Deficiency Records for Willows Center
Updated as of April 01, 2021
This is not the most recent data for Willows Center. For the most recent information, click here.
A list of the most recent deficiencies for Willows 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? |
|---|---|---|---|---|
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2019-10-29 | 2019-12-11 | N |
| Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. | Fire Safety | 2019-10-29 | 2019-12-11 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2019-10-29 | 2019-12-11 | 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 | 2019-10-30 | 2019-12-11 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2019-10-30 | 2019-12-11 | N |
| Observe each nurse aide's job performance and give regular training. | Health | 2019-10-30 | 2019-12-11 | 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 | 2019-10-30 | 2019-12-11 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2019-07-02 | 2019-08-12 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2019-07-02 | 2019-08-12 | Y |
| Provide and implement an infection prevention and control program. | Health | 2019-07-02 | 2019-08-12 | 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 | 2018-10-03 | 2018-11-08 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2018-10-03 | 2018-11-08 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2018-10-03 | 2018-11-08 | 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 | 2018-10-03 | 2018-11-08 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2018-10-03 | 2018-11-08 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2018-10-03 | 2018-11-08 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2018-10-03 | 2018-11-08 | N |
| Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2018-10-03 | 2018-11-08 | 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 | 2018-10-03 | 2018-11-08 | N |
| Observe each nurse aide's job performance and give regular training. | Health | 2018-10-03 | 2018-11-08 | N |
| Provide or obtain x-rays/tests when ordered and promptly tell the ordering practitioner of the results. | Health | 2018-10-03 | 2018-11-08 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2018-10-03 | 2018-11-08 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2018-10-03 | 2018-11-08 | N |
| Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | Health | 2018-10-03 | 2018-11-08 | N |
| Provide and implement an infection prevention and control program. | Health | 2018-10-03 | 2018-11-08 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2018-09-25 | 2018-11-06 | N |
| Conduct initial and periodic assessments of each resident's functional capacity. | Health | 2017-09-28 | 2017-10-30 | N |
| Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2017-09-28 | 2017-10-30 | N |
| Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. | Health | 2017-09-28 | 2017-10-30 | N |
| Store, cook, and serve food in a safe and clean way. | Health | 2017-09-28 | 2017-10-30 | N |
| Provide routine and emergency drugs through a licensed pharmacist and only under the general supervision of a licensed nurse. | Health | 2017-09-28 | 2017-10-30 | N |
| At least once a month, have a licensed pharmacist review each resident's medication(s) and report any irregularities to the attending doctor. | Health | 2017-09-28 | 2017-10-30 | N |
| Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards. | Health | 2017-09-28 | 2017-10-30 | N |
| Have a program that investigates, controls and keeps infection from spreading. | Health | 2017-09-28 | 2017-10-30 | N |
| Keep all essential equipment working safely. | Health | 2017-09-28 | 2017-10-30 | N |
| Keep accurate, complete and organized clinical records on each resident that meet professional standards. | Health | 2017-09-28 | 2017-10-30 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2017-09-27 | 2017-10-12 | N |
| Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. | Fire Safety | 2017-09-27 | 2017-10-12 | N |
| Ensure that testing and maintenance of electrical equipment is performed. | Fire Safety | 2017-09-27 | 2017-10-12 | N |
