Deficiency Records for Mt Lebanon Rehabilitation and Wellness Center
Updated as of January 01, 2019
This is not the most recent data for Mt Lebanon Rehabilitation and Wellness Center. For the most recent information, click here.
A list of the most recent deficiencies for Mt Lebanon Rehabilitation 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? |
|---|---|---|---|---|
| Conduct risk assessment and an All-Hazards approach. | Fire Safety | 2018-05-01 | 2018-06-02 | N |
| Develop Emergency Preparedness policies and procedures. | Fire Safety | 2018-05-01 | 2018-06-02 | N |
| Establish roles under a Waiver declared by secretary. | Fire Safety | 2018-05-01 | 2018-06-02 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2018-05-01 | 2018-06-02 | N |
| Meet other general requirements that are deficient. | Fire Safety | 2018-05-01 | 2018-06-02 | N |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2018-04-20 | 2018-05-15 | Y |
| Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | Health | 2018-04-27 | 2018-04-27 | N |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2018-04-27 | 2018-04-27 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2018-04-27 | 2018-04-27 | N |
| Assist a resident in gaining access to vision and hearing services. | Health | 2018-04-27 | 2018-04-27 | N |
| Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder. | Health | 2018-04-27 | 2018-04-27 | 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 | 2018-04-27 | 2018-04-27 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2018-04-27 | 2018-04-27 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2017-12-01 | 2018-01-09 | Y |
| Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2017-08-28 | 2017-10-11 | Y |
| Provide necessary care and services to maintain or improve the highest well being of each resident . | Health | 2017-08-28 | 2017-10-11 | Y |
| Meet other general requirements. | Fire Safety | 2017-03-06 | 2017-04-13 | 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 | 2017-03-06 | 2017-04-13 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2017-03-06 | 2017-04-13 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2017-03-06 | 2017-04-13 | N |
| Give residents a notice of rights, rules, services and charges. | Health | 2017-03-03 | 2017-04-13 | N |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2017-03-03 | 2017-04-13 | N |
| Develop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property. | Health | 2017-03-03 | 2017-04-13 | N |
| Ensure each resident receives an accurate assessment by a qualified health professional. | Health | 2017-03-03 | 2017-04-13 | N |
| Provide necessary care and services to maintain or improve the highest well being of each resident . | Health | 2017-03-03 | 2017-04-13 | N |
| Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. | Health | 2017-03-03 | 2017-04-13 | N |
| Store, cook, and serve food in a safe and clean way. | Health | 2017-03-03 | 2017-04-13 | N |
| Make sure that doctors see a resident's plan of care at every visit and make notes about progress and orders in writing. | Health | 2017-03-03 | 2017-04-13 | N |
| Keep accurate, complete and organized clinical records on each resident that meet professional standards. | Health | 2017-03-03 | 2017-04-13 | N |
| Provide care for residents in a way that maintains or improves their dignity and respect in full recognition of their individuality. | Health | 2017-03-03 | 2017-04-13 | Y |
| Proper stairway enclosures and vertical shafts. | Fire Safety | 2016-04-18 | 2016-06-07 | N |
| Exits that are accessible at all times. | Fire Safety | 2016-04-18 | 2016-06-07 | N |
| Record of quarterly fire drills for each shift under varying conditions. | Fire Safety | 2016-04-18 | 2016-06-07 | N |
| Weekly inspections and monthly testing of generators. | Fire Safety | 2016-04-18 | 2016-06-07 | N |
| Properly installed electrical wiring and equipment. | Fire Safety | 2016-04-18 | 2016-06-07 | N |
| Provide a safe, clean, comfortable and home-like environment; and allow residents to use personal belongings to the extent possible. | Health | 2016-04-14 | 2016-06-07 | N |
| Post nurse staffing information/data on a daily basis. | Health | 2016-04-14 | 2016-06-07 | N |
| Store, cook, and serve food in a safe and clean way. | Health | 2016-04-14 | 2016-06-07 | N |
