Deficiency Records for The Oaks at Byron Center
Updated as of March 01, 2022
This is not the most recent data for The Oaks at Byron Center. For the most recent information, click here.
A list of the most recent deficiencies for The Oaks at Byron 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? |
|---|---|---|---|---|
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2021-04-14 | 2021-05-05 | N |
| Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2021-04-14 | 2021-05-05 | N |
| Ensure that residents are free from significant medication errors. | Health | 2021-04-14 | 2021-05-05 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2021-04-14 | 2021-05-05 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2021-04-14 | 2021-05-05 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2021-04-14 | 2021-05-04 | N |
| 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 | 2021-04-14 | 2021-05-04 | 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 | 2021-04-15 | 2021-05-04 | N |
| Have corridors or aisles that are unobstructed and are at least 8 feet in width. | Fire Safety | 2021-04-15 | 2021-05-04 | 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 | 2021-04-15 | 2021-05-04 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2021-04-15 | 2021-05-04 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2021-04-15 | 2021-05-04 | N |
| Meet other general requirements that are deficient. | Fire Safety | 2021-04-15 | 2021-05-04 | N |
| Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2021-02-24 | 2021-03-24 | Y |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2021-02-24 | 2021-03-24 | 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 | 2021-02-24 | 2021-03-24 | Y |
| Provide and implement an infection prevention and control program. | Health | 2020-05-21 | 2020-06-16 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2019-08-05 | 2019-09-10 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2019-08-05 | 2019-09-10 | N |
| Provide and implement an infection prevention and control program. | Health | 2019-08-05 | 2019-09-10 | 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 | 2019-08-05 | 2019-09-10 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2019-08-05 | 2019-09-10 | N |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2019-06-19 | 2019-07-05 | Y |
| Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2019-06-05 | 2019-07-05 | Y |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2019-06-05 | 2019-07-05 | 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 | 2019-06-05 | 2019-07-05 | Y |
| Allow residents to self-administer drugs if determined clinically appropriate. | Health | 2018-06-21 | 2018-07-19 | N |
| PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2018-06-21 | 2018-07-19 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2018-06-21 | 2018-07-19 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2018-06-21 | 2018-07-19 | 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 | 2018-06-21 | 2018-07-19 | N |
| 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 | 2018-06-21 | 2018-07-19 | N |
| Have a policy regarding use and storage of foods brought to residents by family and other visitors. | Health | 2018-06-21 | 2018-07-19 | N |
| Provide and implement an infection prevention and control program. | Health | 2018-06-21 | 2018-07-19 | N |
| Implement a program that monitors antibiotic use. | Health | 2018-06-21 | 2018-07-19 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2018-06-26 | 2018-07-19 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2018-06-26 | 2018-07-19 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2018-06-26 | 2018-07-19 | N |
