A list of the most recent deficiencies for Siskin Subacute West. 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? |
|---|---|---|---|---|
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2023-10-29 | 2023-11-28 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2023-10-29 | 2023-11-28 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2023-10-29 | 2023-11-28 | 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 | 2023-10-29 | 2023-11-28 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-10-29 | 2023-11-28 | N |
| Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | Health | 2023-10-29 | 2023-11-28 | N |
| Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. | Health | 2023-10-29 | 2023-11-28 | N |
| Post nurse staffing information every day. | Health | 2023-10-29 | 2023-11-28 | N |
| Administer the facility in a manner that enables it to use its resources effectively and efficiently. | Health | 2023-10-29 | 2023-11-28 | N |
| Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility. | Health | 2023-10-29 | 2023-11-28 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2023-10-29 | 2023-11-28 | N |
| Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | Health | 2023-10-29 | 2023-11-28 | N |
| Provide and implement an infection prevention and control program. | Health | 2023-10-29 | 2023-11-28 | N |
| Develop and implement policies and procedures for flu and pneumonia vaccinations. | Health | 2023-10-29 | 2023-11-28 | N |
| Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame. | Health | 2023-10-29 | 2023-11-28 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2023-10-16 | 2023-11-14 | N |
| Conduct risk assessment and an All-Hazards approach. | Fire Safety | 2023-10-16 | 2023-10-17 | N |
| The resident has the right to receive notices in a format and a language he or she understands. | Health | 2020-02-20 | 2020-03-31 | N |
| Provide activities to meet all resident's needs. | Health | 2020-02-20 | 2020-03-31 | N |
| Conduct risk assessment and an All-Hazards approach. | Fire Safety | 2020-02-19 | 2020-03-31 | N |
| Have a battery powered remote alarm panel in a location accessible by operating personnel. | Fire Safety | 2020-02-19 | 2020-03-31 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2019-01-16 | 2019-02-28 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2019-01-15 | 2019-02-28 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2019-01-15 | 2019-02-28 | N |
