A list of the most recent deficiencies for Accordius Health at Concord. 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? |
|---|---|---|---|---|
| Have exits that are accessible at all times. | Fire Safety | 2023-08-23 | 2023-10-09 | N |
| Ensure electrical receptacles or cover plates have distinctive color or marking. | Fire Safety | 2023-08-23 | 2023-10-09 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2023-08-23 | 2023-10-09 | N |
| Protect each resident from the wrongful use of the resident's belongings or money. | Health | 2023-09-14 | 2023-10-06 | Y |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2023-07-28 | 2023-09-14 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-07-28 | 2023-09-14 | N |
| Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | Health | 2023-07-28 | 2023-09-14 | N |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2023-07-28 | 2023-09-14 | Y |
| Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | Health | 2023-07-28 | 2023-09-14 | Y |
| Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2023-07-28 | 2023-09-14 | Y |
| Provide safe, appropriate pain management for a resident who requires such services. | Health | 2023-07-28 | 2023-09-14 | Y |
| Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | Health | 2023-07-28 | 2023-09-14 | Y |
| Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | Health | 2022-07-29 | 2022-08-15 | Y |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-07-29 | 2022-08-15 | Y |
| Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations and emergencies. | Health | 2022-07-29 | 2022-08-15 | Y |
| Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | Health | 2022-07-29 | 2022-08-15 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2022-07-29 | 2022-07-29 | Y |
| Ensure that residents are free from significant medication errors. | Health | 2022-07-29 | 2022-07-29 | Y |
| Have exits that are accessible at all times. | Fire Safety | 2022-03-23 | 2022-05-06 | 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 | 2022-02-14 | 2022-03-11 | N |
| Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | Health | 2022-02-14 | 2022-03-11 | N |
| Ensure each resident receives an accurate assessment. | Health | 2022-02-14 | 2022-03-11 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2022-02-14 | 2022-03-11 | 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 | 2022-02-14 | 2022-03-11 | N |
| Post nurse staffing information every day. | Health | 2022-02-14 | 2022-03-11 | 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 | 2022-02-14 | 2022-03-11 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-02-14 | 2022-03-11 | N |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2022-02-14 | 2022-03-11 | Y |
| Prepare residents for a safe transfer or discharge from the nursing home. | Health | 2022-02-14 | 2022-03-11 | Y |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2022-02-14 | 2022-03-11 | 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 | 2022-02-14 | 2022-03-11 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2022-02-14 | 2022-03-11 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-02-14 | 2022-03-04 | Y |
| Satisfy building requirements after a repair, renovation, modification, or change of user/occupancy. | Fire Safety | 2021-08-31 | 2021-10-15 | Y |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2022-02-14 | 2021-09-30 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2021-08-31 | 2021-09-28 | 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 | 2021-08-31 | 2021-09-28 | Y |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2021-08-31 | 2021-09-28 | 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 | 2021-08-31 | 2021-09-28 | Y |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2021-04-21 | 2021-06-05 | N |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2020-02-28 | 2020-03-23 | N |
| Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | Health | 2020-02-28 | 2020-03-23 | N |
| Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | Health | 2020-02-28 | 2020-03-23 | N |
| Assess the resident when there is a significant change in condition | Health | 2020-02-28 | 2020-03-23 | N |
| Assure that each resident?s assessment is updated at least once every 3 months. | Health | 2020-02-28 | 2020-03-23 | N |
| Encode each resident?s assessment data and transmit these data to the State within 7 days of assessment. | Health | 2020-02-28 | 2020-03-23 | N |
| Ensure each resident receives an accurate assessment. | Health | 2020-02-28 | 2020-03-23 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2020-02-28 | 2020-03-23 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2020-02-28 | 2020-03-23 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2020-02-28 | 2020-03-23 | 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 | 2020-02-28 | 2020-03-23 | N |
| Administer the facility in a manner that enables it to use its resources effectively and efficiently. | Health | 2020-02-28 | 2020-03-23 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2020-02-28 | 2020-03-23 | N |
| Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | Health | 2020-02-28 | 2020-03-23 | N |
| Provide and implement an infection prevention and control program. | Health | 2020-02-28 | 2020-03-23 | N |
| Develop and implement policies and procedures for flu and pneumonia vaccinations. | Health | 2020-02-28 | 2020-03-23 | N |
| Establish emergency prep training and testing. | Fire Safety | 2020-02-28 | 2020-03-23 | N |
