A list of the most recent deficiencies for Naamans Creek Country Manor. 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? |
|---|---|---|---|---|
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2023-08-07 | 2023-10-06 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2023-08-07 | 2023-10-06 | N |
| Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2023-08-07 | 2023-10-06 | N |
| The resident has the right to receive notices in a format and a language he or she understands. | Health | 2023-07-20 | 2023-09-08 | N |
| Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | Health | 2023-07-20 | 2023-09-08 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2023-07-20 | 2023-09-08 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2023-07-20 | 2023-09-08 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-07-20 | 2023-09-08 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-05-09 | 2023-05-24 | Y |
| Meet other general requirements. | Fire Safety | 2022-08-03 | 2022-09-30 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2022-08-03 | 2022-09-30 | N |
| Have an enclosure around a vertical opening shaft. | Fire Safety | 2022-08-03 | 2022-09-30 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-08-03 | 2022-09-30 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2022-08-03 | 2022-09-30 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2022-08-03 | 2022-09-30 | N |
| Have proper power supply for life support equipment. | Fire Safety | 2022-08-03 | 2022-09-30 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2022-08-03 | 2022-09-30 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2022-08-03 | 2022-09-30 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2022-07-22 | 2022-09-07 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2022-07-22 | 2022-09-07 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2022-07-22 | 2022-09-07 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2022-07-22 | 2022-09-07 | 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 | 2022-07-22 | 2022-09-07 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2021-06-30 | 2021-08-19 | N |
| Meet other general requirements. | Fire Safety | 2021-06-30 | 2021-08-12 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2021-06-30 | 2021-08-12 | 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 | 2021-06-30 | 2021-08-12 | 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 | 2021-06-30 | 2021-08-12 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2021-06-30 | 2021-08-12 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2021-06-30 | 2021-08-12 | N |
| Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2021-06-30 | 2021-08-12 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2021-06-30 | 2021-08-12 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2021-06-28 | 2021-07-15 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2021-06-28 | 2021-07-15 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2021-06-28 | 2021-07-15 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2021-06-28 | 2021-07-15 | N |
