Deficiency Records for Gallup Nursing and Rehabilitation LLC
Updated as of March 01, 2024
A list of the most recent deficiencies for Gallup Nursing and Rehabilitation LLC. 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? |
|---|---|---|---|---|
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2023-06-16 | 2023-07-26 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2023-06-16 | 2023-07-26 | N |
| Provide activities to meet all resident's needs. | Health | 2023-06-16 | 2023-07-26 | N |
| Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | Health | 2023-06-16 | 2023-07-26 | N |
| Ensure each resident must receive and the facility must provide necessary behavioral health care and services. | Health | 2023-06-16 | 2023-07-26 | 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 | 2023-06-16 | 2023-07-26 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-06-16 | 2023-07-26 | N |
| Provide and implement an infection prevention and control program. | Health | 2023-06-16 | 2023-07-26 | N |
| Address subsistence needs for staff and patients. | Fire Safety | 2023-06-14 | 2023-07-21 | N |
| Establish policies and procedures including evacuation. | Fire Safety | 2023-06-14 | 2023-07-21 | N |
| Establish policies and procedures for sheltering. | Fire Safety | 2023-06-14 | 2023-07-21 | N |
| Establish roles under a Waiver declared by secretary. | Fire Safety | 2023-06-14 | 2023-07-21 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2023-06-14 | 2023-07-21 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2022-11-09 | 2022-11-09 | Y |
| Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | Health | 2022-05-03 | 2022-06-09 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2022-05-03 | 2022-06-09 | Y |
| Respond appropriately to all alleged violations. | Health | 2022-05-03 | 2022-06-09 | Y |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2022-05-03 | 2022-06-09 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-05-03 | 2022-06-09 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2022-05-03 | 2022-06-09 | Y |
| Provide and implement an infection prevention and control program. | Health | 2022-05-03 | 2022-06-09 | Y |
| Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | Health | 2022-03-17 | 2022-04-29 | N |
| Inform each resident of his or her visitation rights and ensure that all visitors enjoy equal visitation privileges. | Health | 2022-03-17 | 2022-04-29 | Y |
| Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | Health | 2022-03-17 | 2022-04-29 | Y |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2022-03-17 | 2022-04-29 | Y |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2022-03-17 | 2022-04-29 | Y |
| 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 | 2022-03-17 | 2022-04-29 | Y |
| Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | Health | 2022-03-17 | 2022-04-29 | Y |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2022-03-17 | 2022-04-29 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-03-17 | 2022-04-29 | Y |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2022-03-17 | 2022-04-29 | Y |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2022-03-17 | 2022-04-29 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-03-17 | 2022-04-29 | Y |
| Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | Health | 2022-03-17 | 2022-04-29 | Y |
| Provide enough food/fluids to maintain a resident's health. | Health | 2022-03-17 | 2022-04-29 | Y |
| Provide safe, appropriate pain management for a resident who requires such services. | Health | 2022-03-17 | 2022-04-29 | Y |
| Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2022-03-17 | 2022-04-29 | Y |
| Ensure that the facility has sufficient staff members who possess the competencies and skills to meet the behavioral health needs of residents. | Health | 2022-03-17 | 2022-04-29 | Y |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2022-03-17 | 2022-04-29 | Y |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2022-03-17 | 2022-04-29 | Y |
| 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 | 2022-03-17 | 2022-04-29 | Y |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2022-03-17 | 2022-04-29 | Y |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-03-17 | 2022-04-29 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2022-03-17 | 2022-04-29 | Y |
| Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | Health | 2022-03-17 | 2022-04-29 | Y |
| Provide and implement an infection prevention and control program. | Health | 2022-03-17 | 2022-04-29 | Y |
| Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | Health | 2022-03-17 | 2022-04-29 | Y |
| Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation. | Health | 2022-03-17 | 2022-04-29 | Y |
| Conduct testing and exercise requirements. | Fire Safety | 2022-03-17 | 2022-04-29 | Y |
| Provide properly protected cooking facilities. | Fire Safety | 2022-03-29 | 2022-04-22 | N |
| Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | Health | 2021-03-04 | 2021-04-15 | N |
| Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | Health | 2021-03-04 | 2021-04-15 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2021-03-04 | 2021-04-15 | 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 | 2021-03-04 | 2021-04-15 | N |
| Provide timely, quality laboratory services/tests to meet the needs of residents. | Health | 2021-03-04 | 2021-04-15 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2021-03-04 | 2021-04-15 | N |
| Respond appropriately to all alleged violations. | Health | 2021-03-04 | 2021-04-15 | Y |
| Obtain a doctor's order to admit a resident and ensure the resident is under a doctor's care. | Health | 2021-03-04 | 2021-04-15 | Y |
| Address patient/client population and determine types of services needed. | Fire Safety | 2021-03-03 | 2021-04-15 | N |
| Provide family notifications of emergency plan. | Fire Safety | 2021-03-03 | 2021-04-15 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2021-03-03 | 2021-04-15 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2021-03-03 | 2021-04-15 | N |
