Deficiency Records for Staunton Post Acute and Rehabilitation
Updated as of March 01, 2020
This is not the most recent data for Staunton Post Acute and Rehabilitation. For the most recent information, click here.
A list of the most recent deficiencies for Staunton Post Acute and Rehabilitation. 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? |
|---|---|---|---|---|
| Allow residents to easily view the nursing home's survey results and communicate with advocate agencies. | Health | 2019-05-09 | 2019-08-14 | 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 | 2019-05-09 | 2019-08-14 | Y |
| Ensure each resident receives an accurate assessment. | Health | 2019-05-09 | 2019-08-14 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2019-05-09 | 2019-08-14 | 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 | 2019-05-09 | 2019-08-14 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2019-05-09 | 2019-08-14 | Y |
| Ensure that the facility has sufficient staff members who possess the competencies and skills to meet the behavioral health needs of residents. | Health | 2019-05-09 | 2019-08-14 | Y |
| Provide or get specialized rehabilitative services as required for a resident. | Health | 2019-05-09 | 2019-08-14 | Y |
| Administer the facility in a manner that enables it to use its resources effectively and efficiently. | Health | 2019-05-09 | 2019-08-14 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2019-05-09 | 2019-08-14 | Y |
| Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | Health | 2019-05-09 | 2019-08-14 | Y |
| Provide and implement an infection prevention and control program. | Health | 2019-05-09 | 2019-08-14 | Y |
| Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | Health | 2019-05-09 | 2019-08-14 | Y |
| Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention. | Health | 2019-05-09 | 2019-08-14 | Y |
| Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2019-05-09 | 2019-06-21 | Y |
| Protect each resident from separation (from other residents, his/her room, or confinement to his/her room). | Health | 2019-05-09 | 2019-06-21 | Y |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2019-05-09 | 2019-06-21 | Y |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2019-05-09 | 2019-06-21 | Y |
| Respond appropriately to all alleged violations. | Health | 2019-05-09 | 2019-06-21 | Y |
| Provide medically-related social services to help each resident achieve the highest possible quality of life. | Health | 2019-05-09 | 2019-06-21 | Y |
| Properly install and monitor supervisory attachments on automatic sprinkler systems. | Fire Safety | 2018-11-13 | 2019-01-09 | N |
| Have elevators that firefighters can control in the event of a fire. | Fire Safety | 2018-11-13 | 2019-01-09 | N |
| Have a battery powered remote alarm panel in a location accessible by operating personnel. | Fire Safety | 2018-11-13 | 2019-01-09 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2018-10-25 | 2018-11-27 | 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 | 2018-10-25 | 2018-11-27 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2018-10-25 | 2018-11-27 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2018-10-25 | 2018-11-27 | 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 | 2018-10-25 | 2018-11-27 | 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 | Health | 2018-10-25 | 2018-11-27 | N |
| Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia. | Health | 2018-10-25 | 2018-11-27 | 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 ne | Health | 2018-10-25 | 2018-11-27 | 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 | 2018-10-25 | 2018-11-27 | N |
| Provide and implement an infection prevention and control program. | Health | 2018-10-25 | 2018-11-27 | N |
| Develop and implement policies and procedures for flu and pneumonia vaccinations. | Health | 2018-10-25 | 2018-11-27 | 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 | 2018-10-25 | 2018-11-27 | N |
| Reasonably accommodate the needs and preferences of each resident. | Health | 2017-07-20 | 2017-09-03 | N |
| Provide a safe, clean, comfortable and home-like environment; and allow residents to use personal belongings to the extent possible. | Health | 2017-07-20 | 2017-09-03 | N |
| Ensure that residents with limited range of motion receive appropriate treatment and services to increase range of motion or prevent further decrease in range of motion. | Health | 2017-07-20 | 2017-09-03 | N |
| Have a program that investigates, controls and keeps infection from spreading. | Health | 2017-07-20 | 2017-09-03 | N |
| Keep accurate, complete and organized clinical records on each resident that meet professional standards. | Health | 2017-07-20 | 2017-09-03 | N |
| Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2017-07-20 | 2017-09-03 | Y |
| Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. | Health | 2017-07-20 | 2017-09-03 | Y |
| 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 | 2017-08-07 | 2017-08-29 | N |
| Have properly located and lighted "Exit" signs. | Fire Safety | 2017-08-07 | 2017-08-29 | N |
| Provide a written emergency evacuation plan. | Fire Safety | 2017-08-07 | 2017-08-29 | N |
| Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2017-08-07 | 2017-08-29 | N |
| Meet other general requirements that are deficient. | Fire Safety | 2017-08-07 | 2017-08-29 | N |
| Provide a safe, clean, comfortable and home-like environment; and allow residents to use personal belongings to the extent possible. | Health | 2016-06-16 | 2016-07-26 | N |
| Allow residents the right to participate in the planning or revision of care and treatment. | Health | 2016-06-16 | 2016-07-26 | N |
| Ensure that residents with limited range of motion receive appropriate treatment and services to increase range of motion or prevent further decrease in range of motion. | Health | 2016-06-16 | 2016-07-26 | N |
| Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. | Health | 2016-06-16 | 2016-07-26 | N |
| Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%. | Health | 2016-06-16 | 2016-07-26 | N |
| Make sure that special or therapeutic diets are ordered by the attending doctor. | Health | 2016-06-16 | 2016-07-26 | N |
| Store, cook, and serve food in a safe and clean way. | Health | 2016-06-16 | 2016-07-26 | N |
| Approved construction type or materials. | Fire Safety | 2016-06-30 | 2016-07-18 | N |
| Automatic sprinkler systems that have been maintained in working order. | Fire Safety | 2016-06-30 | 2016-07-18 | N |
| Properly installed hallway dispensers for alcohol-based hand rub. | Fire Safety | 2016-06-30 | 2016-07-18 | N |
