Deficiency Records for Ssm Health Depaul Hospital - Anna House
Updated as of April 01, 2024
A list of the most recent deficiencies for Ssm Health Depaul Hospital - Anna House. 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? |
|---|---|---|---|---|
| Implement emergency and standby power systems. | Fire Safety | 2023-05-12 | 2023-07-17 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-05-12 | 2023-07-09 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2023-05-12 | 2023-06-26 | 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 | 2023-05-12 | 2023-06-26 | N |
| Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | Health | 2023-05-12 | 2023-06-26 | N |
| Post nurse staffing information every day. | Health | 2023-05-12 | 2023-06-26 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2023-05-12 | 2023-06-26 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-05-12 | 2023-06-26 | N |
| Provide and implement an infection prevention and control program. | Health | 2023-05-12 | 2023-06-26 | N |
| List the names and contact information of those in the facility. | Fire Safety | 2023-05-12 | 2023-06-26 | N |
| Establish staff and initial training requirements. | Fire Safety | 2023-05-12 | 2023-06-26 | N |
| Conduct testing and exercise requirements. | Fire Safety | 2023-05-12 | 2023-06-26 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2023-05-12 | 2023-06-26 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2023-05-12 | 2023-06-26 | N |
| Have properly located and lighted "Exit" signs. | Fire Safety | 2023-05-12 | 2023-06-26 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2023-05-12 | 2023-06-26 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2023-05-12 | 2023-06-26 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2023-05-12 | 2023-06-26 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2023-05-12 | 2023-06-26 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2023-05-12 | 2023-06-26 | N |
| Install smoke barrier doors that can resist smoke for at least 20 minutes. | Fire Safety | 2023-05-12 | 2023-06-26 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2023-05-12 | 2023-06-26 | N |
| Have elevators that firefighters can control in the event of a fire. | Fire Safety | 2023-05-12 | 2023-06-26 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2023-05-12 | 2023-06-26 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2023-05-12 | 2023-06-26 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2023-05-12 | 2023-06-26 | N |
| Ensure residents have reasonable access to and privacy in their use of communication methods. | Health | 2019-11-13 | 2019-12-05 | N |
| Respond appropriately to all alleged violations. | Health | 2019-11-13 | 2019-11-26 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2019-11-13 | 2019-11-26 | 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 | 2019-11-13 | 2019-11-26 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2019-11-13 | 2019-11-26 | N |
| Not require residents to give up Medicare or Medicaid benefits, or pay privately as a condition of admission; and must tell residents what care they do not provide. | Health | 2018-10-25 | 2018-11-30 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2018-10-25 | 2018-11-30 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2018-10-25 | 2018-11-30 | N |
| Provide safe, appropriate pain management for a resident who requires such services. | Health | 2018-10-25 | 2018-11-30 | N |
| Provide medically-related social services to help each resident achieve the highest possible quality of life. | Health | 2018-10-25 | 2018-11-30 | 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 | 2018-10-25 | 2018-11-30 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2018-10-25 | 2018-11-30 | N |
