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Deficiency Records for The Pavilion at Edgefield For Nursing and Rehabili

View the most recent health deficiencies and inspection results for The Pavilion at Edgefield For Nursing and Rehabili. Stay informed about quality of care issues.

View the most recent health deficiencies and inspection results for The Pavilion at Edgefield For Nursing and Rehabili. Stay informed about quality of care issues.

Deficiency Type of Deficiency Deficiency Date Date Corrected Resulted from a Complaint?
Provide and implement an infection prevention and control program. Health 2026-02-18 2026-03-17 Y
Provide safe and appropriate respiratory care for a resident when needed. Health 2025-11-20 2025-12-12 N
Reasonably accommodate the needs and preferences of each resident. Health 2025-11-20 2025-12-12 N
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 2025-11-20 2025-12-12 N
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 2025-11-20 2025-12-12 N
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. Health 2025-11-20 2025-12-12 N
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge. Health 2025-11-20 2025-12-12 N
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. Health 2025-11-20 2025-12-12 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 2025-11-20 2025-12-12 N
Provide care and assistance to perform activities of daily living for any resident who is unable. Health 2025-11-20 2025-12-12 N
Provide appropriate treatment and care according to orders, resident?s preferences and goals. Health 2025-11-20 2025-12-12 N
Assist a resident in gaining access to vision and hearing services. Health 2025-11-20 2025-12-12 N
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2025-11-20 2025-12-12 N
Have corridors or aisles that are unobstructed and are at least 8 feet in width. Fire Safety 2025-11-20 2025-12-12 N
Provide safe, appropriate pain management for a resident who requires such services. Health 2025-11-20 2025-12-12 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 2025-11-20 2025-12-12 N
Provide or obtain dental services for each resident. Health 2025-11-20 2025-12-12 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 2025-11-20 2025-12-12 N
Ensure each resident receives and the facility provides drinks consistent with resident needs and preferences and sufficient to maintain resident hydration. Health 2025-11-20 2025-12-12 N
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Health 2025-11-20 2025-12-12 N
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Health 2025-11-20 2025-12-12 N
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. Health 2025-11-20 2025-12-12 N
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly Health 2025-11-20 2025-12-12 N
Provide and implement an infection prevention and control program. Health 2025-11-20 2025-12-12 N
Implement a program that monitors antibiotic use. Health 2025-11-20 2025-12-12 N
Install corridor and hallway doors that block smoke. Fire Safety 2025-11-20 2025-12-12 N
Have proper medical gas storage and administration areas. Fire Safety 2025-11-20 2025-12-12 N
Have generator or other power source capable of supplying service within 10 seconds. Fire Safety 2025-11-20 2025-12-12 N
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Fire Safety 2025-11-20 2025-12-12 N
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Fire Safety 2025-11-20 2025-12-12 N
Meet other general requirements that are deficient. Fire Safety 2025-11-20 2025-12-12 N
Inspect, test, and maintain automatic sprinkler systems. Fire Safety 2025-11-20 2025-12-12 N
Provide properly protected cooking facilities. Fire Safety 2025-11-20 2025-12-12 N
Have an enclosure around a vertical opening shaft. Fire Safety 2025-11-20 2025-12-12 N
Have stairways and smokeproof enclosures used as exits that meet safety requirements. Fire Safety 2025-11-20 2025-12-12 N
Provide and implement an infection prevention and control program. Health 2025-06-30 2025-07-14 Y
Provide appropriate pressure ulcer care and prevent new ulcers from developing. Health 2024-01-19 2024-02-08 Y
Reasonably accommodate the needs and preferences of each resident. Health 2022-11-17 2023-01-06 N
Provide safe and appropriate respiratory care for a resident when needed. Health 2022-11-17 2023-01-06 N
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. Health 2022-11-17 2023-01-06 N
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Fire Safety 2022-11-17 2023-01-06 N
Inspect, test, and maintain automatic sprinkler systems. Fire Safety 2022-11-17 2023-01-06 N
Have approved installation, maintenance and testing program for fire alarm systems. Fire Safety 2022-11-17 2023-01-06 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 2022-11-17 2023-01-06 N
Have power receptacles that are properly grounded. Fire Safety 2020-01-16 2020-02-22 N
Have ramps, exits, fire escape ladders, steps, and areas of refuge that meet safety requirements. Fire Safety 2020-01-16 2020-02-22 N
Have restrictions on the use of highly flammable decorations. Fire Safety 2020-01-16 2020-02-22 N
Ensure proper usage of power strips and extension cords. Fire Safety 2020-01-16 2020-02-22 N
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Fire Safety 2020-01-16 2020-02-22 N
Install properly constructed and protected linen or trash chutes. Fire Safety 2020-01-16 2020-02-22 N
Ensure smoke barriers are constructed to a 1 hour fire resistance rating. Fire Safety 2020-01-16 2020-02-22 N
Install corridor and hallway doors that block smoke. Fire Safety 2020-01-16 2020-02-22 N
Inspect, test, and maintain automatic sprinkler systems. Fire Safety 2020-01-16 2020-02-22 N
Follow proper procedures when the fire alarm was out of service for more than 4 hours. Fire Safety 2020-01-16 2020-02-22 N
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. Fire Safety 2020-01-16 2020-02-22 N
Have properly located and lighted "Exit" signs. Fire Safety 2020-01-16 2020-02-22 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 2020-01-16 2020-02-22 N
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. Health 2020-01-16 2020-02-18 N
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. Health 2020-01-16 2020-02-18 N
PASARR screening for Mental disorders or Intellectual Disabilities Health 2020-01-16 2020-02-18 N
Ensure that residents are free from significant medication errors. Health 2020-01-16 2020-02-18 N
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Health 2020-01-16 2020-02-18 N
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Health 2020-01-16 2020-02-18 N
Provide and implement an infection prevention and control program. Health 2020-01-16 2020-02-18 N
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2025-12-22 Not Fixed Y

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