A list of the most recent deficiencies for The Elms 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? |
|---|---|---|---|---|
| Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | Health | 2024-01-25 | 2024-03-01 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2024-01-25 | 2024-02-26 | 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 | 2024-01-25 | 2024-02-23 | N |
| Provide and implement an infection prevention and control program. | Health | 2024-01-25 | 2024-02-22 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2024-01-25 | 2024-02-22 | Y |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2024-01-24 | 2024-02-16 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2024-01-24 | 2024-02-16 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2024-01-24 | 2024-02-16 | N |
| Provide and implement an infection prevention and control program. | Health | 2023-01-20 | 2023-02-13 | N |
| PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2023-01-20 | 2023-02-10 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-01-20 | 2023-02-10 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2023-01-23 | 2023-02-08 | N |
| Report COVID19 data to residents and families. | Health | 2023-01-20 | 2023-01-31 | N |
| Establish roles under a Waiver declared by secretary. | Fire Safety | 2021-12-01 | 2022-02-16 | 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 | 2021-12-01 | 2022-02-16 | N |
| Have an enclosure around a vertical opening shaft. | Fire Safety | 2021-12-01 | 2022-02-16 | 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 | 2021-12-01 | 2022-02-16 | N |
| Install a fire alarm system that can be heard throughout the facility. | Fire Safety | 2021-12-01 | 2022-02-16 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2021-12-01 | 2022-02-16 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2021-12-01 | 2022-02-16 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2021-12-01 | 2022-02-16 | N |
| Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made. | Health | 2021-12-02 | 2022-01-27 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2021-12-02 | 2022-01-27 | N |
| Provide activities to meet all resident's needs. | Health | 2021-12-02 | 2022-01-27 | N |
| Provide appropriate foot care. | Health | 2021-12-02 | 2022-01-27 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2021-12-02 | 2022-01-27 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2021-12-02 | 2022-01-27 | N |
| Allow resident to participate in the development and implementation of his or her person-centered plan of care. | Health | 2024-01-25 | Not Fixed | N |
| Ensure that residents are assessed for appropriateness for a feeding assistant program, receive services as per their plan of care, and feeding assistants are trained and supervised. | Health | 2024-01-25 | Not Fixed | N |
