-03 | 2021-04-16 | N |
Have proper medical gas storage and administration areas. | Fire Safety | 2021-03-03 | 2021-04-16 | N |
Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2021-03-22 | 2021-04-16 | Y |
Post nurse staffing information every day. | Health | 2021-03-03 | 2021-04-16 | 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 | 2021-03-03 | 2021-04-16 | N |
Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2021-03-03 | 2021-04-16 | 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 | 2021-03-03 | 2021-04-16 | N |
Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2021-03-03 | 2021-04-16 | N |
Ensure that residents are free from significant medication errors. | Health | 2021-03-03 | 2021-04-16 | N |
Make sure that a working call system is available in each resident's bathroom and bathing area. | Health | 2021-03-03 | 2021-04-16 | N |
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2021-03-03 | 2021-04-16 | Y |
Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged. | Health | 2020-11-13 | 2020-12-04 | Y |
Honor each resident's preferences, choices, values and beliefs. | Health | 2020-09-16 | 2020-10-12 | Y |
Provide and implement an infection prevention and control program. | Health | 2020-05-29 | 2020-05-30 | N |
Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2020-01-29 | 2020-02-12 | Y |
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2020-01-29 | 2020-02-12 | Y |
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2019-08-07 | 2019-09-09 | Y |
Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2019-06-19 | 2019-07-19 | N |
Provide properly protected cooking facilities. | Fire Safety | 2019-06-19 | 2019-07-19 | N |
Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2019-06-19 | 2019-07-19 | N |
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. | Fire Safety | 2019-06-19 | 2019-07-19 | N |
Ensure proper usage of power strips and extension cords. | Fire Safety | 2019-06-19 | 2019-07-19 | N |
Provide safe and appropriate respiratory care for a resident when needed. | Health | 2019-06-20 | 2019-07-19 | N |
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | Health | 2019-06-20 | 2019-07-19 | Y |
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2019-06-20 | 2019-07-19 | 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 | 2019-06-20 | 2019-07-19 | Y |
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | Health | 2019-06-20 | 2019-07-19 | Y |
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2019-06-20 | 2019-07-19 | Y |
Ensure medication error rates are not 5 percent or greater. | Health | 2019-06-20 | 2019-07-19 | 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 | 2019-06-20 | 2019-07-19 | Y |
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | Health | 2019-03-05 | 2019-04-10 | Y |
Provide timely, quality laboratory services/tests to meet the needs of residents. | Health | 2019-03-05 | 2019-04-10 | Y |
Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results. | Health | 2019-03-05 | 2019-04-10 | Y |
Conduct testing and exercise requirements. | Fire Safety | 2018-08-01 | 2018-09-07 | N |
Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2018-08-01 | 2018-09-07 | N |
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2018-08-01 | 2018-09-07 | N |
Provide a written emergency evacuation plan. | Fire Safety | 2018-08-01 | 2018-09-07 | N |
Have simulated fire drills held at unexpected times. | Fire Safety | 2018-08-01 | 2018-09-07 | N |
To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2018-08-01 | 2018-09-07 | N |
Ensure proper usage of power strips and extension cords. | Fire Safety | 2018-08-01 | 2018-09-07 | N |
Honor the resident's right to manage his or her financial affairs. | Health | 2018-08-01 | 2018-08-31 | N |
Plan the resident's discharge to meet the resident's goals and needs. | Health | 2018-08-01 | 2018-08-31 | N |
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2018-08-01 | 2018-08-31 | N |
Provide enough food/fluids to maintain a resident's health. | Health | 2018-08-01 | 2018-08-31 | N |
Observe each nurse aide's job performance and give regular training. | Health | 2018-08-01 | 2018-08-31 | 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 | 2018-08-01 | 2018-08-31 | N |
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2018-08-01 | 2018-08-31 | N |
Provide and implement an infection prevention and control program. | Health | 2018-08-01 | 2018-08-31 | N |
Implement a program that monitors antibiotic use. | Health | 2018-08-01 | 2018-08-31 | N |
Make sure each resident has 1) at least one window to the outside in a room; 2) a room at or above ground level; 3) adequate bedding; 4) furniture that meets the resident's needs; or 5) adequate closet space. | Health | 2018-08-01 | 2018-08-31 | N |
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2018-08-01 | 2018-08-31 | N |
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | Health | 2018-08-01 | 2018-08-31 | N |
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention. | Health | 2018-08-01 | 2018-08-31 | N |