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Deficiency Records for Aspire at The Palms

A list of the most recent deficiencies for Aspire at The Palms. 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 Aspire at The Palms. 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 and the facility must promote and facilitate resident self-determination through support of resident choice. Health 2024-08-09 2024-09-09 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 2024-08-09 2024-09-09 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 2024-08-09 2024-09-09 N
PASARR screening for Mental disorders or Intellectual Disabilities Health 2024-08-09 2024-09-09 N
Provide appropriate treatment and care according to orders, resident?s preferences and goals. Health 2024-08-09 2024-09-09 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 2024-08-09 2024-09-09 N
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. Health 2024-08-09 2024-09-09 N
Plan the resident's discharge to meet the resident's goals and needs. Health 2024-08-09 2024-09-09 Y
Establish roles under a Waiver declared by secretary. Fire Safety 2024-08-07 2024-09-09 N
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements. Fire Safety 2024-08-07 2024-09-09 N
Provide properly protected cooking facilities. Fire Safety 2024-08-07 2024-09-09 N
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Fire Safety 2024-08-07 2024-09-09 N
Have generator or other power source capable of supplying service within 10 seconds. Fire Safety 2024-08-07 2024-09-09 N
Ensure that testing and maintenance of electrical equipment is performed. Fire Safety 2024-08-07 2024-09-09 N
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Health 2023-03-23 2023-04-25 Y
Ensure services provided by the nursing facility meet professional standards of quality. Health 2023-03-23 2023-04-25 Y
Provide safe, appropriate pain management for a resident who requires such services. Health 2023-03-23 2023-04-25 Y
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 2023-03-23 2023-04-25 Y
Reasonably accommodate the needs and preferences of each resident. Health 2023-03-23 2023-04-17 Y
Keep residents' personal and medical records private and confidential. Health 2023-03-23 2023-04-17 Y
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. Health 2023-03-23 2023-04-17 Y
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 2022-04-22 2022-07-19 N
Ensure medication error rates are not 5 percent or greater. Health 2022-04-22 2022-07-19 N
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. Health 2022-04-22 2022-07-19 N
Ensure that residents are free from significant medication errors. Health 2022-06-30 2022-07-19 Y
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 2022-06-30 2022-07-19 Y
Provide and implement an infection prevention and control program. Health 2022-06-30 2022-07-19 Y
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Health 2022-06-30 2022-07-19 Y
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Health 2022-04-22 2022-07-19 Y
Respond appropriately to all alleged violations. Health 2022-04-22 2022-07-19 Y
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. Health 2022-04-22 2022-05-19 N
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 2022-04-22 2022-05-19 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 2022-04-22 2022-05-19 N
Assist a resident in gaining access to vision and hearing services. Health 2022-04-22 2022-05-19 N
Provide appropriate pressure ulcer care and prevent new ulcers from developing. Health 2022-04-22 2022-05-19 N
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. Health 2022-04-22 2022-05-19 N
Provide medically-related social services to help each resident achieve the highest possible quality of life. Health 2022-04-22 2022-05-19 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 2022-04-22 2022-05-19 N
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Health 2022-04-22 2022-05-19 Y
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2022-04-22 2022-05-19 Y
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Health 2022-04-22 2022-05-19 Y
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Health 2022-04-22 2022-05-19 Y
Ensure smoke barriers are constructed to a 1 hour fire resistance rating. Fire Safety 2022-04-19 2022-05-19 N
Provide a written emergency evacuation plan. Fire Safety 2022-04-19 2022-05-19 N
Have simulated fire drills held at unexpected times. Fire Safety 2022-04-19 2022-05-19 N
Have proper medical gas storage and administration areas. Fire Safety 2022-04-19 2022-05-19 N
Allow residents to self-administer drugs if determined clinically appropriate. Health 2021-02-18 2021-03-18 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 2021-02-18 2021-03-18 N
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Health 2021-02-18 2021-03-18 N
Provide appropriate treatment and care according to orders, resident?s preferences and goals. Health 2021-02-18 2021-03-18 N
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2021-02-18 2021-03-18 N
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Health 2021-02-18 2021-03-18 N
Employ or obtain outside professional resources to provide services in the nursing home when the facility does not employ a qualified professional to furnish a required service. Health 2021-02-18 2021-03-18 N
Develop and implement policies and procedures for flu and pneumonia vaccinations. Health 2021-02-18 2021-03-18 N
Develop and maintain an Emergency Preparedness Program (EP). Fire Safety 2021-02-16 2021-03-18 N
Install emergency lighting that can last at least 1 1/2 hours. Fire Safety 2021-02-16 2021-03-18 N
Provide properly protected cooking facilities. Fire Safety 2021-02-16 2021-03-18 N
Inspect, test, and maintain automatic sprinkler systems. Fire Safety 2021-02-16 2021-03-18 N
Ensure smoke barriers are constructed to a 1 hour fire resistance rating. Fire Safety 2021-02-16 2021-03-18 N
Install smoke barrier doors that can resist smoke for at least 20 minutes. Fire Safety 2021-02-16 2021-03-18 N
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Fire Safety 2021-02-16 2021-03-18 N

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