A list of the most recent deficiencies for Spring Lake Village. 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? |
|---|---|---|---|---|
| Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Health | 2023-04-07 | 2023-06-30 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2023-04-07 | 2023-06-30 | N |
| Provide activities to meet all resident's needs. | Health | 2023-04-07 | 2023-06-30 | N |
| Ensure that residents are free from significant medication errors. | Health | 2023-04-07 | 2023-06-30 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-04-07 | 2023-06-30 | N |
| Dispose of garbage and refuse properly. | Health | 2023-04-07 | 2023-06-30 | N |
| Use approved construction type or materials. | Fire Safety | 2023-04-19 | 2023-05-15 | N |
| Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements. | Fire Safety | 2023-04-19 | 2023-05-15 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2023-04-19 | 2023-05-15 | N |
| Have properly located and lighted "Exit" signs. | Fire Safety | 2023-04-19 | 2023-05-15 | N |
| Install a fire alarm system that can be heard throughout the facility. | Fire Safety | 2023-04-19 | 2023-05-15 | N |
| Have a fire alarm with audible and visual signals that transmits the alarm automatically to notify emergency forces in event of fire. | Fire Safety | 2023-04-19 | 2023-05-15 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2023-04-19 | 2023-05-15 | N |
| Properly provide smoke detection systems in areas open to corridors. | Fire Safety | 2023-04-19 | 2023-05-15 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2023-04-19 | 2023-05-15 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2023-04-19 | 2023-05-15 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2023-04-19 | 2023-05-15 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2023-04-19 | 2023-05-15 | N |
| Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2023-04-19 | 2023-05-15 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2023-04-19 | 2023-05-15 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2023-04-19 | 2023-05-15 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2023-04-19 | 2023-05-15 | N |
| Meet requirements for the use of electrical equipment. | Fire Safety | 2023-04-19 | 2023-05-15 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2023-04-19 | 2023-05-15 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-07-27 | 2022-09-29 | Y |
| Conduct risk assessment and an All-Hazards approach. | Fire Safety | 2020-03-12 | 2020-04-08 | N |
| Provide emergency officials' contact information. | Fire Safety | 2020-03-12 | 2020-04-08 | N |
| Use approved construction type or materials. | Fire Safety | 2020-03-12 | 2020-04-08 | N |
| Have properly located and lighted "Exit" signs. | Fire Safety | 2020-03-12 | 2020-04-08 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2020-02-28 | 2020-04-02 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2020-02-28 | 2020-04-02 | 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 | 2020-02-28 | 2020-04-02 | N |
| 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 | 2020-02-28 | 2020-04-02 | 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 | 2020-02-28 | 2020-04-02 | N |
| Develop and implement policies and procedures for flu and pneumonia vaccinations. | Health | 2020-02-28 | 2020-04-02 | N |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2020-02-28 | 2020-04-02 | N |
| Use approved construction type or materials. | Fire Safety | 2019-04-16 | 2019-05-06 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2019-04-16 | 2019-05-06 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2019-02-01 | 2019-04-09 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2019-02-01 | 2019-04-09 | 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 | 2019-02-01 | 2019-04-09 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2019-02-01 | 2019-04-09 | N |
| Ensure that residents are free from significant medication errors. | Health | 2019-02-01 | 2019-04-09 | N |
| Provide and implement an infection prevention and control program. | Health | 2019-02-01 | 2019-04-09 | N |
| Keep all essential equipment working safely. | Health | 2019-02-01 | 2019-04-09 | N |
