Deficiency Records for Susquehanna Health and Wellness Center
Updated as of March 01, 2024
A list of the most recent deficiencies for Susquehanna Health and Wellness 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? |
|---|---|---|---|---|
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2023-08-23 | 2023-10-02 | Y |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2023-05-16 | 2023-06-26 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2023-05-16 | 2023-06-26 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2023-05-16 | 2023-06-26 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-05-10 | 2023-06-08 | N |
| Provide for the safe, appropriate administration of IV fluids for a resident when needed. | Health | 2023-05-10 | 2023-06-08 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2023-05-10 | 2023-06-08 | 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 | 2023-05-10 | 2023-06-08 | N |
| Ensure that residents are free from significant medication errors. | Health | 2023-05-10 | 2023-06-08 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-05-10 | 2023-06-08 | N |
| Perform COVID19 testing on residents and staff. | Health | 2023-05-10 | 2023-06-08 | N |
| Ensure staff are vaccinated for COVID-19 | Health | 2023-05-10 | 2023-06-08 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-02-14 | 2023-03-13 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-10-19 | 2022-12-15 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2022-06-23 | 2022-07-12 | Y |
| Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2022-05-19 | 2022-07-06 | N |
| Respond appropriately to all alleged violations. | Health | 2022-05-19 | 2022-07-06 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2022-05-19 | 2022-07-06 | N |
| Observe each nurse aide's job performance and give regular training. | Health | 2022-05-19 | 2022-07-06 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2022-05-19 | 2022-07-06 | 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 | 2022-05-19 | 2022-07-06 | N |
| Ensure that residents are free from significant medication errors. | Health | 2022-05-19 | 2022-07-06 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-05-19 | 2022-07-06 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2022-05-19 | 2022-07-06 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2022-05-09 | 2022-06-15 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2022-05-09 | 2022-06-15 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-05-09 | 2022-06-15 | N |
| Have properly sized and located compartments to protect residents from smoke. | Fire Safety | 2022-05-09 | 2022-06-15 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2022-05-09 | 2022-06-15 | N |
| Meet other general requirements. | Fire Safety | 2022-05-09 | 2022-06-15 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-02-09 | 2022-03-15 | Y |
| Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards. | Health | 2022-02-09 | 2022-03-15 | Y |
| Employ staff that are licensed, certified, or registered in accordance with state laws. | Health | 2022-02-09 | 2022-03-15 | Y |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2021-04-30 | 2021-09-14 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2021-07-28 | 2021-08-10 | Y |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2021-06-30 | 2021-07-19 | Y |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2021-04-30 | 2021-06-22 | N |
| Not hire anyone with a finding of abuse, neglect, exploitation, or theft. | Health | 2021-04-30 | 2021-06-22 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2021-04-30 | 2021-06-22 | N |
| Respond appropriately to all alleged violations. | Health | 2021-04-30 | 2021-06-22 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2021-04-30 | 2021-06-22 | 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 | 2021-04-30 | 2021-06-22 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2021-04-30 | 2021-06-22 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2021-04-30 | 2021-06-22 | N |
| Provide safe, appropriate pain management for a resident who requires such services. | Health | 2021-04-30 | 2021-06-22 | N |
| Observe each nurse aide's job performance and give regular training. | Health | 2021-04-30 | 2021-06-22 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2021-04-30 | 2021-06-22 | N |
| Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation. | Health | 2021-04-30 | 2021-06-22 | N |
| Provide and implement an infection prevention and control program. | Health | 2022-12-19 | Not Fixed | Y |
