Deficiency Records for Focused Care at Brenham
Updated as of May 01, 2018
This is not the most recent data for Focused Care at Brenham. For the most recent information, click here.
A list of the most recent deficiencies for Focused Care at Brenham. 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? |
|---|---|---|---|---|
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2018-02-21 | 2018-03-25 | N |
| Have properly located and lighted "Exit" signs. | Fire Safety | 2018-02-21 | 2018-03-25 | N |
| Set up an ongoing quality assessment and assurance group to review quality deficiencies quarterly, and develop corrective plans of action. | Health | 2017-03-22 | 2017-05-22 | N |
| Have an alternate power supply for its alarm system. | Fire Safety | 2017-03-29 | 2017-05-20 | N |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2017-03-22 | 2017-05-20 | N |
| Ensure that building systems meet requirements determined by risk assessment procedures performed by qualified personnel. | Fire Safety | 2017-03-29 | 2017-04-28 | N |
| Keep each resident free from physical restraints, unless needed for medical treatment. | Health | 2017-03-22 | 2017-04-28 | N |
| Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. | Health | 2017-03-22 | 2017-04-28 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2017-03-29 | 2017-04-21 | N |
| Store, cook, and serve food in a safe and clean way. | Health | 2017-03-22 | 2017-04-21 | N |
| Dispose of garbage and refuse properly. | Health | 2017-03-22 | 2017-04-21 | N |
| Keep accurate, complete and organized clinical records on each resident that meet professional standards. | Health | 2017-03-22 | 2017-04-21 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2017-03-29 | 2017-03-30 | N |
| Help the resident in making transportation arrangements to and from radiology services. | Health | 2017-02-27 | 2017-03-16 | 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 | 2016-05-04 | 2016-06-01 | 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 | 2016-05-04 | 2016-06-01 | Y |
| Corridor and hallway doors that block smoke. | Fire Safety | 2016-02-10 | 2016-04-01 | N |
| Special areas constructed so that walls can resist fire for one hour or an approved fire extinguishing system. | Fire Safety | 2016-02-10 | 2016-04-01 | N |
| Exits that are accessible at all times. | Fire Safety | 2016-02-10 | 2016-04-01 | N |
| Properly located and lighted "Exit" signs. | Fire Safety | 2016-02-10 | 2016-04-01 | N |
| A fire alarm system that can be heard throughout the facility. | Fire Safety | 2016-02-10 | 2016-04-01 | N |
| An approved automatic sprinkler system connected to the fire alarm system. | Fire Safety | 2016-02-10 | 2016-04-01 | N |
| Properly working alarms on sprinkler valves. | Fire Safety | 2016-02-10 | 2016-04-01 | N |
| Provide activities to meet the interests and needs of each resident. | Health | 2016-02-11 | 2016-03-18 | N |
| Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. | Health | 2016-02-11 | 2016-03-18 | N |
| Ensure that each resident who enters the nursing home without a catheter is not given a catheter, unless medically necessary, and that incontinent patients receive proper services to prevent urinary tract infections and restore normal bladder functions. | Health | 2016-02-11 | 2016-03-18 | N |
| Ensure that residents with limited range of motion receive appropriate treatment and services to increase range of motion or prevent further decrease in range of motion. | Health | 2016-02-11 | 2016-03-18 | N |
| Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. | Health | 2016-02-11 | 2016-03-18 | N |
| Have a program that investigates, controls and keeps infection from spreading. | Health | 2016-02-11 | 2016-03-18 | N |
| Make sure that nurse aides show they have the skills and techniques to be able to care for residents' needs. | Health | 2016-02-11 | 2016-03-18 | N |
| Keep accurate, complete and organized clinical records on each resident that meet professional standards. | Health | 2016-02-11 | 2016-03-18 | N |
| Train all employees on what to do in an emergency, and carry out unannounced staff drills. | Health | 2016-02-11 | 2016-03-18 | N |
| Protect each resident from mistreatment, neglect and misappropriation of personal property. | Health | 2015-06-25 | 2015-06-25 | 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 | 2015-06-25 | 2015-06-25 | Y |
| Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. | Health | 2015-06-25 | 2015-06-25 | Y |
| 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 | 2018-02-07 | Not Fixed | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2018-02-07 | Not Fixed | 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 | 2018-02-07 | Not Fixed | 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 ne | Health | 2018-02-07 | Not Fixed | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2018-02-07 | Not Fixed | N |
| Provide and implement an infection prevention and control program. | Health | 2018-02-07 | Not Fixed | N |
