A list of the most recent deficiencies for Edgebrook Care 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? |
|---|---|---|---|---|
| Conduct testing and exercise requirements. | Fire Safety | 2024-01-24 | 2024-03-08 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2024-01-23 | 2024-03-01 | 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 | 2024-01-24 | 2024-02-28 | N |
| Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data. | Health | 2024-01-24 | 2024-02-13 | N |
| Encode each resident?s assessment data and transmit these data to the State within 7 days of assessment. | Health | 2024-01-24 | 2024-02-09 | N |
| Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | Health | 2024-01-24 | 2024-02-09 | 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 | 2023-07-12 | 2023-08-14 | Y |
| Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | Health | 2022-10-20 | 2022-12-16 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-10-20 | 2022-12-16 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-10-20 | 2022-12-16 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-10-20 | 2022-12-16 | N |
| Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | Health | 2022-10-20 | 2022-12-16 | N |
| Allow residents to self-administer drugs if determined clinically appropriate. | Health | 2022-10-20 | 2022-12-16 | 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 | 2022-10-20 | 2022-12-16 | Y |
| Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2022-10-20 | 2022-12-16 | Y |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-10-20 | 2022-12-16 | Y |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-10-18 | 2022-12-16 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2022-10-18 | 2022-12-16 | N |
| Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2022-10-18 | 2022-12-16 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2022-10-18 | 2022-12-16 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2021-11-10 | 2022-01-10 | Y |
| Provide and implement an infection prevention and control program. | Health | 2021-07-29 | 2021-09-22 | N |
| Establish staff and initial training requirements. | Fire Safety | 2021-07-29 | 2021-09-22 | 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 | 2021-07-29 | 2021-09-17 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2021-07-29 | 2021-09-10 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2021-07-29 | 2021-09-10 | N |
| Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. | Health | 2021-07-29 | 2021-09-10 | Y |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2021-07-29 | 2021-09-10 | Y |
| Address patient/client population and determine types of services needed. | Fire Safety | 2021-07-29 | 2021-09-10 | N |
| Establish policies and procedures for volunteers. | Fire Safety | 2021-07-29 | 2021-09-10 | N |
| Provide a means of sharing information on occupancy/needs. | Fire Safety | 2021-07-29 | 2021-09-10 | N |
| Provide family notifications of emergency plan. | Fire Safety | 2021-07-29 | 2021-09-10 | N |
