A list of the most recent deficiencies for Alden Estates of Countryside, Inc. 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? |
|---|---|---|---|---|
| Respond appropriately to all alleged violations. | Health | 2023-12-08 | 2023-12-28 | 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 | 2023-12-08 | 2023-12-28 | Y |
| Allow residents to self-administer drugs if determined clinically appropriate. | Health | 2023-10-27 | 2023-11-14 | Y |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2023-10-27 | 2023-11-14 | Y |
| Provide and implement an infection prevention and control program. | Health | 2023-10-27 | 2023-11-14 | Y |
| Provide properly protected cooking facilities. | Fire Safety | 2022-11-30 | 2023-01-02 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2022-11-30 | 2023-01-02 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2022-12-05 | 2022-12-28 | N |
| PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2022-12-05 | 2022-12-28 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2022-12-05 | 2022-12-28 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-12-05 | 2022-12-28 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2022-12-05 | 2022-12-28 | N |
| Provide and implement an infection prevention and control program. | Health | 2022-12-05 | 2022-12-28 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2022-12-05 | 2022-12-28 | Y |
| Respond appropriately to all alleged violations. | Health | 2022-12-05 | 2022-12-28 | Y |
| Meet requirements for the use of electrical equipment. | Fire Safety | 2022-11-30 | 2022-12-19 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2022-09-29 | 2022-10-17 | Y |
| Honor the resident's right to choose his or her attending physician. | Health | 2022-05-26 | 2022-06-21 | Y |
| Provide safe, appropriate pain management for a resident who requires such services. | Health | 2022-04-04 | 2022-04-18 | Y |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2022-04-04 | 2022-04-18 | Y |
| Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | Health | 2021-09-23 | 2021-10-14 | Y |
| Plan the resident's discharge to meet the resident's goals and needs. | Health | 2021-09-23 | 2021-10-14 | 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 | 2021-08-05 | 2021-09-08 | N |
| Allow residents to self-administer drugs if determined clinically appropriate. | Health | 2021-08-16 | 2021-09-07 | N |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2021-08-16 | 2021-09-07 | N |
| Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | Health | 2021-08-16 | 2021-09-07 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2021-08-16 | 2021-09-07 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2021-08-16 | 2021-09-07 | 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 | 2021-08-16 | 2021-09-07 | 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 | 2021-08-16 | 2021-09-07 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2021-08-16 | 2021-09-07 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2021-08-16 | 2021-09-07 | N |
| Provide and implement an infection prevention and control program. | Health | 2021-08-16 | 2021-09-07 | 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 | 2021-08-16 | 2021-09-07 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2021-08-16 | 2021-09-07 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2021-08-16 | 2021-09-07 | Y |
| Have ramps, exits, fire escape ladders, steps, and areas of refuge that meet safety requirements. | Fire Safety | 2021-08-05 | 2021-09-07 | N |
| Have proper fire barriers, ventilation and signs for the transfilling of oxygen. | Fire Safety | 2021-08-05 | 2021-08-07 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2021-08-05 | 2021-08-06 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2021-08-05 | 2021-08-05 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2019-08-01 | 2019-09-03 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2019-08-01 | 2019-09-03 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2019-08-01 | 2019-09-03 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2019-08-01 | 2019-09-03 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2019-08-01 | 2019-09-03 | N |
| Verify that a nurse aide has been trained; and if they haven't worked as a nurse aide for 2 years, receive retraining. | Health | 2019-08-01 | 2019-09-03 | 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 | 2019-08-01 | 2019-09-03 | 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 | 2019-08-01 | 2019-09-03 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2019-08-01 | 2019-09-03 | 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 | 2019-08-01 | 2019-09-03 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2019-08-01 | 2019-09-03 | 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 | 2019-07-30 | 2019-07-31 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2019-07-30 | 2019-07-31 | N |
| Meet requirements for the use of electrical equipment. | Fire Safety | 2019-07-30 | 2019-07-30 | N |
