Deficiency Records for Elizabeth Adam Crump Health and Rehab
Updated as of March 01, 2024
A list of the most recent deficiencies for Elizabeth Adam Crump Health and Rehab. 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? |
|---|---|---|---|---|
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2023-06-28 | 2023-07-27 | 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 | 2023-06-28 | 2023-07-27 | Y |
| Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy. | Health | 2023-06-28 | 2023-07-27 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2023-06-28 | 2023-07-27 | Y |
| Plan the resident's discharge to meet the resident's goals and needs. | Health | 2023-06-28 | 2023-07-27 | Y |
| Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. | Health | 2023-06-28 | 2023-07-27 | Y |
| Use approved construction type or materials. | Fire Safety | 2022-09-13 | 2022-11-18 | N |
| Have properly located and lighted "Exit" signs. | Fire Safety | 2022-09-13 | 2022-11-18 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-09-13 | 2022-11-18 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2022-09-13 | 2022-11-18 | N |
| Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2022-09-13 | 2022-11-18 | N |
| Provide a written emergency evacuation plan. | Fire Safety | 2022-09-13 | 2022-11-18 | N |
| Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2022-09-13 | 2022-11-18 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2022-09-13 | 2022-11-18 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2022-09-13 | 2022-11-18 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2022-08-18 | 2022-09-20 | N |
| Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | Health | 2022-08-18 | 2022-09-20 | 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 | 2022-08-18 | 2022-09-20 | N |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2022-08-18 | 2022-09-20 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2022-08-18 | 2022-09-20 | 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 | 2022-08-18 | 2022-09-20 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2022-08-18 | 2022-09-20 | 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 | 2022-08-18 | 2022-09-20 | N |
| Ensure each resident receives an accurate assessment. | Health | 2022-08-18 | 2022-09-20 | N |
| Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | Health | 2022-08-18 | 2022-09-20 | N |
| PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2022-08-18 | 2022-09-20 | 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 | 2022-08-18 | 2022-09-20 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-08-18 | 2022-09-20 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-08-18 | 2022-09-20 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2022-08-18 | 2022-09-20 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2022-08-18 | 2022-09-20 | N |
| Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2022-08-18 | 2022-09-20 | 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 | 2022-08-18 | 2022-09-20 | N |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2022-08-18 | 2022-09-20 | N |
| Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | Health | 2022-08-18 | 2022-09-20 | N |
| Ensure meals and snacks are served at times in accordance with resident?s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. | Health | 2022-08-18 | 2022-09-20 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-08-18 | 2022-09-20 | N |
| Employ staff that are licensed, certified, or registered in accordance with state laws. | Health | 2022-08-18 | 2022-09-20 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2022-08-18 | 2022-09-20 | N |
| Provide and implement an infection prevention and control program. | Health | 2022-08-18 | 2022-09-20 | N |
| Keep all essential equipment working safely. | Health | 2022-08-18 | 2022-09-20 | N |
| Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | Health | 2022-08-18 | 2022-09-20 | 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 | 2022-08-18 | 2022-09-20 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2022-08-18 | 2022-09-20 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-08-18 | 2022-09-20 | Y |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2022-08-18 | 2022-09-20 | Y |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2022-08-18 | 2022-09-20 | Y |
| Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | Health | 2022-08-18 | 2022-09-20 | Y |
| Provide routine and 24-hour emergency dental care for each resident. | Health | 2022-08-18 | 2022-09-20 | Y |
| Include a process for Emergency Preparedness collaboration. | Fire Safety | 2022-08-18 | 2022-09-20 | N |
| Provide family notifications of emergency plan. | Fire Safety | 2022-08-18 | 2022-09-20 | N |
| Establish staff and initial training requirements. | Fire Safety | 2022-08-18 | 2022-09-20 | N |
| Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident?s advance directives. | Health | 2022-08-18 | 2022-06-28 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2021-12-15 | 2022-01-11 | Y |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2021-12-15 | 2022-01-11 | Y |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2021-12-15 | 2022-01-11 | Y |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2021-04-14 | 2021-07-12 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2021-04-14 | 2021-06-02 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2021-04-14 | 2021-06-02 | N |
| Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2021-04-14 | 2021-06-02 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2021-04-14 | 2021-06-02 | N |
| Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. | Fire Safety | 2021-04-14 | 2021-06-02 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2021-04-14 | 2021-06-02 | N |
| Keep residents' personal and medical records private and confidential. | Health | 2021-03-18 | 2021-04-14 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2021-03-18 | 2021-04-14 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2021-03-18 | 2021-04-14 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2021-03-18 | 2021-04-14 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2021-03-18 | 2021-04-14 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2021-03-18 | 2021-04-14 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2021-03-18 | 2021-04-14 | N |
| Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2021-03-18 | 2021-04-14 | N |
| Observe each nurse aide's job performance and give regular training. | Health | 2021-03-18 | 2021-04-14 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2021-03-18 | 2021-04-14 | 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 | 2021-03-18 | 2021-04-14 | 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 | 2021-04-14 | N |
| Develop and implement policies and procedures for flu and pneumonia vaccinations. | Health | 2021-03-18 | 2021-04-14 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2019-06-27 | 2019-08-30 | 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 | 2019-06-27 | 2019-08-30 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2019-06-27 | 2019-08-30 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2019-06-27 | 2019-08-30 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2019-06-27 | 2019-08-30 | N |
| Have an externally vented heating system. | Fire Safety | 2019-06-27 | 2019-08-30 | N |
| Have elevators that firefighters can control in the event of a fire. | Fire Safety | 2019-06-27 | 2019-08-30 | N |
| Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2019-06-27 | 2019-08-30 | N |
| Meet requirements for the installation and maintenance of electrical systems. | Fire Safety | 2019-06-27 | 2019-08-30 | 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 | 2019-06-14 | 2019-07-14 | N |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2019-06-14 | 2019-07-14 | 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 | 2019-06-14 | 2019-07-14 | N |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2019-06-14 | 2019-07-14 | N |
| Develop and implement policies and procedures to ensure (1) employees report any suspicion of a crime against any resident, according to timelines; (2) post the notice of employee rights; and (3) prohibit and prevent retaliation for reporting. | Health | 2019-06-14 | 2019-07-14 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2019-06-14 | 2019-07-14 | N |
| Assure that each resident?s assessment is updated at least once every 3 months. | Health | 2019-06-14 | 2019-07-14 | N |
| Ensure each resident receives an accurate assessment. | Health | 2019-06-14 | 2019-07-14 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2019-06-14 | 2019-07-14 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2019-06-14 | 2019-07-14 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2019-06-14 | 2019-07-14 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2019-06-14 | 2019-07-14 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2019-06-14 | 2019-07-14 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2019-06-14 | 2019-07-14 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2019-06-14 | 2019-07-14 | 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 | 2019-06-14 | 2019-07-14 | N |
| Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | Health | 2019-06-14 | 2019-07-14 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2019-06-14 | 2019-07-14 | 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 | 2019-06-14 | 2019-07-14 | 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 | 2019-06-14 | 2019-07-14 | N |
| Ensure that residents are free from significant medication errors. | Health | 2019-06-14 | 2019-07-14 | N |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2019-06-14 | 2019-07-14 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2019-06-14 | 2019-07-14 | N |
