Deficiency Records for Mountain Villa Nursing Center
Updated as of June 01, 2019
This is not the most recent data for Mountain Villa Nursing Center. For the most recent information, click here.
A list of the most recent deficiencies for Mountain Villa Nursing 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? |
|---|---|---|---|---|
| Develop and maintain an Emergency Preparedness Program (EP). | Fire Safety | 2018-07-19 | 2018-08-20 | N |
| Include a process for Emergency Preparedness collaboration. | Fire Safety | 2018-07-19 | 2018-08-20 | N |
| Develop Emergency Preparedness policies and procedures. | Fire Safety | 2018-07-19 | 2018-08-20 | N |
| Establish roles under a Waiver declared by secretary. | Fire Safety | 2018-07-19 | 2018-08-20 | N |
| Develop a communication plan. | Fire Safety | 2018-07-19 | 2018-08-20 | N |
| Provide primary/alternate means for communication. | Fire Safety | 2018-07-19 | 2018-08-20 | N |
| Provide a means of sharing information on occupancy/needs. | Fire Safety | 2018-07-19 | 2018-08-20 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2018-07-19 | 2018-08-20 | N |
| Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2018-07-19 | 2018-08-20 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2018-07-20 | 2018-08-20 | N |
| Encode each resident?s assessment data and transmit these data to the State within 7 days of assessment. | Health | 2018-07-20 | 2018-08-20 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2018-07-20 | 2018-08-20 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2018-07-20 | 2018-08-20 | N |
| Provide and implement an infection prevention and control program. | Health | 2018-07-20 | 2018-08-20 | N |
| Implement a program that monitors antibiotic use. | Health | 2018-07-20 | 2018-08-20 | N |
| Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | Health | 2018-05-01 | 2018-05-31 | Y |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2017-07-13 | 2017-08-28 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2017-07-13 | 2017-08-28 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2017-07-13 | 2017-08-28 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2017-07-13 | 2017-08-28 | N |
| Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2017-07-13 | 2017-08-28 | N |
| Ensure each resident receives an accurate assessment by a qualified health professional. | Health | 2017-07-14 | 2017-08-28 | N |
| Coordinate assessments with the pre-admission screening and resident review program for mentally-ill and mentally-retarded patients. | Health | 2017-07-14 | 2017-08-28 | N |
| Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. | Health | 2017-07-14 | 2017-08-28 | N |
| Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature. | Health | 2017-07-14 | 2017-08-28 | N |
| Make sure that special or therapeutic diets are ordered by the attending doctor. | Health | 2017-07-14 | 2017-08-28 | N |
| Store, cook, and serve food in a safe and clean way. | Health | 2017-07-14 | 2017-08-28 | N |
| Provide routine and emergency drugs through a licensed pharmacist and only under the general supervision of a licensed nurse. | Health | 2017-07-14 | 2017-08-28 | N |
| At least once a month, have a licensed pharmacist review each resident's medication(s) and report any irregularities to the attending doctor. | Health | 2017-07-14 | 2017-08-28 | N |
| Have a program that investigates, controls and keeps infection from spreading. | Health | 2017-07-14 | 2017-08-28 | N |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2017-07-14 | 2017-08-28 | N |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2016-11-16 | 2016-11-18 | Y |
| Provide necessary care and services to maintain or improve the highest well being of each resident . | Health | 2016-11-16 | 2016-11-18 | Y |
| 1) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. | Health | 2016-10-24 | 2016-11-11 | Y |
| Develop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property. | Health | 2016-10-24 | 2016-11-11 | Y |
| Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. | Health | 2016-10-24 | 2016-11-11 | Y |
| Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. | Health | 2016-08-26 | 2016-11-11 | Y |
| Provide care for residents in a way that maintains or improves their dignity and respect in full recognition of their individuality. | Health | 2016-06-30 | 2016-08-27 | N |
| Listen to the resident groups and act on their complaints and suggestions that affect resident care and life. | Health | 2016-06-30 | 2016-08-27 | N |
| Reasonably accommodate the needs and preferences of each resident. | Health | 2016-06-30 | 2016-08-27 | N |
| Provide activities to meet the interests and needs of each resident. | Health | 2016-06-30 | 2016-08-27 | N |
| Provide a safe, clean, comfortable and home-like environment; and allow residents to use personal belongings to the extent possible. | Health | 2016-06-30 | 2016-08-27 | N |
| Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2016-06-30 | 2016-08-27 | N |
| Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature. | Health | 2016-06-30 | 2016-08-27 | N |
| Store, cook, and serve food in a safe and clean way. | Health | 2016-06-30 | 2016-08-27 | N |
| Have a program that investigates, controls and keeps infection from spreading. | Health | 2016-06-30 | 2016-08-27 | N |
| Make sure that the facility is administered in an acceptable way that maintains the well-being of each resident . | Health | 2016-06-30 | 2016-08-27 | N |
| 1) Review the work of each nurse aide every year; and 2) give regular in-service training based upon these reviews. | Health | 2016-06-30 | 2016-08-27 | N |
| Make sure that nurse aides show they have the skills and techniques to be able to care for residents' needs. | Health | 2016-06-30 | 2016-08-27 | N |
| Have a detailed, written plan for disasters and emergencies, such as fire, severe weather, and missing residents. | Health | 2016-06-30 | 2016-08-27 | N |
| Automatic sprinkler systems that have been maintained in working order. | Fire Safety | 2016-07-01 | 2016-08-15 | N |
| Portable fire extinguishers. | Fire Safety | 2016-07-01 | 2016-08-15 | N |
| Heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2016-07-01 | 2016-08-15 | N |
