Deficiency Records for Chandler Therapy and Living Center LLC
Updated as of March 01, 2024
A list of the most recent deficiencies for Chandler Therapy and Living Center LLC. 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? |
|---|---|---|---|---|
| Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2023-07-17 | 2023-10-31 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2023-07-17 | 2023-10-31 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-08-29 | 2023-10-18 | Y |
| Make sure that a working call system is available in each resident's bathroom and bathing area. | Health | 2023-05-18 | 2023-10-18 | Y |
| Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death. | Health | 2023-07-17 | 2023-10-18 | N |
| Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | Health | 2023-07-17 | 2023-10-18 | N |
| Assure that each resident?s assessment is updated at least once every 3 months. | Health | 2023-07-17 | 2023-10-18 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2023-07-17 | 2023-10-18 | N |
| Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2023-07-17 | 2023-10-18 | N |
| Ensure that residents are free from significant medication errors. | Health | 2023-07-17 | 2023-10-18 | N |
| Provide timely, quality laboratory services/tests to meet the needs of residents. | Health | 2023-07-17 | 2023-10-18 | N |
| Administer the facility in a manner that enables it to use its resources effectively and efficiently. | Health | 2023-07-17 | 2023-10-18 | N |
| Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations and emergencies. | Health | 2023-07-17 | 2023-10-18 | N |
| Have a plan that describes the process for conducting QAPI and QAA activities. | Health | 2023-07-17 | 2023-10-18 | N |
| Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | Health | 2023-07-17 | 2023-10-18 | N |
| Provide and implement an infection prevention and control program. | Health | 2023-07-17 | 2023-10-18 | N |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2023-07-17 | 2023-10-18 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2023-05-18 | 2023-07-31 | Y |
| 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 | 2023-05-18 | 2023-07-31 | Y |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2023-05-18 | 2023-07-31 | Y |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-05-18 | 2023-07-31 | Y |
| Ensure staff are vaccinated for COVID-19 | Health | 2023-05-18 | 2023-07-31 | Y |
| Develop and maintain an Emergency Preparedness Program (EP). | Fire Safety | 2022-03-30 | 2022-06-23 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2022-03-30 | 2022-06-23 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-04-06 | 2022-06-17 | N |
| Install smoke barrier doors that can resist smoke for at least 20 minutes. | Fire Safety | 2022-03-30 | 2022-06-17 | N |
| Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2022-03-30 | 2022-06-17 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2022-03-30 | 2022-06-17 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2022-04-06 | 2022-06-10 | 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 | 2022-04-06 | 2022-06-10 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-04-06 | 2022-06-10 | N |
| Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations and emergencies. | Health | 2022-04-06 | 2022-06-10 | N |
| Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | Health | 2022-04-06 | 2022-05-31 | N |
| Keep residents' personal and medical records private and confidential. | Health | 2022-04-06 | 2022-05-31 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-04-06 | 2022-05-31 | 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 | 2022-04-06 | 2022-05-31 | N |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2022-04-06 | 2022-05-31 | N |
| Administer the facility in a manner that enables it to use its resources effectively and efficiently. | Health | 2022-04-06 | 2022-05-31 | N |
| Provide and implement an infection prevention and control program. | Health | 2022-04-06 | 2022-05-31 | N |
| Develop and implement policies and procedures for flu and pneumonia vaccinations. | Health | 2022-04-06 | 2022-05-31 | 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 | 2022-03-30 | 2022-05-31 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2022-03-30 | 2022-05-31 | N |
| Have properly located and lighted "Exit" signs. | Fire Safety | 2022-03-30 | 2022-05-31 | 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 | 2022-03-30 | 2022-05-31 | N |
| Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke. | Fire Safety | 2022-03-30 | 2022-05-31 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2022-03-30 | 2022-05-21 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2022-03-30 | 2022-05-21 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2022-03-30 | 2022-05-21 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2022-03-30 | 2022-05-11 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2022-03-30 | 2022-05-11 | N |
| Properly provide smoke detection systems in areas open to corridors. | Fire Safety | 2022-03-30 | 2022-05-11 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2022-03-30 | 2022-05-11 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-03-30 | 2022-05-11 | N |
| Ensure each resident receives an accurate assessment. | Health | 2021-06-08 | 2021-07-29 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2021-06-08 | 2021-07-29 | Y |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2021-06-08 | 2021-07-29 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2021-06-08 | 2021-07-29 | Y |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2019-08-19 | 2019-09-05 | N |
| Respond appropriately to all alleged violations. | Health | 2019-08-19 | 2019-09-05 | N |
| Provide activities to meet all resident's needs. | Health | 2019-08-19 | 2019-09-05 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2019-08-19 | 2019-09-05 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2019-08-13 | 2019-09-05 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2019-08-13 | 2019-09-05 | N |
| Have power receptacles that are properly grounded. | Fire Safety | 2019-08-13 | 2019-09-05 | N |
