Deficiency Records for Westgate Nursing and Rehab Community
Updated as of April 01, 2024
A list of the most recent deficiencies for Westgate Nursing and Rehab Community. 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? |
|---|---|---|---|---|
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2023-09-14 | 2023-10-10 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2023-09-14 | 2023-10-10 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2023-09-14 | 2023-10-10 | N |
| Provide safe, appropriate pain management for a resident who requires such services. | Health | 2023-09-14 | 2023-10-10 | N |
| Ensure that the facility has sufficient staff members who possess the competencies and skills to meet the behavioral health needs of residents. | Health | 2023-09-14 | 2023-10-10 | N |
| Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | Health | 2023-09-14 | 2023-10-10 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-09-14 | 2023-10-10 | N |
| Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. | Health | 2023-09-14 | 2023-10-10 | N |
| Provide and implement an infection prevention and control program. | Health | 2023-09-14 | 2023-10-10 | N |
| Respond appropriately to all alleged violations. | Health | 2023-09-14 | 2023-10-10 | Y |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2023-09-14 | 2023-10-10 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-09-14 | 2023-10-10 | Y |
| Conduct testing and exercise requirements. | Fire Safety | 2023-09-22 | 2023-10-10 | 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 | 2023-09-22 | 2023-10-10 | N |
| Have corridors or aisles that are unobstructed and are at least 8 feet in width. | Fire Safety | 2023-09-22 | 2023-10-10 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2023-09-22 | 2023-10-10 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2023-09-22 | 2023-10-10 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2023-09-22 | 2023-10-10 | N |
| Provide a written emergency evacuation plan. | Fire Safety | 2023-09-22 | 2023-10-10 | N |
| Ensure that sources of ignition are removed from patients receiving respiratory therapy. | Fire Safety | 2023-09-22 | 2023-10-10 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-08-03 | 2022-08-29 | Y |
| Develop a communication plan. | Fire Safety | 2022-08-16 | 2022-08-29 | N |
| Have exits that are accessible at all times. | Fire Safety | 2022-08-16 | 2022-08-29 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2022-08-16 | 2022-08-29 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2022-08-16 | 2022-08-29 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2022-08-16 | 2022-08-29 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2021-04-13 | 2021-05-28 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2021-04-13 | 2021-05-28 | 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 | 2021-04-13 | 2021-05-28 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2021-04-13 | 2021-05-28 | N |
| Construct fire resistant interior walls. | Fire Safety | 2021-04-13 | 2021-05-28 | N |
| Have a fire alarm with audible and visual signals that transmits the alarm automatically to notify emergency forces in event of fire. | Fire Safety | 2021-04-13 | 2021-05-28 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2021-04-13 | 2021-05-28 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2021-04-13 | 2021-05-28 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2021-04-13 | 2021-05-28 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2021-04-13 | 2021-05-28 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2021-04-13 | 2021-05-28 | N |
| Have power receptacles that are properly grounded. | Fire Safety | 2021-04-13 | 2021-05-28 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2021-04-13 | 2021-05-28 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2021-04-13 | 2021-05-28 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2021-04-13 | 2021-05-28 | N |
| Ensure that sources of ignition are removed from patients receiving respiratory therapy. | Fire Safety | 2021-04-13 | 2021-05-28 | N |
| Reasonably accommodate the needs and preferences of each resident. | Health | 2021-04-07 | 2021-05-07 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2021-04-07 | 2021-05-07 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2021-04-07 | 2021-05-07 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2021-04-07 | 2021-05-07 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2021-04-07 | 2021-05-07 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2021-04-07 | 2021-05-07 | N |
| Provide and implement an infection prevention and control program. | Health | 2021-04-07 | 2021-05-07 | N |
