A list of the most recent deficiencies for Casa Maria Healthcare. 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? |
|---|---|---|---|---|
| Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Health | 2023-12-22 | 2024-01-24 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-12-22 | 2024-01-24 | Y |
| Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | Health | 2023-07-07 | 2023-08-07 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-07-07 | 2023-08-07 | N |
| Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | Health | 2023-07-07 | 2023-08-07 | N |
| Post nurse staffing information every day. | Health | 2023-07-07 | 2023-08-07 | 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 | 2023-07-07 | 2023-08-07 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-07-07 | 2023-08-07 | N |
| Dispose of garbage and refuse properly. | Health | 2023-07-07 | 2023-08-07 | N |
| Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | Health | 2023-07-07 | 2023-08-07 | Y |
| Provide properly protected cooking facilities. | Fire Safety | 2023-07-05 | 2023-08-07 | N |
| Meet other general requirements that are deficient. | Fire Safety | 2023-07-05 | 2023-08-07 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2022-08-10 | 2022-09-30 | 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 | 2022-08-10 | 2022-09-08 | 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 | 2022-08-10 | 2022-09-08 | N |
| Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2022-08-10 | 2022-09-08 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2022-08-10 | 2022-09-08 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-08-10 | 2022-09-08 | 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 | 2022-08-10 | 2022-09-08 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2022-08-10 | 2022-09-08 | N |
| Provide activities to meet all resident's needs. | Health | 2022-08-10 | 2022-09-08 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-08-10 | 2022-09-08 | 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 | 2022-08-10 | 2022-09-08 | 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 | 2022-08-10 | 2022-09-08 | N |
| Post nurse staffing information every day. | Health | 2022-08-10 | 2022-09-08 | 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 | 2022-08-10 | 2022-09-08 | N |
| Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | Health | 2022-08-10 | 2022-09-08 | N |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2022-08-10 | 2022-09-08 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-08-10 | 2022-09-08 | N |
| Establish procedures for tracking staff and patients during an emergency. | Fire Safety | 2022-08-10 | 2022-09-08 | N |
| Establish policies and procedures for sheltering. | Fire Safety | 2022-08-10 | 2022-09-08 | N |
| Establish policies and procedures for medical documentation. | Fire Safety | 2022-08-10 | 2022-09-08 | N |
| Provide family notifications of emergency plan. | Fire Safety | 2022-08-10 | 2022-09-08 | N |
| Establish emergency prep training and testing. | Fire Safety | 2022-08-10 | 2022-09-08 | N |
| Establish staff and initial training requirements. | Fire Safety | 2022-08-10 | 2022-09-08 | 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 | 2022-08-10 | 2022-09-08 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2022-08-10 | 2022-09-08 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2022-08-10 | 2022-09-08 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2022-06-09 | 2022-07-08 | Y |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2022-06-09 | 2022-07-08 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-06-09 | 2022-07-08 | Y |
| Administer the facility in a manner that enables it to use its resources effectively and efficiently. | Health | 2022-06-09 | 2022-07-08 | Y |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2022-02-22 | 2022-03-22 | Y |
| Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Health | 2022-02-22 | 2022-03-22 | Y |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2022-02-22 | 2022-03-22 | Y |
| Post nurse staffing information every day. | Health | 2021-05-19 | 2021-05-31 | 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 | 2021-05-18 | 2021-05-31 | N |
| Have properly sized and located compartments to protect residents from smoke. | Fire Safety | 2021-05-18 | 2021-05-31 | N |
