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Deficiency Records for Reformed Presbyterian Home
A list of the most recent deficiencies for Reformed Presbyterian Home. The list is based on the information provided by CMS from both standard inspections and from complaints filed by residents.
A list of the most recent deficiencies for Reformed Presbyterian Home. 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 | 2025-02-27 | 2025-04-10 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2024-11-22 | 2025-01-10 | Y |
| Use approved construction type or materials. | Fire Safety | 2024-08-21 | 2024-09-27 | 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 | 2024-08-21 | 2024-09-27 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2024-08-21 | 2024-09-27 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2024-08-21 | 2024-09-27 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2024-08-21 | 2024-09-27 | N |
| Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2024-08-21 | 2024-09-27 | N |
| Provide and implement an infection prevention and control program. | Health | 2024-08-14 | 2024-09-27 | 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 | 2024-08-14 | 2024-09-27 | 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 | 2024-08-14 | 2024-09-27 | N |
| Observe each nurse aide's job performance and give regular training. | Health | 2024-08-14 | 2024-09-27 | N |
| Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | Health | 2024-08-14 | 2024-09-27 | N |
| Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2024-08-14 | 2024-09-27 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2024-08-14 | 2024-09-27 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2024-08-14 | 2024-09-27 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2024-08-14 | 2024-09-27 | N |
| Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | Health | 2024-08-14 | 2024-09-27 | N |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2024-08-14 | 2024-09-27 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2024-03-09 | 2024-04-20 | Y |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2023-09-28 | 2023-11-20 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2023-09-28 | 2023-11-20 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2023-09-28 | 2023-11-20 | 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 | 2023-09-28 | 2023-11-20 | N |
| Use approved construction type or materials. | Fire Safety | 2023-09-28 | 2023-11-20 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2023-09-28 | 2023-11-20 | N |
| Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2023-09-28 | 2023-11-20 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2023-09-28 | 2023-11-20 | N |
| Meet requirements for the installation and maintenance of electrical systems. | Fire Safety | 2023-09-28 | 2023-11-20 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2023-09-28 | 2023-11-20 | N |
| Provide and implement an infection prevention and control program. | Health | 2023-09-29 | 2023-11-15 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2023-09-29 | 2023-11-15 | N |
| Assist a resident in gaining access to vision and hearing services. | Health | 2023-09-29 | 2023-11-15 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2023-09-29 | 2023-11-15 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2023-09-29 | 2023-11-15 | N |
| Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | Health | 2023-09-29 | 2023-11-15 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2023-09-29 | 2023-11-15 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-04-28 | 2023-05-30 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-04-28 | 2023-05-30 | Y |
| Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Health | 2023-04-28 | 2023-05-30 | Y |
| Use approved construction type or materials. | Fire Safety | 2022-11-28 | 2023-01-20 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2022-11-28 | 2023-01-20 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2022-11-28 | 2023-01-20 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-11-28 | 2023-01-20 | N |
| Install smoke barrier doors that can resist smoke for at least 20 minutes. | Fire Safety | 2022-11-28 | 2023-01-20 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-11-23 | 2023-01-02 | N |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2022-11-23 | 2023-01-02 | N |
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