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Deficiency Records for Loft Rehab of Decatur

A list of the most recent deficiencies for Loft Rehab of Decatur. 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 Loft Rehab of Decatur. 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?
Inspect, test, and maintain automatic sprinkler systems. Fire Safety 2024-05-03 2024-09-20 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 2024-08-30 2024-09-12 Y
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2024-08-30 2024-09-12 Y
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Health 2024-08-07 2024-08-30 Y
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. Health 2024-08-07 2024-08-30 Y
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Health 2024-08-07 2024-08-30 Y
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Health 2024-07-11 2024-07-23 Y
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2024-07-11 2024-07-23 Y
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2024-06-28 2024-07-15 Y
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Health 2024-06-20 2024-07-12 Y
Provide care by qualified persons according to each resident's written plan of care. Health 2024-06-20 2024-07-12 Y
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Health 2024-06-20 2024-07-12 Y
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. Health 2024-06-28 2024-07-11 Y
Respond appropriately to all alleged violations. Health 2024-06-28 2024-06-29 Y
Have generator or other power source capable of supplying service within 10 seconds. Fire Safety 2024-05-03 2024-06-28 N
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Health 2024-05-31 2024-06-18 Y
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2024-05-31 2024-06-18 Y
Install corridor and hallway doors that block smoke. Fire Safety 2024-05-03 2024-06-10 N
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Health 2024-04-24 2024-05-25 N
Allow residents to self-administer drugs if determined clinically appropriate. Health 2024-04-24 2024-05-25 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 2024-04-24 2024-05-25 N
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. Health 2024-04-24 2024-05-25 N
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. Health 2024-04-24 2024-05-25 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 2024-04-24 2024-05-25 N
PASARR screening for Mental disorders or Intellectual Disabilities Health 2024-04-24 2024-05-25 N
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted Health 2024-04-24 2024-05-25 N
Provide care and assistance to perform activities of daily living for any resident who is unable. Health 2024-04-24 2024-05-25 N
Provide appropriate pressure ulcer care and prevent new ulcers from developing. Health 2024-04-24 2024-05-25 N
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 2024-04-24 2024-05-25 N
Provide enough food/fluids to maintain a resident's health. Health 2024-04-24 2024-05-25 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 2024-04-24 2024-05-25 N
Provide safe, appropriate dialysis care/services for a resident who requires such services. Health 2024-04-24 2024-05-25 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 2024-04-24 2024-05-25 N
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Health 2024-04-24 2024-05-25 N
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly Health 2024-04-24 2024-05-25 N
Provide and implement an infection prevention and control program. Health 2024-04-24 2024-05-25 N
Develop and implement policies and procedures for flu and pneumonia vaccinations. Health 2024-04-24 2024-05-25 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 2024-04-24 2024-05-25 N
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. Fire Safety 2024-05-03 2024-05-25 N
Provide properly protected cooking facilities. Fire Safety 2024-05-03 2024-05-25 N
Ensure proper storage of liquid oxygen. Fire Safety 2024-05-03 2024-05-25 N
Have approved installation, maintenance and testing program for fire alarm systems. Fire Safety 2024-05-03 2024-05-20 N
Install smoke barrier doors that can resist smoke for at least 20 minutes. Fire Safety 2024-05-03 2024-05-20 N
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. Fire Safety 2024-05-03 2024-05-20 N
Have simulated fire drills held at unexpected times. Fire Safety 2024-05-03 2024-05-13 N
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2024-01-30 2024-03-19 Y
Respond appropriately to all alleged violations. Health 2024-01-30 2024-03-05 Y
Provide appropriate treatment and care according to orders, resident?s preferences and goals. Health 2023-08-21 2023-09-06 Y
Provide properly protected cooking facilities. Fire Safety 2023-06-28 2023-07-25 N
Install smoke barrier doors that can resist smoke for at least 20 minutes. Fire Safety 2023-06-28 2023-07-25 N
Have simulated fire drills held at unexpected times. Fire Safety 2023-06-28 2023-07-25 N
Have generator or other power source capable of supplying service within 10 seconds. Fire Safety 2023-06-28 2023-07-11 N
Conduct testing and exercise requirements. Fire Safety 2023-06-28 2023-07-10 N
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. Fire Safety 2023-06-28 2023-07-10 N
Have approved installation, maintenance and testing program for fire alarm systems. Fire Safety 2023-06-28 2023-07-10 N
Inspect, test, and maintain automatic sprinkler systems. Fire Safety 2023-06-28 2023-07-10 N
To conduct inspection, testing and maintenance of fire doors by qualified individuals. Fire Safety 2023-06-28 2023-07-10 N
Ensure operating rooms are properly protected and written records are maintained and available for inspection. Fire Safety 2023-06-28 2023-07-10 N
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. Fire Safety 2023-06-28 2023-07-10 N
Ensure proper storage of liquid oxygen. Fire Safety 2023-06-28 2023-07-10 N
Allow residents to self-administer drugs if determined clinically appropriate. Health 2023-06-14 2023-07-05 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 2023-06-14 2023-07-05 N
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. Health 2023-06-14 2023-07-05 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 2023-06-14 2023-07-05 N
Provide care by qualified persons according to each resident's written plan of care. Health 2023-06-14 2023-07-05 N
Provide care and assistance to perform activities of daily living for any resident who is unable. Health 2023-06-14 2023-07-05 N
Provide appropriate treatment and care according to orders, resident?s preferences and goals. Health 2023-06-14 2023-07-05 N
Provide appropriate pressure ulcer care and prevent new ulcers from developing. Health 2023-06-14 2023-07-05 N
