A list of the most recent deficiencies for Pisgah Manor Health Care 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? |
|---|---|---|---|---|
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2024-01-30 | 2024-02-14 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2024-01-30 | 2024-02-14 | N |
| Ensure each resident receives an accurate assessment. | Health | 2023-12-06 | 2024-01-02 | N |
| Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | Health | 2023-12-06 | 2024-01-02 | 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 | 2023-12-06 | 2024-01-02 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-12-06 | 2024-01-02 | N |
| Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | Health | 2023-12-06 | 2024-01-02 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2023-12-06 | 2024-01-02 | Y |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2023-12-06 | 2024-01-02 | Y |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2023-12-06 | 2024-01-02 | 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 | 2023-12-06 | 2024-01-02 | Y |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2022-07-12 | 2022-07-25 | N |
| Meet requirements for the installation and maintenance of electrical systems. | Fire Safety | 2022-07-12 | 2022-07-25 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2022-06-10 | 2022-07-04 | Y |
| Allow residents to self-administer drugs if determined clinically appropriate. | Health | 2022-06-10 | 2022-07-04 | Y |
| Reasonably accommodate the needs and preferences of each resident. | Health | 2022-06-10 | 2022-07-04 | Y |
| Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | Health | 2022-06-10 | 2022-07-04 | 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 | 2022-06-10 | 2022-07-04 | Y |
| Keep residents' personal and medical records private and confidential. | Health | 2022-06-10 | 2022-07-04 | Y |
| Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged. | Health | 2022-06-10 | 2022-07-04 | Y |
| Ensure each resident receives an accurate assessment. | Health | 2022-06-10 | 2022-07-04 | Y |
| Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | Health | 2022-06-10 | 2022-07-04 | 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 | 2022-06-10 | 2022-07-04 | Y |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2022-06-10 | 2022-07-04 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-06-10 | 2022-07-04 | Y |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2022-06-10 | 2022-07-04 | Y |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2022-06-10 | 2022-07-04 | 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 | 2022-06-10 | 2022-07-04 | Y |
| Provide special eating equipment and utensils for residents who need them and appropriate assistance. | Health | 2022-06-10 | 2022-07-04 | Y |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-06-10 | 2022-07-04 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2022-06-10 | 2022-07-04 | Y |
| Provide and implement an infection prevention and control program. | Health | 2022-06-10 | 2022-07-04 | Y |
| Ensure staff are vaccinated for COVID-19 | Health | 2022-06-10 | 2022-07-04 | Y |
| Provide properly protected cooking facilities. | Fire Safety | 2020-03-11 | 2020-03-12 | N |
