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Deficiency Records for Providence of Sparta Health and Rehab
A list of the most recent deficiencies for Providence of Sparta Health and Rehab. 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 Providence of Sparta Health and Rehab. 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? |
|---|---|---|---|---|
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2024-08-11 | 2024-09-07 | 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 | 2024-08-11 | 2024-09-07 | N |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2024-08-11 | 2024-09-07 | N |
| Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | Health | 2024-08-11 | 2024-09-07 | N |
| PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2024-08-11 | 2024-09-07 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2024-08-11 | 2024-09-07 | 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 | 2024-08-11 | 2024-09-07 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2024-08-11 | 2024-09-07 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2024-08-11 | 2024-09-07 | 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 | 2024-08-11 | 2024-09-07 | 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 | 2024-08-11 | 2024-09-07 | N |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2024-08-11 | 2024-09-07 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2024-08-11 | 2024-09-07 | N |
| Dispose of garbage and refuse properly. | Health | 2024-08-11 | 2024-09-07 | N |
| Provide and implement an infection prevention and control program. | Health | 2024-08-11 | 2024-09-07 | N |
| Develop, implement, and/or maintain an effective training program for all new and existing staff members. | Health | 2024-08-11 | 2024-09-07 | N |
| Develop and maintain an Emergency Preparedness Program (EP). | Fire Safety | 2024-08-10 | 2024-09-07 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2024-08-10 | 2024-09-07 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2024-08-10 | 2024-09-07 | N |
| Have an enclosure around a vertical opening shaft. | Fire Safety | 2024-08-10 | 2024-09-07 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2024-08-10 | 2024-09-07 | N |
| Install a fire alarm system that can be heard throughout the facility. | Fire Safety | 2024-08-10 | 2024-09-07 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2024-08-10 | 2024-09-07 | N |
| Install smoke barrier doors that can resist smoke for at least 20 minutes. | Fire Safety | 2024-08-10 | 2024-09-07 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2024-08-10 | 2024-09-07 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2024-08-10 | 2024-09-07 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2024-08-10 | 2024-09-07 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2023-07-27 | 2023-09-10 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-07-27 | 2023-09-10 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2023-07-27 | 2023-09-10 | Y |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2023-07-26 | 2023-09-10 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-02-10 | 2022-04-30 | Y |
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