A list of the most recent deficiencies for Holbrook Healthcare Center. 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? |
|---|---|---|---|---|
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-10-10 | 2023-10-24 | Y |
| Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. | Fire Safety | 2023-08-08 | 2023-10-02 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2023-08-08 | 2023-10-02 | N |
| Install smoke barrier doors that can resist smoke for at least 20 minutes. | Fire Safety | 2023-08-08 | 2023-10-02 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2023-08-08 | 2023-10-02 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2023-08-08 | 2023-10-02 | N |
| Reasonably accommodate the needs and preferences of each resident. | Health | 2023-08-09 | 2023-09-01 | N |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2023-08-09 | 2023-09-01 | 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 | 2023-08-09 | 2023-09-01 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2023-08-09 | 2023-09-01 | N |
| Encode each resident?s assessment data and transmit these data to the State within 7 days of assessment. | Health | 2023-08-09 | 2023-09-01 | N |
| PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2023-08-09 | 2023-09-01 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2023-08-09 | 2023-09-01 | N |
| Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | Health | 2023-08-09 | 2023-09-01 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-08-09 | 2023-09-01 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2023-08-09 | 2023-09-01 | N |
| Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | Health | 2023-08-09 | 2023-09-01 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2022-04-05 | 2022-05-10 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2022-04-05 | 2022-05-10 | N |
| Ensure that testing and maintenance of electrical equipment is performed. | Fire Safety | 2022-04-05 | 2022-05-10 | N |
| Ensure that personnel concerned with handling of medical gases and cylinders are trained on the risk. | Fire Safety | 2022-04-05 | 2022-05-10 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2022-04-06 | 2022-05-03 | 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 | 2022-04-06 | 2022-05-03 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2022-04-06 | 2022-05-03 | N |
| Respond appropriately to all alleged violations. | Health | 2022-04-06 | 2022-05-03 | N |
| Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | Health | 2022-04-06 | 2022-05-03 | N |
| Provide and implement an infection prevention and control program. | Health | 2022-04-06 | 2022-05-03 | 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 | 2020-02-26 | 2020-04-14 | 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 | 2020-02-26 | 2020-04-14 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2020-02-26 | 2020-04-14 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2020-02-26 | 2020-04-14 | N |
| Provide safe, appropriate pain management for a resident who requires such services. | Health | 2020-02-26 | 2020-04-14 | N |
| Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2020-02-26 | 2020-04-14 | N |
| Observe each nurse aide's job performance and give regular training. | Health | 2020-02-26 | 2020-04-14 | N |
| Provide special eating equipment and utensils for residents who need them and appropriate assistance. | Health | 2020-02-26 | 2020-04-14 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2020-02-26 | 2020-04-14 | N |
| Provide and implement an infection prevention and control program. | Health | 2020-02-26 | 2020-04-14 | N |
