Deficiency Records for Brookwood Skilled Nursing and Therapy
Updated as of April 01, 2024
A list of the most recent deficiencies for Brookwood Skilled Nursing and Therapy. 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 appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-07-19 | 2023-08-22 | 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 | 2023-07-19 | 2023-08-22 | Y |
| Make sure that a working call system is available in each resident's bathroom and bathing area. | Health | 2023-07-19 | 2023-08-22 | Y |
| Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | Health | 2023-03-27 | 2023-06-06 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2023-03-27 | 2023-06-06 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-03-27 | 2023-06-06 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2023-03-27 | 2023-06-06 | 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 | 2023-03-27 | 2023-06-06 | N |
| Provide timely, quality laboratory services/tests to meet the needs of residents. | Health | 2023-03-27 | 2023-06-06 | N |
| Have properly located and lighted "Exit" signs. | Fire Safety | 2023-05-18 | 2023-06-06 | 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 | 2023-05-18 | 2023-06-06 | N |
| Properly provide smoke detection systems in areas open to corridors. | Fire Safety | 2023-05-18 | 2023-06-06 | N |
| Install smoke barrier doors that can resist smoke for at least 20 minutes. | Fire Safety | 2023-05-18 | 2023-06-06 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2023-01-17 | 2023-02-15 | 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 | 2022-03-31 | 2022-05-05 | Y |
| Not require residents to give up Medicare or Medicaid benefits, or pay privately as a condition of admission; and must tell residents what care they do not provide. | Health | 2021-06-02 | 2021-07-14 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2021-06-02 | 2021-07-14 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2021-06-02 | 2021-07-14 | Y |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2019-06-20 | 2019-08-06 | N |
| Assess the resident when there is a significant change in condition | Health | 2019-06-20 | 2019-07-10 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2019-06-20 | 2019-07-10 | N |
| Have properly located and lighted "Exit" signs. | Fire Safety | 2019-06-20 | 2019-07-10 | N |
| Properly provide smoke detection systems in areas open to corridors. | Fire Safety | 2019-06-20 | 2019-07-10 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2019-06-20 | 2019-07-10 | N |
| Install smoke barrier doors that can resist smoke for at least 20 minutes. | Fire Safety | 2019-06-20 | 2019-07-10 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2019-06-20 | 2019-07-10 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2019-06-20 | 2019-07-10 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2019-06-20 | 2019-07-10 | N |
| Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home. | Health | 2018-08-01 | 2018-09-12 | N |
| Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death. | Health | 2018-08-01 | 2018-09-12 | 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 | 2018-08-01 | 2018-09-12 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2018-08-01 | 2018-09-12 | 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 | 2018-07-30 | 2018-09-12 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2018-07-30 | 2018-09-12 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2018-07-30 | 2018-09-12 | N |
| Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke. | Fire Safety | 2018-07-30 | 2018-09-12 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2018-07-30 | 2018-09-12 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2018-07-30 | 2018-09-12 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2018-07-30 | 2018-09-12 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2018-07-30 | 2018-09-12 | N |
