A list of the most recent deficiencies for North Starr Postacute Care. 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 residents are fully informed and understand their health status, care and treatments. | Health | 2023-05-31 | 2023-06-30 | Y |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2022-05-06 | 2022-05-30 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-05-06 | 2022-05-30 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2022-05-06 | 2022-05-30 | 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 | 2022-05-06 | 2022-05-30 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-05-06 | 2022-05-30 | N |
| Provide and implement an infection prevention and control program. | Health | 2022-05-06 | 2022-05-30 | N |
| Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. | Health | 2022-05-06 | 2022-05-30 | N |
| Establish policies and procedures for medical documentation. | Fire Safety | 2022-05-09 | 2022-05-23 | N |
| Provide a means of sharing information on occupancy/needs. | Fire Safety | 2022-05-09 | 2022-05-23 | N |
| Conduct testing and exercise requirements. | Fire Safety | 2022-05-09 | 2022-05-23 | N |
| Use approved construction type or materials. | Fire Safety | 2022-05-09 | 2022-05-23 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2022-05-09 | 2022-05-23 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2021-05-13 | 2021-06-24 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2021-05-13 | 2021-06-24 | 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 | 2021-05-13 | 2021-06-24 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2021-05-13 | 2021-06-24 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2021-05-13 | 2021-06-24 | N |
| Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | Health | 2021-05-13 | 2021-06-24 | N |
| Keep all essential equipment working safely. | Health | 2021-05-13 | 2021-06-24 | N |
| Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. | Health | 2021-05-13 | 2021-06-24 | N |
| Make sure that a working call system is available in each resident's bathroom and bathing area. | Health | 2021-05-13 | 2021-06-24 | N |
| Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector. | Fire Safety | 2021-05-17 | 2021-06-01 | 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 | 2021-05-17 | 2021-06-01 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2021-05-17 | 2021-06-01 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2019-11-06 | 2019-12-16 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2019-11-06 | 2019-12-16 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2019-11-06 | 2019-12-16 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2019-10-11 | 2019-11-01 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2019-10-11 | 2019-11-01 | N |
| Observe each nurse aide's job performance and give regular training. | Health | 2019-10-11 | 2019-11-01 | N |
| Provide and implement an infection prevention and control program. | Health | 2019-10-11 | 2019-11-01 | N |
| Implement a program that monitors antibiotic use. | Health | 2019-10-11 | 2019-11-01 | N |
| Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. | Health | 2019-10-11 | 2019-11-01 | N |
