A list of the most recent deficiencies for Colville of Cascadia, LLC. 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 that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2024-01-10 | 2023-12-04 | Y |
| Ensure that residents are free from significant medication errors. | Health | 2023-05-09 | 2023-05-20 | Y |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2023-02-03 | 2023-03-07 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-02-03 | 2023-03-07 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-02-03 | 2023-03-07 | N |
| Provide and implement an infection prevention and control program. | Health | 2023-02-03 | 2023-03-07 | N |
| Make sure that a working call system is available in each resident's bathroom and bathing area. | Health | 2023-02-03 | 2023-03-07 | N |
| Conduct risk assessment and an All-Hazards approach. | Fire Safety | 2023-02-01 | 2023-02-28 | N |
| Address subsistence needs for staff and patients. | Fire Safety | 2023-02-01 | 2023-02-28 | N |
| Create arrangements with other facilities to receive patients. | Fire Safety | 2023-02-01 | 2023-02-28 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2023-02-01 | 2023-02-28 | N |
| Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2023-02-01 | 2023-02-28 | N |
| Provide and implement an infection prevention and control program. | Health | 2022-06-10 | 2022-06-28 | Y |
| Provide and implement an infection prevention and control program. | Health | 2022-02-23 | 2022-03-01 | Y |
| Provide and implement an infection prevention and control program. | Health | 2021-09-28 | 2021-10-20 | Y |
| 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 | 2019-07-19 | 2019-09-02 | N |
| Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2019-07-19 | 2019-09-02 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2019-07-19 | 2019-09-02 | N |
| Respond appropriately to all alleged violations. | Health | 2019-07-19 | 2019-09-02 | 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 | 2019-07-19 | 2019-09-02 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2019-07-19 | 2019-09-02 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2019-07-19 | 2019-09-02 | 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 | 2019-07-19 | 2019-09-02 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2019-07-19 | 2019-09-02 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2019-07-19 | 2019-09-02 | 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 | 2019-07-19 | 2019-09-02 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2019-07-19 | 2019-09-02 | 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 | 2019-07-19 | 2019-09-02 | N |
| Ensure each resident must receive and the facility must provide necessary behavioral health care and services. | Health | 2019-07-19 | 2019-09-02 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2019-07-19 | 2019-09-02 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2019-07-19 | 2019-09-02 | N |
| Provide routine and 24-hour emergency dental care for each resident. | Health | 2019-07-19 | 2019-09-02 | N |
| Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. | Health | 2019-07-19 | 2019-09-02 | N |
| Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations and emergencies. | Health | 2019-07-19 | 2019-09-02 | N |
| Provide and implement an infection prevention and control program. | Health | 2019-07-19 | 2019-09-02 | N |
| Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. | Fire Safety | 2019-07-18 | 2019-08-14 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2019-07-18 | 2019-08-09 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2019-07-18 | 2019-08-09 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2019-07-18 | 2019-08-09 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2019-07-18 | 2019-08-09 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2019-07-18 | 2019-08-01 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2018-06-26 | 2018-07-16 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2018-06-26 | 2018-07-16 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2018-06-26 | 2018-07-16 | 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 | 2018-06-26 | 2018-07-16 | 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 | 2018-06-26 | 2018-07-16 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2018-06-26 | 2018-07-16 | N |
| Obtain a doctor's order to admit a resident and ensure the resident is under a doctor's care. | Health | 2018-06-26 | 2018-07-16 | 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 | 2018-06-26 | 2018-07-16 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2018-06-26 | 2018-07-16 | 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 | 2018-06-26 | 2018-07-16 | N |
| Ensure that residents are free from significant medication errors. | Health | 2018-06-26 | 2018-07-16 | N |
| Provide and implement an infection prevention and control program. | Health | 2018-06-26 | 2018-07-16 | N |
| Develop and implement policies and procedures for flu and pneumonia vaccinations. | Health | 2018-06-26 | 2018-07-16 | N |
| Address subsistence needs for staff and patients. | Fire Safety | 2018-06-25 | 2018-07-16 | N |
| Establish policies and procedures including evacuation. | Fire Safety | 2018-06-25 | 2018-07-16 | N |
| Establish policies and procedures for volunteers. | Fire Safety | 2018-06-25 | 2018-07-16 | N |
| Provide primary/alternate means for communication. | Fire Safety | 2018-06-25 | 2018-07-16 | N |
| Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. | Fire Safety | 2018-06-25 | 2018-07-16 | N |
| Ensure that testing and maintenance of electrical equipment is performed. | Fire Safety | 2018-06-25 | 2018-07-16 | N |