Provide enough food/fluids to maintain a resident's health. Health 2023-06-14 2023-07-05 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 2023-06-14 2023-07-05 N
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Health 2023-06-14 2023-07-05 N
Ensure that residents are fully informed and understand their health status, care and treatments. Health 2023-05-31 2023-06-21 Y
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 2023-05-31 2023-06-21 Y
Provide appropriate pressure ulcer care and prevent new ulcers from developing. Health 2023-05-31 2023-06-21 Y
Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made. Health 2023-05-10 2023-05-25 Y
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Health 2023-05-10 2023-05-25 Y
Provide appropriate treatment and care according to orders, resident?s preferences and goals. Health 2023-05-10 2023-05-25 Y
Provide safe and appropriate respiratory care for a resident when needed. Health 2023-05-10 2023-05-25 Y
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. Health 2023-05-10 2023-05-25 Y
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Health 2023-03-28 2023-05-05 Y
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2023-03-28 2023-04-25 Y
Ensure that residents are free from significant medication errors. Health 2023-03-28 2023-04-25 Y
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Health 2023-02-09 2023-02-23 Y
Keep residents' personal and medical records private and confidential. Health 2023-02-09 2023-02-23 Y
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. Health 2023-02-09 2023-02-23 Y
Ensure medication error rates are not 5 percent or greater. Health 2023-02-09 2023-02-23 Y
Ensure services provided by the nursing facility meet professional standards of quality. Health 2023-01-17 2023-02-03 Y
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2023-01-17 2023-02-03 Y
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Health 2022-12-01 2022-12-09 Y
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2022-11-22 2022-12-08 Y
Provide appropriate pressure ulcer care and prevent new ulcers from developing. Health 2022-10-11 2022-12-08 Y
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Health 2022-12-01 2022-12-07 Y
Provide care and assistance to perform activities of daily living for any resident who is unable. Health 2022-10-11 2022-11-22 Y
Conduct testing and exercise requirements. Fire Safety 2022-10-06 2022-11-07 N
Have approved installation, maintenance and testing program for fire alarm systems. Fire Safety 2022-10-06 2022-10-22 N
Have generator or other power source capable of supplying service within 10 seconds. Fire Safety 2022-10-06 2022-10-22 N
Address subsistence needs for staff and patients. Fire Safety 2022-10-06 2022-10-21 N
Have properly located and lighted "Exit" signs. Fire Safety 2022-10-06 2022-10-20 N
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2022-09-30 2022-10-17 Y
Provide properly protected cooking facilities. Fire Safety 2022-10-06 2022-10-17 N
Inspect, test, and maintain automatic sprinkler systems. Fire Safety 2022-10-06 2022-10-17 N
Have simulated fire drills held at unexpected times. Fire Safety 2022-10-06 2022-10-17 N
Ensure that residents are fully informed and understand their health status, care and treatments. Health 2022-09-14 2022-10-14 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 2022-09-14 2022-10-14 N
Ensure each resident receives an accurate assessment. Health 2022-09-14 2022-10-14 N
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Health 2022-09-14 2022-10-14 N
Provide care by qualified persons according to each resident's written plan of care. Health 2022-09-14 2022-10-14 N
Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. Health 2022-09-14 2022-10-14 N
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2022-09-14 2022-10-14 N
Provide enough food/fluids to maintain a resident's health. Health 2022-09-14 2022-10-14 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 2022-09-14 2022-10-14 N
Provide safe and appropriate respiratory care for a resident when needed. Health 2022-09-14 2022-10-14 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 2022-09-14 2022-10-14 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 2022-09-14 2022-10-14 N
Provide or obtain dental services for each resident. Health 2022-09-14 2022-10-14 N
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Health 2022-09-14 2022-10-14 N
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly Health 2022-09-14 2022-10-14 N
Provide and implement an infection prevention and control program. Health 2022-09-14 2022-10-14 N
Provide and implement an infection prevention and control program. Health 2022-05-25 2022-06-18 Y
Ensure staff are vaccinated for COVID-19 Health 2022-05-25 2022-06-18 Y
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 2022-04-18 2022-04-30 Y
Keep all essential equipment working safely. Health 2022-04-18 2022-04-30 Y
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident?s advance directives. Health 2022-04-18 2022-04-18 Y
Provide safe and appropriate respiratory care for a resident when needed. Health 2022-03-09 2022-04-08 Y
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2022-02-01 2022-04-08 Y
Provide safe and appropriate respiratory care for a resident when needed. Health 2022-02-01 2022-04-08 Y
Provide care and assistance to perform activities of daily living for any resident who is unable. Health 2022-03-09 2022-03-30 Y
Allow residents to self-administer drugs if determined clinically appropriate. Health 2022-02-01 2022-03-30 Y
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Health 2022-02-01 2022-03-30 Y
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Health 2022-02-01 2022-03-30 Y
Respond appropriately to all alleged violations. Health 2022-02-01 2022-03-30 Y
Provide appropriate treatment and care according to orders, resident?s preferences and goals. Health 2022-02-01 2022-03-30 Y
Provide appropriate pressure ulcer care and prevent new ulcers from developing. Health 2022-02-01 2022-03-30 Y
Provide and implement an infection prevention and control program. Health 2022-02-01 2022-03-30 Y
Perform COVID19 testing on residents and staff. Health 2022-02-01 2022-03-30 Y
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Health 2022-01-13 2022-03-30 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 2021-10-14 2021-11-01 Y
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. Health 2021-10-14 2021-11-01 Y
Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law. Health 2021-10-14 2021-11-01 Y

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