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Deficiency Records for Mcgivney Health Care Center

A list of the most recent deficiencies for Mcgivney Health Care Center. 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 Mcgivney Health Care Center. 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?
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 2023-10-26 2023-11-06 N
Install emergency lighting that can last at least 1 1/2 hours. Fire Safety 2023-10-26 2023-11-06 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 2023-10-26 2023-11-06 N
Install an approved automatic sprinkler system. Fire Safety 2023-10-26 2023-11-06 N
To conduct inspection, testing and maintenance of fire doors by qualified individuals. Fire Safety 2023-10-26 2023-11-06 N
Ensure proper usage of power strips and extension cords. Fire Safety 2023-10-26 2023-11-06 N
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Health 2023-09-22 2023-10-27 N
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Health 2023-09-22 2023-10-27 N
Ensure each resident receives an accurate assessment. Health 2023-09-22 2023-10-27 N
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. Health 2023-09-22 2023-10-27 N
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Health 2023-09-22 2023-10-27 N
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2023-09-22 2023-10-27 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 2023-09-22 2023-10-27 N
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. Health 2023-09-22 2023-10-27 N
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 2023-09-22 2023-10-27 N
Observe each nurse aide's job performance and give regular training. Health 2023-09-22 2023-10-27 N
Post nurse staffing information every day. Health 2023-09-22 2023-10-27 N
Ensure that residents are free from significant medication errors. Health 2023-09-22 2023-10-27 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 2023-09-22 2023-10-27 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 2023-09-22 2023-10-27 N
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Health 2023-09-22 2023-10-27 N
Administer the facility in a manner that enables it to use its resources effectively and efficiently. Health 2023-09-22 2023-10-27 N
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Health 2023-09-22 2023-10-27 N
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. Health 2023-09-22 2023-10-27 N
Provide and implement an infection prevention and control program. Health 2023-09-22 2023-10-27 N
Implement a program that monitors antibiotic use. Health 2023-09-22 2023-10-27 N
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. Health 2023-09-22 2023-10-27 N
Develop and implement policies and procedures for flu and pneumonia vaccinations. Health 2023-09-22 2023-10-27 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 2023-09-22 2023-10-27 N
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. Health 2023-09-22 2023-10-27 N
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Health 2023-09-22 2023-10-27 N
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Health 2022-11-14 2022-11-30 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 2022-07-26 2022-10-31 N
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Health 2022-07-26 2022-10-31 N
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. Health 2022-07-26 2022-10-31 N
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Health 2022-07-26 2022-10-31 N
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. Health 2022-07-26 2022-10-31 N
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2022-07-26 2022-10-31 N
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. Health 2022-07-26 2022-10-31 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 2022-07-26 2022-10-31 N
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Health 2022-07-26 2022-10-31 N
Develop and implement policies and procedures for flu and pneumonia vaccinations. Health 2022-07-26 2022-10-31 N
Perform COVID19 testing on residents and staff. Health 2022-07-26 2022-10-31 N
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. Health 2022-07-26 2022-10-31 N
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Health 2022-09-27 2022-10-31 Y
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2022-09-27 2022-10-31 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 2022-09-27 2022-10-31 Y
Provide and implement an infection prevention and control program. Health 2022-09-27 2022-10-31 Y
Establish staff and initial training requirements. Fire Safety 2022-08-15 2022-09-22 N
Conduct testing and exercise requirements. Fire Safety 2022-08-15 2022-09-22 N
Implement emergency and standby power systems. Fire Safety 2022-08-15 2022-09-22 N
Keep aisles, corridors, and exits free of obstruction in case of emergency. Fire Safety 2022-08-15 2022-09-22 N
Have corridors or aisles that are unobstructed and are at least 8 feet in width. Fire Safety 2022-08-15 2022-09-22 N
Have properly located and lighted "Exit" signs. Fire Safety 2022-08-15 2022-09-22 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 2022-08-15 2022-09-22 N
Provide properly protected cooking facilities. Fire Safety 2022-08-15 2022-09-22 N
Ensure smoke barriers are constructed to a 1 hour fire resistance rating. Fire Safety 2022-08-15 2022-09-22 N
Install smoke barrier doors that can resist smoke for at least 20 minutes. Fire Safety 2022-08-15 2022-09-22 N
Meet other general requirements that are deficient. Fire Safety 2022-08-15 2022-09-22 N
Have properly installed electrical wiring and gas equipment. Fire Safety 2022-08-15 2022-09-22 N
Have restrictions on the use of portable space heaters. Fire Safety 2022-08-15 2022-09-22 N
Have generator or other power source capable of supplying service within 10 seconds. Fire Safety 2022-08-15 2022-09-22 N
Ensure proper usage of power strips and extension cords. Fire Safety 2022-08-15 2022-09-22 N
Ensure staff are vaccinated for COVID-19 Health 2022-04-25 2022-05-17 Y
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 2021-07-19 2021-08-09 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 2021-07-19 2021-08-09 N
Install a fire alarm system that can be heard throughout the facility. Fire Safety 2021-07-19 2021-08-09 N
Install an approved automatic sprinkler system. Fire Safety 2021-07-19 2021-08-09 N
Inspect, test, and maintain automatic sprinkler systems. Fire Safety 2021-07-19 2021-08-09 N
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours. Fire Safety 2021-07-19 2021-08-09 N
Properly select, install, inspect, or maintain portable fire extinguishes. Fire Safety 2021-07-19 2021-08-09 N
Ensure smoke barriers are constructed to a 1 hour fire resistance rating. Fire Safety 2021-07-19 2021-08-09 N
Have restrictions on the use of highly flammable decorations. Fire Safety 2021-07-19 2021-08-09 N
Construct fire resistant interior walls. Fire Safety 2021-07-19 2021-08-06 N
Assure the security of all personal funds of residents deposited with the facility. Health 2021-06-11 2021-07-16 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 2021-06-11 2021-07-16 N
Ensure each resident receives an accurate assessment. Health 2021-06-11 2021-07-16 N
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Health 2021-06-11 2021-07-16 N
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. Health 2021-06-11 2021-07-16 N
Provide enough food/fluids to maintain a resident's health. Health 2021-06-11 2021-07-16 N
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Health 2021-06-11 2021-07-16 N
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. Health 2021-06-11 2021-07-16 N

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