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Deficiency Records for Warsaw Meadows
A list of the most recent deficiencies for Warsaw Meadows. 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 Warsaw Meadows. 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? |
|---|---|---|---|---|
| Develop and maintain an Emergency Preparedness Program (EP). | Fire Safety | 2024-08-29 | 2024-09-16 | N |
| Develop Emergency Preparedness policies and procedures. | Fire Safety | 2024-08-29 | 2024-09-16 | N |
| Develop a communication plan. | Fire Safety | 2024-08-29 | 2024-09-16 | N |
| List the names and contact information of those in the facility. | Fire Safety | 2024-08-29 | 2024-09-16 | N |
| Establish emergency prep training and testing. | Fire Safety | 2024-08-29 | 2024-09-16 | N |
| Establish staff and initial training requirements. | Fire Safety | 2024-08-29 | 2024-09-16 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2024-08-29 | 2024-09-16 | N |
| Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2024-08-13 | 2024-09-13 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2024-08-13 | 2024-09-13 | 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 | 2024-08-13 | 2024-09-13 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2024-08-13 | 2024-09-13 | N |
| Provide activities to meet all resident's needs. | Health | 2024-08-13 | 2024-09-13 | N |
| Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services. | Health | 2024-08-13 | 2024-09-13 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2024-08-13 | 2024-09-13 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2024-08-13 | 2024-09-13 | 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 | 2024-08-13 | 2024-09-13 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2024-08-13 | 2024-09-13 | N |
| Ensure meals and snacks are served at times in accordance with resident?s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. | Health | 2023-11-28 | 2023-12-15 | Y |
| Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged. | Health | 2023-10-13 | 2023-11-02 | Y |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2023-10-13 | 2023-11-02 | Y |
| Establish procedures for tracking staff and patients during an emergency. | Fire Safety | 2023-09-11 | 2023-10-30 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2023-09-11 | 2023-10-30 | 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 | 2023-09-11 | 2023-10-30 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2023-09-11 | 2023-10-30 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2023-09-11 | 2023-10-30 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-08-10 | 2023-08-29 | 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 | 2023-08-10 | 2023-08-29 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-03-31 | 2023-05-01 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2022-09-24 | 2022-10-16 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-09-24 | 2022-10-16 | Y |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2022-09-12 | 2022-10-15 | 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 | 2022-09-12 | 2022-10-15 | N |
| Have corridors or aisles that are unobstructed and are at least 8 feet in width. | Fire Safety | 2022-09-12 | 2022-10-15 | 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 | 2022-09-12 | 2022-10-15 | N |
| Construct fire resistant interior walls. | Fire Safety | 2022-09-12 | 2022-10-15 | N |
| Install a fire alarm system that can be heard throughout the facility. | Fire Safety | 2022-09-12 | 2022-10-15 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-09-12 | 2022-10-15 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2022-09-12 | 2022-10-15 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2022-09-12 | 2022-10-15 | N |
| Meet other general requirements that are deficient. | Fire Safety | 2022-09-12 | 2022-10-15 | N |
| Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2022-09-12 | 2022-10-15 | N |
| Have an externally vented heating system. | Fire Safety | 2022-09-12 | 2022-10-15 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2022-09-12 | 2022-10-15 | N |
| Have exits that are accessible at all times. | Fire Safety | 2022-09-12 | 2022-09-30 | 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 | 2022-08-08 | 2022-09-09 | N |
| Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged. | Health | 2022-08-08 | 2022-09-09 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2022-08-08 | 2022-09-09 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2022-08-08 | 2022-09-09 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-08-08 | 2022-09-09 | 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 | 2022-08-08 | 2022-09-09 | N |
| Plan the resident's discharge to meet the resident's goals and needs. | Health | 2022-08-08 | 2022-09-09 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-08-08 | 2022-09-09 | N |
| Assist a resident in gaining access to vision and hearing services. | Health | 2022-08-08 | 2022-09-09 | 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 | 2022-08-08 | 2022-09-09 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2022-08-08 | 2022-09-09 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2022-08-08 | 2022-09-09 | N |
| Ensure that residents are free from significant medication errors. | Health | 2022-08-08 | 2022-09-09 | N |
| Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | Health | 2022-08-08 | 2022-09-09 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-08-08 | 2022-09-09 | N |
| Provide and implement an infection prevention and control program. | Health | 2022-08-08 | 2022-09-09 | N |
| Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | Health | 2022-08-08 | 2022-09-09 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2022-08-08 | 2022-09-09 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-08-08 | 2022-09-09 | Y |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2022-08-08 | 2022-09-09 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2022-03-02 | 2022-03-18 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-03-02 | 2022-03-18 | Y |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2022-03-02 | 2022-03-18 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-02-09 | 2022-03-07 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-02-09 | 2022-03-07 | Y |
| Ensure that residents are free from significant medication errors. | Health | 2022-02-09 | 2022-03-07 | Y |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2022-02-09 | 2022-03-07 | Y |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2021-11-16 | 2021-12-14 | Y |
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