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Deficiency Records for Oak Grove Center
A list of the most recent deficiencies for Oak Grove 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 Oak Grove 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? |
|---|---|---|---|---|
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2024-05-29 | 2024-09-27 | Y |
| Have an agreement with at least one or more hospitals certified by Medicare or Medicaid to make sure residents can be moved quickly to the hospital when they need medical care. | Health | 2024-05-29 | 2024-09-27 | Y |
| Have a plan that describes the process for conducting QAPI and QAA activities. | Health | 2024-05-29 | 2024-09-27 | Y |
| Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | Health | 2024-05-29 | 2024-09-27 | Y |
| Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members. | Health | 2024-05-29 | 2024-09-27 | Y |
| Conduct mandatory training, for all staff, on the facility?s Quality Assurance and Performance Improvement Program. | Health | 2024-05-29 | 2024-09-27 | Y |
| Provide training in compliance and ethics. | Health | 2024-05-29 | 2024-09-27 | Y |
| Provide behavior health training consistent with the requirements and as determined by a facility assessment. | Health | 2024-05-29 | 2024-09-27 | Y |
| Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. | Health | 2024-05-29 | 2024-07-09 | Y |
| Reasonably accommodate the needs and preferences of each resident. | Health | 2024-05-29 | 2024-07-09 | Y |
| Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy. | Health | 2024-05-29 | 2024-07-09 | Y |
| Notify the appropriate authorities when residents with MD or ID services has a significant change in condition. | Health | 2024-05-29 | 2024-07-09 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2024-05-29 | 2024-07-09 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2024-05-29 | 2024-07-09 | Y |
| Provide and implement an infection prevention and control program. | Health | 2024-05-29 | 2024-07-09 | Y |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2024-05-29 | 2024-07-09 | Y |
| Provide and implement an infection prevention and control program. | Health | 2024-02-27 | 2024-03-26 | Y |
| 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 | 2024-02-01 | 2024-03-13 | 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 | 2024-02-01 | 2024-03-13 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2024-02-01 | 2024-03-13 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2024-02-01 | 2024-03-13 | N |
| Provide activities to meet all resident's needs. | Health | 2024-02-01 | 2024-03-13 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2024-02-01 | 2024-03-13 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2024-02-01 | 2024-03-13 | N |
| Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2024-02-01 | 2024-03-13 | N |
| Observe each nurse aide's job performance and give regular training. | Health | 2024-02-01 | 2024-03-13 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2024-02-01 | 2024-03-13 | N |
| Provide and implement an infection prevention and control program. | Health | 2024-02-01 | 2024-03-13 | N |
| Keep all essential equipment working safely. | Health | 2024-02-01 | 2024-03-13 | N |
| Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention. | Health | 2024-02-01 | 2024-03-13 | 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 | 2024-02-01 | 2024-03-13 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2024-02-01 | 2024-03-13 | Y |
| Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. | Fire Safety | 2024-01-30 | 2024-02-07 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2024-01-30 | 2024-02-07 | N |
| Meet requirements for the installation and maintenance of electrical systems. | Fire Safety | 2024-01-30 | 2024-02-07 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2023-06-06 | 2023-07-05 | 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 | 2023-06-06 | 2023-07-05 | Y |
| Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy. | Health | 2023-06-06 | 2023-07-05 | Y |
| Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | Health | 2023-04-11 | 2023-05-16 | Y |
| Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Health | 2022-10-18 | 2022-11-22 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-10-18 | 2022-11-22 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2022-10-18 | 2022-11-22 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2022-10-11 | 2022-11-22 | Y |
| 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 | 2022-05-23 | 2022-06-23 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-05-23 | 2022-06-23 | Y |
| 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 | 2022-03-17 | 2022-04-25 | N |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2022-03-17 | 2022-04-25 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-03-17 | 2022-04-25 | 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 | 2022-03-17 | 2022-04-25 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-03-17 | 2022-04-25 | N |
| Provide special eating equipment and utensils for residents who need them and appropriate assistance. | Health | 2022-03-17 | 2022-04-25 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-03-17 | 2022-04-25 | N |
| Provide and implement an infection prevention and control program. | Health | 2022-03-17 | 2022-04-25 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2022-03-17 | 2022-04-25 | Y |
| Establish staff and initial training requirements. | Fire Safety | 2022-03-14 | 2022-04-19 | N |
| Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector. | Fire Safety | 2022-03-14 | 2022-04-19 | N |
| Have corridors or aisles that are unobstructed and are at least 8 feet in width. | Fire Safety | 2022-03-14 | 2022-04-19 | N |
| Have exits that are accessible at all times. | Fire Safety | 2022-03-14 | 2022-04-19 | N |
| Meet other general requirements that are deficient. | Fire Safety | 2022-03-14 | 2022-04-19 | 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 | 2022-03-14 | 2022-04-19 | N |
| Construct fire resistant interior walls. | Fire Safety | 2022-03-14 | 2022-04-19 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-03-14 | 2022-04-19 | N |
| Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke. | Fire Safety | 2022-03-14 | 2022-04-19 | N |
| Provide properly sized and located linen or trash receptacles. | Fire Safety | 2022-03-14 | 2022-04-19 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2022-03-14 | 2022-04-19 | 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 | 2022-02-01 | 2022-03-01 | Y |
| Provide and implement an infection prevention and control program. | Health | 2022-02-01 | 2022-03-01 | Y |
| 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 | 2020-03-11 | 2020-11-30 | N |
| Post nurse staffing information every day. | Health | 2020-03-11 | 2020-11-30 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2020-03-11 | 2020-11-30 | N |
| Provide rooms that can be unlocked from inside without a key. | Fire Safety | 2020-03-10 | 2020-03-20 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2020-03-10 | 2020-03-20 | N |
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