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Deficiency Records for Alta Vista Healthcare and Wellness Centre
A list of the most recent deficiencies for Alta Vista Healthcare and Wellness Centre. The list is based on the information provided by CMS from both standard inspections and from complaints filed by residents.
A list of the most recent deficiencies for Alta Vista Healthcare and Wellness Centre. 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? |
|---|---|---|---|---|
| Conduct risk assessment and an All-Hazards approach. | Fire Safety | 2024-05-29 | 2024-06-13 | N |
| List the names and contact information of those in the facility. | Fire Safety | 2024-05-29 | 2024-06-13 | N |
| Use approved construction type or materials. | Fire Safety | 2024-05-29 | 2024-06-13 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2024-05-29 | 2024-06-13 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2024-05-29 | 2024-06-13 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2024-05-29 | 2024-06-13 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2024-05-29 | 2024-06-13 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2024-05-29 | 2024-06-13 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2024-05-29 | 2024-06-13 | N |
| Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2024-05-29 | 2024-06-13 | N |
| Meet requirements for the installation and maintenance of electrical systems. | Fire Safety | 2024-05-29 | 2024-06-13 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2024-05-29 | 2024-06-13 | N |
| Ensure each resident receives an accurate assessment. | Health | 2024-05-23 | 2024-06-12 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2024-05-23 | 2024-06-12 | 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 | 2024-05-23 | 2024-06-12 | 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 | 2024-05-23 | 2024-06-12 | N |
| Provide and implement an infection prevention and control program. | Health | 2024-05-23 | 2024-06-12 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2023-12-13 | 2023-12-18 | Y |
| Reasonably accommodate the needs and preferences of each resident. | Health | 2023-12-13 | 2023-12-18 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-10-05 | 2023-10-13 | Y |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2023-10-05 | 2023-10-13 | Y |
| Allow residents to self-administer drugs if determined clinically appropriate. | Health | 2023-06-06 | 2023-06-25 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2023-05-11 | 2023-05-30 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-05-09 | 2023-05-24 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2022-10-18 | 2022-11-09 | Y |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2021-11-03 | 2021-11-22 | Y |
| Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. | Fire Safety | 2021-07-27 | 2021-08-17 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2021-07-27 | 2021-08-17 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2021-07-27 | 2021-08-17 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2021-07-27 | 2021-08-17 | N |
| Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2021-07-27 | 2021-08-17 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2021-07-27 | 2021-08-17 | N |
| 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 | 2021-07-23 | 2021-08-16 | N |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2021-07-23 | 2021-08-16 | 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 | 2021-07-23 | 2021-08-16 | N |
| PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2021-07-23 | 2021-08-16 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2021-07-23 | 2021-08-16 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2021-07-23 | 2021-08-16 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2021-07-23 | 2021-08-16 | 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 | 2021-07-23 | 2021-08-16 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2021-07-23 | 2021-08-16 | N |
| Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | Health | 2021-07-23 | 2021-08-16 | 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 | 2021-07-23 | 2021-08-16 | N |
| Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results. | Health | 2021-07-23 | 2021-08-16 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2021-07-23 | 2021-08-16 | N |
| Provide or get specialized rehabilitative services as required for a resident. | Health | 2021-07-23 | 2021-08-16 | N |
| Implement a program that monitors antibiotic use. | Health | 2021-07-23 | 2021-08-16 | N |
| Develop and implement policies and procedures for flu and pneumonia vaccinations. | Health | 2021-07-23 | 2021-08-16 | N |
| Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. | Health | 2021-07-23 | 2021-08-16 | N |
| Address subsistence needs for staff and patients. | Fire Safety | 2019-10-02 | 2019-10-22 | N |
| Establish policies and procedures for medical documentation. | Fire Safety | 2019-10-02 | 2019-10-22 | N |
| Provide emergency officials' contact information. | Fire Safety | 2019-10-02 | 2019-10-22 | N |
| Conduct testing and exercise requirements. | Fire Safety | 2019-10-02 | 2019-10-22 | N |
| Implement emergency and standby power systems. | Fire Safety | 2019-10-02 | 2019-10-22 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2019-10-02 | 2019-10-22 | 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 | 2019-10-02 | 2019-10-22 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2019-10-02 | 2019-10-22 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2019-10-02 | 2019-10-22 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2019-10-02 | 2019-10-22 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2019-10-02 | 2019-10-22 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2019-10-02 | 2019-10-22 | N |
| Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2019-10-02 | 2019-10-22 | N |
| Meet Health Care Facilities Code mechanical requirements. | Fire Safety | 2019-10-02 | 2019-10-22 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2019-10-02 | 2019-10-22 | N |
| PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2019-09-06 | 2019-10-02 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2019-09-06 | 2019-10-02 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2019-09-06 | 2019-10-02 | N |
| Provide appropriate foot care. | Health | 2019-09-06 | 2019-10-02 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2019-09-06 | 2019-10-02 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2019-09-06 | 2019-10-02 | N |
| Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2019-09-06 | 2019-10-02 | 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 | 2019-09-06 | 2019-10-02 | 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 | 2019-09-06 | 2019-10-02 | N |
| Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | Health | 2019-09-06 | 2019-10-02 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2019-09-06 | 2019-10-02 | N |
| Dispose of garbage and refuse properly. | Health | 2019-09-06 | 2019-10-02 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2019-09-06 | 2019-10-02 | N |
| Provide and implement an infection prevention and control program. | Health | 2019-09-06 | 2019-10-02 | N |
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