Deficiency Records for Fairview Fellowship Home For Senior Citizens, Inc
Updated as of March 01, 2024
A list of the most recent deficiencies for Fairview Fellowship Home For Senior Citizens, Inc. 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 simulated fire drills held at unexpected times. | Fire Safety | 2023-06-07 | 2023-06-23 | N |
| Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2023-06-07 | 2023-06-23 | N |
| Ensure each resident receives an accurate assessment. | Health | 2023-04-06 | 2023-06-21 | N |
| Properly provide smoke detection systems in areas open to corridors. | Fire Safety | 2023-06-07 | 2023-06-16 | 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 | 2023-06-07 | 2023-06-12 | N |
| Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | Health | 2023-04-06 | 2023-06-08 | N |
| Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | Health | 2023-04-06 | 2023-05-24 | N |
| Assess the resident when there is a significant change in condition | Health | 2023-04-06 | 2023-05-24 | N |
| Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | Health | 2023-04-06 | 2023-05-24 | N |
| Install smoke barrier doors that can resist smoke for at least 20 minutes. | Fire Safety | 2019-08-20 | 2019-09-30 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2019-08-20 | 2019-09-30 | N |
| Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | Health | 2019-08-22 | 2019-09-26 | N |
| Assess the resident when there is a significant change in condition | Health | 2019-08-22 | 2019-09-26 | N |
| Assure that each resident?s assessment is updated at least once every 3 months. | Health | 2019-08-22 | 2019-09-26 | N |
| Encode each resident?s assessment data and transmit these data to the State within 7 days of assessment. | Health | 2019-08-22 | 2019-09-26 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2019-08-22 | 2019-09-26 | 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 | 2019-08-22 | 2019-09-26 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2019-08-22 | 2019-09-26 | N |
| Have a plan that describes the process for conducting QAPI and QAA activities. | Health | 2019-08-22 | 2019-09-26 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2018-06-25 | 2018-08-24 | N |
| Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | Health | 2018-06-25 | 2018-08-24 | N |
| Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | Health | 2018-06-25 | 2018-08-24 | N |
| 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 | 2018-06-25 | 2018-08-24 | N |
| Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | Health | 2018-06-25 | 2018-08-24 | N |
| Assure that each resident?s assessment is updated at least once every 3 months. | Health | 2018-06-25 | 2018-08-24 | N |
| Ensure each resident receives an accurate assessment. | Health | 2018-06-25 | 2018-08-24 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2018-06-25 | 2018-08-24 | 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 | 2018-06-25 | 2018-08-24 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2018-06-25 | 2018-08-24 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2018-06-25 | 2018-08-24 | 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 | 2018-06-25 | 2018-08-24 | 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 | 2018-06-25 | 2018-08-24 | N |
| Establish an Emergency Preparedness Program (EP). | Fire Safety | 2018-06-20 | 2018-08-24 | N |
| Address subsistence needs for staff and patients. | Fire Safety | 2018-06-20 | 2018-08-24 | N |
| Establish emergency prep training and testing. | Fire Safety | 2018-06-20 | 2018-08-24 | 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 | 2018-06-20 | 2018-08-24 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2018-06-20 | 2018-08-24 | N |
| Have an externally vented heating system. | Fire Safety | 2018-06-20 | 2018-08-24 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2018-06-20 | 2018-08-24 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2018-06-20 | 2018-07-18 | N |
