A list of the most recent deficiencies for Gordon Lane Care 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? |
|---|---|---|---|---|
| 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 | 2023-12-13 | 2024-01-05 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-12-13 | 2024-01-05 | Y |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2023-10-24 | 2023-12-11 | Y |
| 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 | 2023-10-24 | 2023-12-11 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-10-24 | 2023-12-11 | Y |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2023-10-02 | 2023-10-31 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2023-08-24 | 2023-09-23 | Y |
| Keep residents' personal and medical records private and confidential. | Health | 2023-08-24 | 2023-09-23 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2023-08-24 | 2023-09-23 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-08-24 | 2023-09-23 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-08-24 | 2023-09-23 | Y |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2023-08-24 | 2023-09-23 | Y |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2023-08-24 | 2023-09-23 | Y |
| Ensure that residents are free from significant medication errors. | Health | 2023-08-24 | 2023-09-23 | 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 | 2023-08-24 | 2023-09-23 | Y |
| Provide timely, quality laboratory services/tests to meet the needs of residents. | Health | 2023-08-24 | 2023-09-23 | Y |
| Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards. | Health | 2023-08-24 | 2023-09-23 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2023-08-24 | 2023-09-23 | Y |
| Provide and implement an infection prevention and control program. | Health | 2023-08-24 | 2023-09-23 | Y |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2023-08-02 | 2023-08-18 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-05-18 | 2023-06-18 | Y |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2023-03-08 | 2023-03-24 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2022-05-25 | 2022-06-10 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-05-25 | 2022-06-10 | Y |
| 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 | 2022-03-22 | 2022-04-11 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-03-22 | 2022-04-11 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2022-03-22 | 2022-04-11 | N |
| Install smoke barrier doors that can resist smoke for at least 20 minutes. | Fire Safety | 2022-03-22 | 2022-04-11 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2022-03-22 | 2022-04-11 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2022-03-22 | 2022-04-11 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2022-03-18 | 2022-04-08 | 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 | 2022-03-18 | 2022-04-08 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2022-03-18 | 2022-04-08 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2022-03-18 | 2022-04-08 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2022-03-18 | 2022-04-08 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2022-03-18 | 2022-04-08 | 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 | 2022-03-18 | 2022-04-08 | 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 | 2022-03-18 | 2022-04-08 | 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 | 2022-03-18 | 2022-04-08 | N |
| Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | Health | 2022-03-18 | 2022-04-08 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-03-18 | 2022-04-08 | N |
| Provide and implement an infection prevention and control program. | Health | 2022-03-18 | 2022-04-08 | N |
| Implement a program that monitors antibiotic use. | Health | 2022-03-18 | 2022-04-08 | N |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2022-03-18 | 2022-04-08 | N |
| Plan the resident's discharge to meet the resident's goals and needs. | Health | 2022-03-24 | 2022-04-05 | Y |
| Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | Health | 2021-08-31 | 2021-09-30 | Y |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2021-04-28 | 2021-05-28 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2021-04-28 | 2021-05-28 | Y |
| Conduct risk assessment and an All-Hazards approach. | Fire Safety | 2020-02-13 | 2020-03-03 | N |
| Address patient/client population and determine types of services needed. | Fire Safety | 2020-02-13 | 2020-03-03 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2020-02-13 | 2020-03-03 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2020-02-13 | 2020-03-03 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2020-02-13 | 2020-03-03 | N |
| Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2020-02-13 | 2020-03-03 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2020-02-13 | 2020-03-03 | N |
| Ensure precautions for handling oxygen cylinders and equipment are correctly followed. | Fire Safety | 2020-02-13 | 2020-03-03 | N |
| Reasonably accommodate the needs and preferences of each resident. | Health | 2020-01-29 | 2020-02-25 | N |
| Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | Health | 2020-01-29 | 2020-02-25 | N |
| Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. | Health | 2020-01-29 | 2020-02-25 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2020-01-29 | 2020-02-25 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2020-01-29 | 2020-02-25 | N |
| Provide safe, appropriate pain management for a resident who requires such services. | Health | 2020-01-29 | 2020-02-25 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2020-01-29 | 2020-02-25 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2020-01-29 | 2020-02-25 | 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 | 2020-01-29 | 2020-02-25 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2020-01-29 | 2020-02-25 | N |
| Ensure that residents are free from significant medication errors. | Health | 2020-01-29 | 2020-02-25 | 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 | 2020-01-29 | 2020-02-25 | 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 | 2020-01-29 | 2020-02-25 | N |
| Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | Health | 2020-01-29 | 2020-02-25 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2020-01-29 | 2020-02-25 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2020-01-29 | 2020-02-25 | N |
| Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | Health | 2020-01-29 | 2020-02-25 | N |
| Provide and implement an infection prevention and control program. | Health | 2020-01-29 | 2020-02-25 | N |
| Make sure that a working call system is available in each resident's bathroom and bathing area. | Health | 2020-01-29 | 2020-02-25 | N |
| Develop and maintain an Emergency Preparedness Program (EP). | Fire Safety | 2019-05-08 | 2019-06-03 | N |
| Conduct risk assessment and an All-Hazards approach. | Fire Safety | 2019-05-08 | 2019-06-03 | N |
| List the names and contact information of those in the facility. | Fire Safety | 2019-05-08 | 2019-06-03 | N |
| Provide emergency officials' contact information. | Fire Safety | 2019-05-08 | 2019-06-03 | N |
| Establish staff and initial training requirements. | Fire Safety | 2019-05-08 | 2019-06-03 | N |
| Implement emergency and standby power systems. | Fire Safety | 2019-05-08 | 2019-06-03 | N |
| Meet other general requirements. | Fire Safety | 2019-05-08 | 2019-06-03 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2019-05-08 | 2019-06-03 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2019-05-08 | 2019-06-03 | N |
| Have properly located and lighted "Exit" signs. | Fire Safety | 2019-05-08 | 2019-06-03 | N |
| Have a complete alarm system manually initiated and initiated by fire sprinkler system connection. | Fire Safety | 2019-05-08 | 2019-06-03 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2019-05-08 | 2019-06-03 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2019-05-08 | 2019-06-03 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2019-05-08 | 2019-06-03 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2019-03-19 | 2019-04-18 | N |
| Allow residents to self-administer drugs if determined clinically appropriate. | Health | 2019-03-19 | 2019-04-18 | N |
| Ensure residents have reasonable access to and privacy in their use of communication methods. | Health | 2019-03-19 | 2019-04-18 | N |
| Keep residents' personal and medical records private and confidential. | Health | 2019-03-19 | 2019-04-18 | 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 | 2019-03-19 | 2019-04-18 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2019-03-19 | 2019-04-18 | 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 | 2019-03-19 | 2019-04-18 | N |
| Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. | Health | 2019-03-19 | 2019-04-18 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2019-03-19 | 2019-04-18 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2019-03-19 | 2019-04-18 | N |
| Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2019-03-19 | 2019-04-18 | 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 | 2019-03-19 | 2019-04-18 | 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 | 2019-03-19 | 2019-04-18 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2019-03-19 | 2019-04-18 | 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 | 2019-03-19 | 2019-04-18 | N |
| Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. | Health | 2019-03-19 | 2019-04-18 | 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 | 2019-03-19 | 2019-04-18 | N |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2019-03-19 | 2019-04-18 | N |
| Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | Health | 2019-03-19 | 2019-04-18 | N |
| Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law. | Health | 2019-03-19 | 2019-04-18 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2019-03-19 | 2019-04-18 | N |
| Have a policy regarding use and storage of foods brought to residents by family and other visitors. | Health | 2019-03-19 | 2019-04-18 | N |
| Dispose of garbage and refuse properly. | Health | 2019-03-19 | 2019-04-18 | N |
| Provide and implement an infection prevention and control program. | Health | 2019-03-19 | 2019-04-18 | N |
| Keep all essential equipment working safely. | Health | 2019-03-19 | 2019-04-18 | N |
| Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame. | Health | 2019-03-19 | 2019-04-18 | N |
