Deficiency Records for Mount Vernon Healthcare Center

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Updated as of April 01, 2024

A list of the most recent deficiencies for Mount Vernon Healthcare 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?
Ensure services provided by the nursing facility meet professional standards of quality. Health 2023-11-15 2023-12-28 Y
Keep aisles, corridors, and exits free of obstruction in case of emergency. Fire Safety 2022-09-22 2023-07-19 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 2022-09-22 2023-07-19 N
Have properly sized and located compartments to protect residents from smoke. Fire Safety 2022-09-22 2023-07-19 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 2022-09-29 2023-02-22 Y
Notify the resident or the resident?s representative in writing how long the nursing home will hold the resident?s bed in cases of transfer to a hospital or therapeutic leave. Health 2022-09-29 2023-02-22 Y
Provide care and assistance to perform activities of daily living for any resident who is unable. Health 2022-09-29 2023-02-22 Y
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 2023-01-11 2023-02-22 Y
Notify the resident or the resident?s representative in writing how long the nursing home will hold the resident?s bed in cases of transfer to a hospital or therapeutic leave. Health 2023-01-11 2023-02-22 Y
Provide care and assistance to perform activities of daily living for any resident who is unable. Health 2023-01-11 2023-02-22 Y
Limit the charges against residents' personal funds for items or services for which payment is made under Medicare or Medicaid. Health 2022-09-29 2023-02-10 N
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. Health 2022-09-29 2023-02-10 N
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. Health 2022-09-29 2023-02-10 N
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2022-09-29 2023-02-10 N
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Health 2022-09-29 2023-02-10 N
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death. Health 2022-09-29 2023-02-10 Y
Keep residents' personal and medical records private and confidential. Health 2022-09-29 2023-02-10 Y
Respond appropriately to all alleged violations. Health 2022-09-29 2023-02-10 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 2022-09-29 2023-02-10 Y
Ensure each resident?s drug regimen must be free from unnecessary drugs. Health 2022-09-29 2023-02-10 Y
Ensure that residents are free from significant medication errors. Health 2022-09-29 2023-02-10 Y
Provide or get specialized rehabilitative services as required for a resident. Health 2022-09-29 2023-02-10 Y
Allow resident to participate in the development and implementation of his or her person-centered plan of care. Health 2023-01-11 2023-02-10 Y
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death. Health 2023-01-11 2023-02-10 Y
Limit the charges against residents' personal funds for items or services for which payment is made under Medicare or Medicaid. Health 2023-01-11 2023-02-10 Y
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. Health 2023-01-11 2023-02-10 Y
Keep residents' personal and medical records private and confidential. Health 2023-01-11 2023-02-10 Y
Respond appropriately to all alleged violations. Health 2023-01-11 2023-02-10 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 2023-01-11 2023-02-10 Y
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. Health 2023-01-11 2023-02-10 Y
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2023-01-11 2023-02-10 Y
Ensure each resident?s drug regimen must be free from unnecessary drugs. Health 2023-01-11 2023-02-10 Y
Ensure that residents are free from significant medication errors. Health 2023-01-11 2023-02-10 Y
Provide or get specialized rehabilitative services as required for a resident. Health 2023-01-11 2023-02-10 Y
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Health 2023-01-11 2023-02-10 Y
Allow resident to participate in the development and implementation of his or her person-centered plan of care. Health 2022-09-29 2023-02-10 Y
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. Health 2022-09-29 2022-11-13 N
Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home. Health 2022-09-29 2022-11-13 N
The resident has the right to receive notices in a format and a language he or she understands. Health 2022-09-29 2022-11-13 N
Allow residents to easily view the nursing home's survey results and communicate with advocate agencies. Health 2022-09-29 2022-11-13 N
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. Health 2022-09-29 2022-11-13 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 2022-09-29 2022-11-13 N
Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged. Health 2022-09-29 2022-11-13 N
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. Health 2022-09-29 2022-11-13 N
PASARR screening for Mental disorders or Intellectual Disabilities Health 2022-09-29 2022-11-13 N
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted Health 2022-09-29 2022-11-13 N
Plan the resident's discharge to meet the resident's goals and needs. Health 2022-09-29 2022-11-13 N
Provide appropriate treatment and care according to orders, resident?s preferences and goals. Health 2022-09-29 2022-11-13 N
