A list of the most recent deficiencies for Colonial Manor Nursing Home. 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 that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-10-19 | 2023-12-01 | N |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2023-10-19 | 2023-12-01 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2023-10-18 | 2023-12-01 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2023-10-18 | 2023-11-02 | N |
| Keep residents' personal and medical records private and confidential. | Health | 2022-07-28 | 2022-09-09 | N |
| Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | Health | 2022-07-28 | 2022-09-09 | N |
| Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | Health | 2022-07-28 | 2022-09-09 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2022-07-28 | 2022-09-09 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-07-28 | 2022-09-09 | N |
| Keep all essential equipment working safely. | Health | 2022-07-28 | 2022-09-09 | N |
| Implement emergency and standby power systems. | Fire Safety | 2022-07-28 | 2022-09-09 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2022-07-27 | 2022-09-09 | N |
| Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. | Fire Safety | 2022-07-27 | 2022-09-09 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2022-07-27 | 2022-09-09 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2022-07-27 | 2022-09-09 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-07-28 | 2022-09-02 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2022-07-28 | 2022-09-02 | 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 | 2022-07-28 | 2022-09-02 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2022-07-28 | 2022-09-02 | N |
| Have exits that are accessible at all times. | Fire Safety | 2022-07-27 | 2022-09-02 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2022-07-27 | 2022-09-02 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2022-07-27 | 2022-09-02 | N |
| Install smoke barrier doors that can resist smoke for at least 20 minutes. | Fire Safety | 2022-07-27 | 2022-09-02 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2022-07-27 | 2022-09-02 | 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 | 2022-07-28 | 2022-08-03 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2021-03-08 | 2021-03-31 | Y |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2020-02-13 | 2020-03-12 | N |
| Respond appropriately to all alleged violations. | Health | 2020-02-13 | 2020-03-12 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2020-02-13 | 2020-03-12 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2020-02-13 | 2020-03-12 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2020-02-13 | 2020-03-05 | N |
| Provide and implement an infection prevention and control program. | Health | 2020-02-13 | 2020-03-05 | N |
| Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. | Fire Safety | 2020-02-11 | 2020-02-25 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2020-02-11 | 2020-02-17 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2020-02-11 | 2020-02-12 | N |
