A list of the most recent deficiencies for Heritage Hall Grundy. 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? |
|---|---|---|---|---|
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2023-03-17 | 2023-07-28 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2023-03-17 | 2023-05-09 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2023-03-17 | 2023-05-09 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2023-03-17 | 2023-05-09 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2023-02-28 | 2023-04-26 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2023-02-28 | 2023-04-26 | N |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2023-02-28 | 2023-04-26 | 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 | 2021-04-05 | 2021-05-26 | N |
| Have properly located and lighted "Exit" signs. | Fire Safety | 2021-04-05 | 2021-05-26 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2021-04-05 | 2021-05-26 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2021-04-05 | 2021-05-26 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2021-04-05 | 2021-05-26 | N |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2021-03-18 | 2021-04-26 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2021-03-18 | 2021-04-26 | N |
| Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | Health | 2021-03-18 | 2021-04-26 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2021-03-18 | 2021-04-26 | 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 | 2021-03-18 | 2021-04-26 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2021-03-18 | 2021-04-26 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2019-03-21 | 2019-05-05 | N |
| Honor the resident's right to organize and participate in resident/family groups in the facility. | Health | 2019-03-21 | 2019-05-05 | N |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2019-03-21 | 2019-05-05 | 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 | 2019-03-21 | 2019-05-05 | 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 | 2019-03-21 | 2019-05-05 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2019-03-21 | 2019-05-05 | N |
| 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 | 2019-03-21 | 2019-05-05 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2019-03-21 | 2019-05-05 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2019-03-21 | 2019-05-05 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2019-03-21 | 2019-05-05 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2019-03-21 | 2019-05-05 | 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 | 2019-03-21 | 2019-05-05 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2019-03-21 | 2019-05-05 | N |
| Provide and implement an infection prevention and control program. | Health | 2019-03-21 | 2019-05-05 | N |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2019-03-21 | 2019-05-05 | N |
