A list of the most recent deficiencies for Meadowbrook at Appleton. 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 | 2023-10-06 | 2023-10-31 | Y |
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2023-03-29 | 2023-04-27 | N |
PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2023-03-29 | 2023-04-27 | N |
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2023-03-29 | 2023-04-27 | N |
Provide enough food/fluids to maintain a resident's health. | Health | 2023-03-29 | 2023-04-27 | N |
Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2023-03-29 | 2023-04-27 | N |
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2023-03-29 | 2023-04-27 | N |
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-03-29 | 2023-04-27 | N |
Provide and implement an infection prevention and control program. | Health | 2023-03-29 | 2023-04-27 | N |
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | Health | 2023-03-29 | 2023-04-27 | N |
Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2023-03-30 | 2023-04-27 | N |
Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2023-03-30 | 2023-04-27 | N |
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2023-01-09 | 2023-02-09 | Y |
Ensure medication error rates are not 5 percent or greater. | Health | 2023-01-09 | 2023-02-09 | Y |
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | Health | 2022-09-27 | 2022-10-20 | Y |
Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2022-09-27 | 2022-10-20 | Y |
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2022-09-27 | 2022-10-20 | Y |
Respond appropriately to all alleged violations. | Health | 2022-09-27 | 2022-10-20 | Y |
Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2022-09-27 | 2022-10-20 | Y |
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 | 2022-09-27 | 2022-10-20 | Y |
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2022-08-04 | 2022-08-24 | Y |
Provide enough food/fluids to maintain a resident's health. | Health | 2022-08-04 | 2022-08-24 | 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 | 2022-04-18 | 2022-05-17 | 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 | 2022-04-18 | 2022-05-17 | N |
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | Health | 2022-04-18 | 2022-05-17 | N |
PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2022-04-18 | 2022-05-17 | N |
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-04-18 | 2022-05-17 | N |
Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-04-18 | 2022-05-17 | N |
Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2022-04-18 | 2022-05-17 | N |
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-04-18 | 2022-05-17 | N |
Provide safe, appropriate pain management for a resident who requires such services. | Health | 2022-04-18 | 2022-05-17 | N |
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2022-04-18 | 2022-05-17 | 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 | 2022-04-18 | 2022-05-17 | 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 | 2022-04-18 | 2022-05-17 | N |
Ensure that residents are free from significant medication errors. | Health | 2022-04-18 | 2022-05-17 | N |
Ensure each resident receives and the facility provides drinks consistent with resident needs and preferences and sufficient to maintain resident hydration. | Health | 2022-04-18 | 2022-05-17 | N |
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-04-18 | 2022-05-17 | N |
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2022-04-18 | 2022-05-17 | 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 | 2022-04-18 | 2022-05-17 | Y |
Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2022-04-18 | 2022-05-17 | Y |
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 | 2022-04-18 | 2022-05-17 | Y |
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2022-04-13 | 2022-05-17 | N |
Develop a communication plan. | Fire Safety | 2022-04-13 | 2022-05-13 | N |
Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2022-04-13 | 2022-05-02 | N |
Install corridor and hallway doors that block smoke. | Fire Safety | 2022-04-13 | 2022-04-25 | N |
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-01-03 | 2022-01-21 | Y |
Obtain a doctor's order to admit a resident and ensure the resident is under a doctor's care. | Health | 2021-10-18 | 2021-10-29 | Y |
Provide and implement an infection prevention and control program. | Health | 2021-10-18 | 2021-10-29 | Y |
Provide and implement an infection prevention and control program. | Health | 2021-09-07 | 2021-10-29 | Y |
Provide and implement an infection prevention and control program. | Health | 2021-08-05 | 2021-10-29 | Y |
Provide and implement an infection prevention and control program. | Health | 2021-07-15 | 2021-10-29 | Y |
Honor the resident's right to receive visitors of his or her choosing, at the time of his or her choosing. | Health | 2021-09-07 | 2021-10-06 | Y |
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 | 2021-09-07 | 2021-10-06 | Y |
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2021-09-07 | 2021-10-06 | Y |
Respond appropriately to all alleged violations. | Health | 2021-09-07 | 2021-10-06 | Y |
Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2021-09-07 | 2021-10-06 | Y |
Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2021-09-07 | 2021-10-06 | Y |
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 | 2021-09-07 | 2021-10-06 | Y |
Post nurse staffing information every day. | Health | 2021-09-07 | 2021-10-06 | Y |
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2021-09-07 | 2021-10-06 | Y |
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2021-08-05 | 2021-10-06 | Y |
Respond appropriately to all alleged violations. | Health | 2021-08-05 | 2021-10-06 | Y |
Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2021-08-05 | 2021-10-06 | Y |
Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2021-08-05 | 2021-10-06 | Y |
Post nurse staffing information every day. | Health | 2021-08-05 | 2021-10-06 | Y |
Honor the resident's right to receive visitors of his or her choosing, at the time of his or her choosing. | Health | 2021-07-15 | 2021-10-06 | Y |
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 | 2021-07-15 | 2021-10-06 | Y |
Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2021-07-15 | 2021-10-06 | Y |
Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2021-07-15 | 2021-10-06 | Y |
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2021-07-15 | 2021-10-06 | Y |
Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2021-08-05 | 2021-08-27 | Y |
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2021-08-05 | 2021-08-27 | Y |
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 | 2021-08-05 | 2021-08-27 | Y |
Provide safe and appropriate respiratory care for a resident when needed. | Health | 2021-08-05 | 2021-08-27 | 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 | 2021-08-05 | 2021-08-27 | Y |
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 | 2021-08-05 | 2021-08-27 | Y |
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 | 2021-08-05 | 2021-08-27 | Y |
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2021-08-05 | 2021-08-27 | Y |
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2021-07-15 | 2021-08-27 | Y |
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2021-07-15 | 2021-08-13 | Y |
Ensure residents have reasonable access to and privacy in their use of communication methods. | Health | 2021-07-15 | 2021-08-13 | Y |
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2021-07-15 | 2021-08-13 | 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 | 2021-07-15 | 2021-08-13 | Y |
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Health | 2021-07-15 | 2021-08-13 | Y |
Provide timely, quality laboratory services/tests to meet the needs of residents. | Health | 2021-07-15 | 2021-08-13 | Y |
Provide or get specialized rehabilitative services as required for a resident. | Health | 2021-07-15 | 2021-08-13 | Y |
Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2021-05-05 | 2021-06-18 | Y |
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2021-05-05 | 2021-06-02 | Y |
Not hire anyone with a finding of abuse, neglect, exploitation, or theft. | Health | 2021-05-05 | 2021-06-02 | Y |
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2021-05-05 | 2021-06-02 | Y |
Respond appropriately to all alleged violations. | Health | 2021-05-05 | 2021-06-02 | Y |
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2021-04-21 | 2021-05-21 | Y |
Provide enough food/fluids to maintain a resident's health. | Health | 2021-04-21 | 2021-05-21 | Y |
Allow residents to self-administer drugs if determined clinically appropriate. | Health | 2021-04-21 | 2021-05-21 | N |
Ensure residents have reasonable access to and privacy in their use of communication methods. | Health | 2021-04-21 | 2021-05-21 | N |
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2021-04-21 | 2021-05-21 | 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 | 2021-04-21 | 2021-05-21 | N |
Post nurse staffing information every day. | Health | 2021-04-21 | 2021-05-21 | N |
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2021-04-21 | 2021-05-21 | N |
Ensure medication error rates are not 5 percent or greater. | Health | 2021-04-21 | 2021-05-21 | 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 | 2021-04-21 | 2021-05-21 | N |
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2021-04-21 | 2021-05-21 | N |
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | Health | 2021-04-21 | 2021-05-21 | N |
Ensure each resident receives an accurate assessment. | Health | 2021-04-21 | 2021-05-21 | Y |
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2021-04-21 | 2021-05-21 | Y |
Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2021-04-21 | 2021-05-21 | Y |
Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2021-04-21 | 2021-05-21 | 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 | 2021-04-21 | 2021-05-21 | Y |
Provide properly protected cooking facilities. | Fire Safety | 2021-04-19 | 2021-05-21 | N |
Follow proper procedures when the fire alarm was out of service for more than 4 hours. | Fire Safety | 2021-04-19 | 2021-05-21 | N |
Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2021-04-19 | 2021-05-21 | N |
Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2021-04-19 | 2021-05-21 | N |
Have simulated fire drills held at unexpected times. | Fire Safety | 2021-04-19 | 2021-05-21 | N |