Deficiency Records for Tiffany Square
Updated as of March 01, 2023
This is not the most recent data for Tiffany Square. For the most recent information, click here.
A list of the most recent deficiencies for Tiffany Square. 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? |
---|---|---|---|---|
Notify the resident or the resident?s representative in writing how long the nursing home will hold the resident?s bed in cases of transfer to a hospital or therapeutic leave. | Health | 2022-07-26 | 2022-08-26 | N |
Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2022-07-26 | 2022-08-26 | 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 | 2022-07-26 | 2022-08-26 | N |
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-07-26 | 2022-08-26 | N |
Provide and implement an infection prevention and control program. | Health | 2022-07-26 | 2022-08-26 | N |
Perform COVID19 testing on residents and staff. | Health | 2022-07-26 | 2022-08-26 | N |
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector. | Fire Safety | 2022-07-20 | 2022-08-26 | 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 | 2022-07-20 | 2022-08-26 | N |
Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2022-07-20 | 2022-08-26 | N |
Provide properly sized and located linen or trash receptacles. | Fire Safety | 2022-07-20 | 2022-08-26 | N |
Ensure each resident receives an accurate assessment. | Health | 2021-04-08 | 2021-05-06 | 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 | 2021-04-08 | 2021-05-06 | N |
Provide and implement an infection prevention and control program. | Health | 2021-04-08 | 2021-05-06 | N |
Construct fire resistant interior walls. | Fire Safety | 2021-04-08 | 2021-04-30 | N |
Have proper fire barriers, ventilation and signs for the transfilling of oxygen. | Fire Safety | 2021-04-08 | 2021-04-30 | N |
Provide and implement an infection prevention and control program. | Health | 2020-10-27 | 2020-11-25 | Y |
Respond appropriately to all alleged violations. | Health | 2020-10-08 | 2020-10-29 | Y |
Keep residents' personal and medical records private and confidential. | Health | 2019-07-01 | 2019-08-15 | 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 | 2019-07-01 | 2019-08-15 | N |
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2019-07-01 | 2019-08-15 | N |
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2019-07-01 | 2019-08-15 | N |
Notify the resident or the resident?s representative in writing how long the nursing home will hold the resident?s bed in cases of transfer to a hospital or therapeutic leave. | Health | 2019-07-01 | 2019-08-15 | N |
Assure that each resident?s assessment is updated at least once every 3 months. | Health | 2019-07-01 | 2019-08-15 | N |
Ensure each resident receives an accurate assessment. | Health | 2019-07-01 | 2019-08-15 | N |
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2019-07-01 | 2019-08-15 | N |
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Health | 2019-07-01 | 2019-08-15 | N |
Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2019-07-01 | 2019-08-15 | N |
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2019-07-01 | 2019-08-15 | 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 | 2019-07-01 | 2019-08-15 | N |
Ensure medication error rates are not 5 percent or greater. | Health | 2019-07-01 | 2019-08-15 | N |
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2019-07-01 | 2019-08-15 | N |
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2019-07-01 | 2019-08-15 | N |
Provide and implement an infection prevention and control program. | Health | 2019-07-01 | 2019-08-15 | N |
Implement a program that monitors antibiotic use. | Health | 2019-07-01 | 2019-08-15 | N |
Have enough outside ventilation via a window or mechanical ventilation, or both. | Health | 2019-07-01 | 2019-08-15 | 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 | 2019-06-25 | 2019-08-15 | N |
Have simulated fire drills held at unexpected times. | Fire Safety | 2019-06-25 | 2019-08-15 | N |
Meet requirements for the use of electrical equipment. | Fire Safety | 2019-06-25 | 2019-08-15 | N |
Have proper medical gas storage and administration areas. | Fire Safety | 2019-06-25 | 2019-08-15 | N |