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. Health 2022-09-29 2022-11-13 N
Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services. Health 2022-09-29 2022-11-13 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 2022-09-29 2022-11-13 N
Observe each nurse aide's job performance and give regular training. Health 2022-09-29 2022-11-13 N
Post nurse staffing information every day. Health 2022-09-29 2022-11-13 N
Ensure that the facility has sufficient staff members who possess the competencies and skills to meet the behavioral health needs of residents. Health 2022-09-29 2022-11-13 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 2022-09-29 2022-11-13 N
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Health 2022-09-29 2022-11-13 N
Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs. Health 2022-09-29 2022-11-13 N
Perform COVID19 testing on residents and staff. Health 2022-09-29 2022-11-13 N
Ensure staff are vaccinated for COVID-19 Health 2022-09-29 2022-11-13 N
Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation. Health 2022-09-29 2022-11-13 N
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention. Health 2022-09-29 2022-11-13 N
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Health 2022-09-29 2022-11-13 Y
Allow residents to self-administer drugs if determined clinically appropriate. Health 2022-09-29 2022-11-13 Y
Honor the resident's right to manage his or her financial affairs. Health 2022-09-29 2022-11-13 Y
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Health 2022-09-29 2022-11-13 Y
Protect each resident from the wrongful use of the resident's belongings or money. Health 2022-09-29 2022-11-13 Y
Develop and implement policies and procedures to prevent abuse, neglect, and theft. Health 2022-09-29 2022-11-13 Y
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Health 2022-09-29 2022-11-13 Y
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. Health 2022-09-29 2022-11-13 Y
Ensure each resident receives an accurate assessment. Health 2022-09-29 2022-11-13 Y
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Health 2022-09-29 2022-11-13 Y
Ensure services provided by the nursing facility meet professional standards of quality. Health 2022-09-29 2022-11-13 Y
Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. Health 2022-09-29 2022-11-13 Y
Provide appropriate pressure ulcer care and prevent new ulcers from developing. Health 2022-09-29 2022-11-13 Y
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 2022-09-29 2022-11-13 Y
Provide and implement an infection prevention and control program. Health 2022-09-29 2022-11-13 Y
Conduct testing and exercise requirements. Fire Safety 2022-09-29 2022-11-13 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 2022-08-17 2022-09-20 Y
Keep aisles, corridors, and exits free of obstruction in case of emergency. Fire Safety 2020-03-11 2020-06-08 N
Provide rooms that can be unlocked from inside without a key. Fire Safety 2020-03-11 2020-06-08 N
Have elevators that firefighters can control in the event of a fire. Fire Safety 2020-03-11 2020-06-08 N
Have simulated fire drills held at unexpected times. Fire Safety 2020-03-11 2020-06-08 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 2019-11-08 2020-01-15 N
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Health 2019-11-08 2020-01-15 N
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Health 2019-11-08 2019-12-10 N
Allow residents to self-administer drugs if determined clinically appropriate. Health 2019-11-08 2019-12-10 N
Reasonably accommodate the needs and preferences of each resident. Health 2019-11-08 2019-12-10 N
Allow residents to easily view the nursing home's survey results and communicate with advocate agencies. Health 2019-11-08 2019-12-10 N
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. Health 2019-11-08 2019-12-10 N
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Health 2019-11-08 2019-12-10 N
Ensure services provided by the nursing facility meet professional standards of quality. Health 2019-11-08 2019-12-10 N
Provide appropriate pressure ulcer care and prevent new ulcers from developing. Health 2019-11-08 2019-12-10 N
Ensure that residents are free from significant medication errors. Health 2019-11-08 2019-12-10 N
Provide and implement an infection prevention and control program. Health 2019-11-08 2019-12-10 N
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. Health 2018-05-24 2018-07-06 N
PASARR screening for Mental disorders or Intellectual Disabilities Health 2018-05-24 2018-07-06 N
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Health 2018-05-24 2018-07-06 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 2018-05-24 2018-07-06 N
Provide appropriate treatment and care according to orders, resident?s preferences and goals. Health 2018-05-24 2018-07-06 N
Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit. Health 2018-05-24 2018-07-06 N
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. Health 2018-05-24 2018-07-06 N
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Health 2018-05-24 2018-07-06 N
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Health 2018-05-24 2018-07-06 N
Provide and implement an infection prevention and control program. Health 2018-05-24 2018-07-06 N