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Deficiency Records for Avalon Health and Rehabilitation Center - Pasco
View the most recent health deficiencies and inspection results for Avalon Health and Rehabilitation Center - Pasco. Stay informed about quality of care issues.
View the most recent health deficiencies and inspection results for Avalon Health and Rehabilitation Center - Pasco. Stay informed about quality of care issues.
| Deficiency | Type of Deficiency | Deficiency Date | Date Corrected | Resulted from a Complaint? |
|---|---|---|---|---|
| Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge. | Health | 2026-04-30 | 2026-05-20 | Y |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2026-04-07 | 2026-04-28 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2026-03-19 | 2026-04-14 | Y |
| Provide and implement an infection prevention and control program. | Health | 2026-03-19 | 2026-04-14 | Y |
| Respond appropriately to all alleged violations. | Health | 2026-03-19 | 2026-04-14 | Y |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2026-03-19 | 2026-04-14 | Y |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2026-03-19 | 2026-04-14 | Y |
| Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2026-03-19 | 2026-04-14 | Y |
| 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 | 2026-03-19 | 2026-04-14 | Y |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2025-12-23 | 2026-01-19 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2025-12-23 | 2026-01-19 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2025-09-17 | 2025-10-08 | Y |
| Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made. | Health | 2025-08-05 | 2025-08-15 | Y |
| Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | Health | 2025-05-27 | 2025-07-10 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2025-05-27 | 2025-07-10 | N |
| Give residents a notice of rights, rules, services and charges. | Health | 2025-05-27 | 2025-07-10 | N |
| The resident has the right to receive notices in a format and a language he or she understands. | Health | 2025-05-27 | 2025-07-10 | 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 | 2025-05-27 | 2025-07-10 | 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 | 2025-05-27 | 2025-07-10 | N |
| Respond appropriately to all alleged violations. | Health | 2025-05-27 | 2025-07-10 | N |
| Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. | Health | 2025-05-27 | 2025-07-10 | N |
| PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2025-05-27 | 2025-07-10 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2025-05-27 | 2025-07-10 | N |
| Provide activities to meet all resident's needs. | Health | 2025-05-27 | 2025-07-10 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2025-05-27 | 2025-07-10 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2025-05-27 | 2025-07-10 | 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 | 2025-05-27 | 2025-07-10 | 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 | 2025-05-27 | 2025-07-10 | N |
| Provide or obtain dental services for each resident. | Health | 2025-05-27 | 2025-07-10 | N |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2025-05-27 | 2025-07-10 | N |
| Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse. | Health | 2025-05-27 | 2025-07-10 | N |
| Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. | Health | 2025-05-27 | 2025-07-10 | N |
| Address patient/client population and determine types of services needed. | Fire Safety | 2025-05-27 | 2025-06-18 | N |
| Establish staff and initial training requirements. | Fire Safety | 2025-05-27 | 2025-06-18 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2025-05-27 | 2025-06-18 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2025-05-27 | 2025-06-18 | N |
| Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. | Fire Safety | 2025-05-27 | 2025-06-18 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2025-05-27 | 2025-06-18 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2025-05-27 | 2025-06-18 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2025-05-27 | 2025-06-18 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2025-05-27 | 2025-06-18 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2025-05-27 | 2025-06-18 | N |
| Have properly located and lighted "Exit" signs. | Fire Safety | 2025-05-27 | 2025-06-18 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2025-05-27 | 2025-06-18 | N |
| Meet other general requirements. | Fire Safety | 2025-05-27 | 2025-06-18 | N |
| Establish emergency prep training and testing. | Fire Safety | 2025-05-27 | 2025-06-18 | N |
| List the names and contact information of those in the facility. | Fire Safety | 2025-05-27 | 2025-06-18 | N |
| Create arrangements with other facilities to receive patients. | Fire Safety | 2025-05-27 | 2025-06-18 | N |
| Develop Emergency Preparedness policies and procedures. | Fire Safety | 2025-05-27 | 2025-06-18 | N |
| Establish an Emergency Preparedness Program (EP). | Fire Safety | 2025-05-27 | 2025-06-18 | N |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2025-01-29 | 2025-02-14 | Y |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2025-01-29 | 2025-02-14 | Y |
| Verify that a nurse aide has been trained; and if they haven't worked as a nurse aide for 2 years, receive retraining. | Health | 2025-01-29 | 2025-02-14 | Y |
| Provide and implement an infection prevention and control program. | Health | 2025-01-29 | 2025-02-14 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2024-12-19 | 2025-01-08 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2024-10-23 | 2024-11-18 | Y |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2024-10-23 | 2024-11-18 | 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 | 2024-09-25 | 2024-10-11 | Y |
| Ensure that residents are fully informed and understand their health status, care and treatments. | Health | 2024-04-23 | 2024-05-15 | N |
| Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2024-04-23 | 2024-05-15 | N |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2024-04-23 | 2024-05-15 | N |
| Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. | Health | 2024-04-23 | 2024-05-15 | N |
| Develop and implement policies and procedures for flu and pneumonia vaccinations. | Health | 2024-04-23 | 2024-05-15 | N |
| Implement a program that monitors antibiotic use. | Health | 2024-04-23 | 2024-05-15 | N |
| Provide and implement an infection prevention and control program. | Health | 2024-04-23 | 2024-05-15 | N |
| Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | Health | 2024-04-23 | 2024-05-15 | N |
| Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. | Health | 2024-04-23 | 2024-05-15 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2024-04-23 | 2024-05-15 | 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 | 2024-04-23 | 2024-05-15 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2024-04-23 | 2024-05-15 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2024-04-23 | 2024-05-15 | 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 | 2024-04-23 | 2024-05-15 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2024-04-23 | 2024-05-15 | N |
| Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | Health | 2024-04-23 | 2024-05-15 | 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 | 2024-04-23 | 2024-05-15 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2024-04-23 | 2024-05-15 | 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 | 2024-04-23 | 2024-05-15 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2024-04-23 | 2024-05-15 | N |
| PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2024-04-23 | 2024-05-15 | N |
| Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | Health | 2024-04-23 | 2024-05-15 | N |
| Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | Health | 2024-04-23 | 2024-05-15 | 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 | 2024-04-23 | 2024-05-15 | 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 | 2024-04-23 | 2024-05-15 | N |
| Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | Health | 2024-04-23 | 2024-05-15 | N |
| Honor the resident's right to choose his or her attending physician. | Health | 2024-04-23 | 2024-05-15 | N |
| Address patient/client population and determine types of services needed. | Fire Safety | 2024-04-23 | 2024-05-15 | N |
| Have an externally vented heating system. | Fire Safety | 2024-04-23 | 2024-05-15 | N |
| Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2024-04-23 | 2024-05-15 | N |
| Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. | Fire Safety | 2024-04-23 | 2024-05-15 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2024-04-23 | 2024-05-15 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2024-04-23 | 2024-05-15 | N |
| Ensure that testing and maintenance of electrical equipment is performed. | Fire Safety | 2024-04-23 | 2024-05-15 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2024-04-23 | 2024-05-15 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2024-04-23 | 2024-05-15 | N |
| Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke. | Fire Safety | 2024-04-23 | 2024-05-15 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2024-04-23 | 2024-05-15 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2024-04-23 | 2024-05-15 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2024-04-23 | 2024-05-15 | N |
| Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector. | Fire Safety | 2024-04-23 | 2024-05-15 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2024-04-23 | 2024-05-15 | N |
| Conduct risk assessment and an All-Hazards approach. | Fire Safety | 2024-04-23 | 2024-05-15 | N |
| Develop Emergency Preparedness policies and procedures. | Fire Safety | 2024-04-23 | 2024-05-15 | N |
| Meet other general requirements. | Fire Safety | 2024-04-23 | 2024-05-15 | N |
| Conduct testing and exercise requirements. | Fire Safety | 2024-04-23 | 2024-05-15 | N |
| Establish staff and initial training requirements. | Fire Safety | 2024-04-23 | 2024-05-15 | N |
| List the names and contact information of those in the facility. | Fire Safety | 2024-04-23 | 2024-05-15 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2024-03-15 | 2024-04-30 | Y |
| Respond appropriately to all alleged violations. | Health | 2024-03-15 | 2024-04-30 | Y |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2024-03-15 | 2024-04-30 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2024-03-28 | 2024-04-30 | Y |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2024-03-28 | 2024-04-30 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2024-02-14 | 2024-03-11 | Y |
| Provide safe, appropriate pain management for a resident who requires such services. | Health | 2024-02-14 | 2024-03-11 | Y |
| Observe each nurse aide's job performance and give regular training. | Health | 2024-02-14 | 2024-03-11 | Y |
| Provide and implement an infection prevention and control program. | Health | 2024-02-14 | 2024-03-11 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2024-01-23 | 2024-02-14 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2023-10-26 | 2023-11-20 | Y |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2023-08-23 | 2023-09-12 | Y |
| Assess the resident when there is a significant change in condition | Health | 2023-05-17 | 2023-06-23 | N |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2023-05-17 | 2023-06-23 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2023-05-17 | 2023-06-23 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-05-17 | 2023-06-23 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2023-05-17 | 2023-06-23 | 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 | 2023-05-17 | 2023-06-23 | 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 | 2023-05-17 | 2023-06-23 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-05-17 | 2023-06-23 | N |
| Provide and implement an infection prevention and control program. | Health | 2023-05-17 | 2023-06-23 | N |
| Develop and implement policies and procedures for flu and pneumonia vaccinations. | Health | 2023-05-17 | 2023-06-23 | N |
| Respond appropriately to all alleged violations. | Health | 2023-05-17 | 2023-06-23 | N |
| Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death. | Health | 2023-05-17 | 2023-06-23 | N |
| Allow residents to self-administer drugs if determined clinically appropriate. | Health | 2023-05-17 | 2023-06-23 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2023-05-17 | 2023-06-12 | N |
| Meet other general requirements. | Fire Safety | 2023-05-17 | 2023-06-12 | N |
| Conduct testing and exercise requirements. | Fire Safety | 2023-05-17 | 2023-06-12 | N |
| Provide a means of sharing information on occupancy/needs. | Fire Safety | 2023-05-17 | 2023-06-12 | N |
| Provide emergency officials' contact information. | Fire Safety | 2023-05-17 | 2023-06-12 | N |
| Develop a communication plan. | Fire Safety | 2023-05-17 | 2023-06-12 | N |
| Include a process for Emergency Preparedness collaboration. | Fire Safety | 2023-05-17 | 2023-06-12 | N |