A list of the most recent deficiencies for Edgewood Manor of Lucasville I. 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? |
|---|---|---|---|---|
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2022-07-05 | 2022-07-15 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2022-07-05 | 2022-07-15 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-07-05 | 2022-07-15 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-07-05 | 2022-07-15 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2022-07-05 | 2022-07-15 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2022-07-05 | 2022-07-15 | 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 | 2022-07-05 | 2022-07-15 | N |
| Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law. | Health | 2022-07-05 | 2022-07-15 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2022-07-05 | 2022-07-15 | N |
| Provide and implement an infection prevention and control program. | Health | 2022-07-05 | 2022-07-15 | N |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2022-07-05 | 2022-07-15 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-06-27 | 2022-07-15 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2022-06-27 | 2022-07-15 | N |
| Have power receptacles that are properly grounded. | Fire Safety | 2022-06-27 | 2022-07-15 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2019-12-18 | 2020-01-10 | N |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2019-12-18 | 2020-01-10 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2019-12-18 | 2020-01-10 | N |
| Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | Health | 2019-12-18 | 2020-01-10 | N |
| Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | Health | 2019-12-18 | 2020-01-10 | N |
| Provide safe, appropriate pain management for a resident who requires such services. | Health | 2019-12-18 | 2020-01-10 | N |
| Provide and implement an infection prevention and control program. | Health | 2019-12-18 | 2020-01-10 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2019-12-18 | 2020-01-10 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2019-12-18 | 2020-01-10 | N |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2018-12-13 | 2019-01-10 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2018-12-13 | 2019-01-10 | N |
| Respond appropriately to all alleged violations. | Health | 2018-12-13 | 2019-01-10 | N |
| Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | Health | 2018-12-13 | 2019-01-10 | 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 | 2018-12-13 | 2019-01-10 | N |
| 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 | 2018-12-13 | 2019-01-10 | N |
| Provide timely, quality laboratory services/tests to meet the needs of residents. | Health | 2018-12-13 | 2019-01-10 | 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 | 2018-12-13 | 2019-01-10 | N |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2018-12-13 | 2019-01-10 | N |
| Provide and implement an infection prevention and control program. | Health | 2018-12-13 | 2019-01-10 | N |
| Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame. | Health | 2018-12-13 | 2019-01-10 | N |
| Develop and maintain an Emergency Preparedness Program (EP). | Fire Safety | 2018-12-11 | 2019-01-10 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2018-12-11 | 2019-01-10 | N |
| Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2018-12-11 | 2019-01-10 | N |
| Ensure operating rooms are properly protected and written records are maintained and available for inspection. | Fire Safety | 2018-12-11 | 2019-01-10 | N |
