A list of the most recent deficiencies for Autumn Care of Drexel. 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? |
|---|---|---|---|---|
| Ensure medication error rates are not 5 percent or greater. | Health | 2022-09-21 | 2022-10-11 | Y |
| Provide bedrooms that don't allow residents to see each other when privacy is needed. | Health | 2022-07-07 | 2022-09-21 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2022-07-07 | 2022-09-21 | Y |
| 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 | 2022-07-07 | 2022-09-21 | Y |
| Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | Health | 2022-07-07 | 2022-09-21 | Y |
| Honor the resident's right to organize and participate in resident/family groups in the facility. | Health | 2022-07-07 | 2022-09-21 | 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 | 2022-07-07 | 2022-09-21 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2022-07-07 | 2022-09-21 | Y |
| Keep residents' personal and medical records private and confidential. | Health | 2022-07-07 | 2022-09-21 | Y |
| Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy. | Health | 2022-07-07 | 2022-09-21 | Y |
| Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | Health | 2022-07-07 | 2022-09-21 | Y |
| Ensure each resident receives an accurate assessment. | Health | 2022-07-07 | 2022-09-21 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-07-07 | 2022-09-21 | Y |
| Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | Health | 2022-07-07 | 2022-09-21 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-07-07 | 2022-09-21 | Y |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2022-07-07 | 2022-09-21 | 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 | 2022-07-07 | 2022-09-21 | Y |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2022-07-07 | 2022-09-21 | Y |
| Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2022-07-07 | 2022-09-21 | 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 | 2022-07-07 | 2022-09-21 | Y |
| 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 | 2022-07-07 | 2022-09-21 | Y |
| Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. | Health | 2022-07-07 | 2022-09-21 | Y |
| Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | Health | 2022-07-07 | 2022-09-21 | Y |
| Administer the facility in a manner that enables it to use its resources effectively and efficiently. | Health | 2022-07-07 | 2022-09-21 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2022-07-07 | 2022-09-21 | Y |
| Provide and implement an infection prevention and control program. | Health | 2022-07-07 | 2022-09-21 | Y |
| Ensure staff are vaccinated for COVID-19 | Health | 2022-07-07 | 2022-09-21 | Y |
| Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | Health | 2022-07-07 | 2022-09-21 | Y |
| 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 | 2022-08-09 | 2022-09-13 | 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 | 2022-08-09 | 2022-09-13 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2022-08-09 | 2022-09-13 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-08-09 | 2022-09-13 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2022-08-09 | 2022-09-13 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2022-08-09 | 2022-09-13 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2021-07-01 | 2021-08-30 | N |
| Ensure each resident receives an accurate assessment. | Health | 2020-02-20 | 2020-03-05 | N |
| Have exits that are accessible at all times. | Fire Safety | 2019-04-16 | 2019-05-24 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2019-04-16 | 2019-05-24 | N |
| Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2019-04-16 | 2019-05-24 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2019-04-16 | 2019-05-24 | N |
| Ensure electrical receptacles or cover plates have distinctive color or marking. | Fire Safety | 2019-04-16 | 2019-05-24 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2019-04-16 | 2019-05-24 | N |
