A list of the most recent deficiencies for St. Theresa 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? |
|---|---|---|---|---|
| Provide medically-related social services to help each resident achieve the highest possible quality of life. | Health | 2024-02-02 | 2024-02-14 | Y |
| Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | Health | 2024-01-09 | 2024-02-14 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2024-01-09 | 2024-02-14 | Y |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2024-01-09 | 2024-02-14 | Y |
| Provide and implement an infection prevention and control program. | Health | 2024-01-09 | 2024-02-14 | Y |
| Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death. | Health | 2023-05-18 | 2023-06-19 | N |
| Ensure each resident receives an accurate assessment. | Health | 2023-05-18 | 2023-06-19 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2023-05-18 | 2023-06-19 | 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 | 2023-05-18 | 2023-06-19 | 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 | 2023-05-18 | 2023-06-19 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2023-05-17 | 2023-06-19 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2023-05-17 | 2023-06-19 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2023-05-17 | 2023-06-19 | N |
| Install properly constructed and protected linen or trash chutes. | Fire Safety | 2023-05-17 | 2023-06-19 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2023-05-17 | 2023-06-19 | N |
| Have a battery powered remote alarm panel in a location accessible by operating personnel. | Fire Safety | 2023-05-17 | 2023-06-19 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2023-05-17 | 2023-06-19 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-03-30 | 2023-04-17 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-10-28 | 2022-11-09 | Y |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2022-10-28 | 2022-11-09 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2022-03-30 | 2022-04-21 | Y |
| Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | Health | 2022-03-30 | 2022-04-21 | Y |
| Ensure medication error rates are not 5 percent or greater. | Health | 2021-11-10 | 2021-11-18 | Y |
| Provide and implement an infection prevention and control program. | Health | 2021-11-10 | 2021-11-18 | Y |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2021-10-02 | 2021-11-18 | Y |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2021-10-02 | 2021-11-18 | Y |
| Ensure that residents are free from significant medication errors. | Health | 2021-10-02 | 2021-11-18 | Y |
| Provide and implement an infection prevention and control program. | Health | 2021-10-02 | 2021-11-18 | Y |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2020-01-09 | 2020-03-05 | N |
| Honor the resident's right to manage his or her financial affairs. | Health | 2020-01-09 | 2020-03-05 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2020-01-09 | 2020-03-05 | N |
| Ensure each resident receives an accurate assessment. | Health | 2020-01-09 | 2020-03-05 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2020-01-09 | 2020-03-05 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2020-01-09 | 2020-03-05 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2020-01-09 | 2020-03-05 | N |
| Provide safe, appropriate pain management for a resident who requires such services. | Health | 2020-01-09 | 2020-03-05 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2020-01-09 | 2020-03-05 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2020-01-09 | 2020-03-05 | 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 | 2020-01-09 | 2020-03-05 | N |
| Provide or obtain dental services for each resident. | Health | 2020-01-09 | 2020-03-05 | N |
| Make sure that a working call system is available in each resident's bathroom and bathing area. | Health | 2020-01-09 | 2020-03-05 | N |
| Meet requirements for sections of health care facilities separated by fire resistive construction. | Fire Safety | 2020-01-06 | 2020-03-05 | N |
| Have exits that are accessible at all times. | Fire Safety | 2020-01-06 | 2020-03-05 | N |
| Have an alternate power supply for its alarm system. | Fire Safety | 2020-01-06 | 2020-03-05 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2020-01-06 | 2020-03-05 | N |
| Follow proper procedures when the fire alarm was out of service for more than 4 hours. | Fire Safety | 2020-01-06 | 2020-03-05 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2020-01-06 | 2020-03-05 | N |
| Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. | Fire Safety | 2020-01-06 | 2020-03-05 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2020-01-06 | 2020-03-05 | N |
| Allow residents to easily view the nursing home's survey results and communicate with advocate agencies. | Health | 2020-01-09 | 2020-02-14 | N |
| Honor the resident's right to manage his or her financial affairs. | Health | 2018-11-29 | 2019-01-15 | N |
| Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | Health | 2018-11-29 | 2019-01-15 | 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 | 2018-11-29 | 2019-01-15 | N |
| Ensure each resident receives an accurate assessment. | Health | 2018-11-29 | 2019-01-15 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2018-11-29 | 2019-01-15 | 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 | 2018-11-29 | 2019-01-15 | N |
| Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | Health | 2018-11-29 | 2019-01-15 | N |
| 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 | 2018-11-27 | 2019-01-15 | N |
| Construct fire resistant interior walls. | Fire Safety | 2018-11-27 | 2019-01-15 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2018-11-27 | 2019-01-15 | N |
| Install properly constructed and protected linen or trash chutes. | Fire Safety | 2018-11-27 | 2019-01-15 | N |
| Have power receptacles that are properly grounded. | Fire Safety | 2018-11-27 | 2019-01-15 | N |
| Have a battery powered remote alarm panel in a location accessible by operating personnel. | Fire Safety | 2018-11-27 | 2019-01-15 | N |
