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Deficiency Records for Marshall Nursing and Rehabilitation Community

A list of the most recent deficiencies for Marshall Nursing and Rehabilitation Community. 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 Marshall Nursing and Rehabilitation Community. 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?
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Health 2024-03-14 2024-04-19 Y
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Health 2024-03-14 2024-04-19 Y
Provide appropriate treatment and care according to orders, resident?s preferences and goals. Health 2024-03-14 2024-04-19 Y
Provide appropriate pressure ulcer care and prevent new ulcers from developing. Health 2024-03-14 2024-04-19 Y
Provide appropriate treatment and care according to orders, resident?s preferences and goals. Health 2023-10-11 2023-11-23 Y
Provide safe and appropriate respiratory care for a resident when needed. Health 2023-10-11 2023-11-23 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 2023-10-11 2023-10-30 Y
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. Health 2023-10-11 2023-10-30 Y
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Health 2023-10-11 2023-10-30 Y
Keep residents' personal and medical records private and confidential. Health 2023-08-02 2023-09-05 N
Ensure services provided by the nursing facility meet professional standards of quality. Health 2023-08-02 2023-09-05 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 2023-08-02 2023-09-05 N
Provide safe, appropriate dialysis care/services for a resident who requires such services. Health 2023-08-02 2023-09-05 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 2023-08-02 2023-09-05 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 2023-08-02 2023-09-05 N
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Health 2023-08-02 2023-09-05 N
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Health 2023-08-02 2023-09-05 N
Provide and implement an infection prevention and control program. Health 2023-08-02 2023-09-05 Y
Implement a program that monitors antibiotic use. Health 2023-08-02 2023-09-05 Y
Have approved installation, maintenance and testing program for fire alarm systems. Fire Safety 2023-08-03 2023-09-05 N
Inspect, test, and maintain automatic sprinkler systems. Fire Safety 2023-08-03 2023-09-05 N
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted Health 2023-04-05 2023-05-01 Y
Provide appropriate treatment and care according to orders, resident?s preferences and goals. Health 2023-04-05 2023-05-01 Y
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Health 2022-11-30 2023-01-24 Y
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Health 2022-11-30 2023-01-09 Y
Provide safe, appropriate pain management for a resident who requires such services. Health 2022-11-30 2023-01-09 Y
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. Health 2022-07-20 2022-08-22 N
Assess the resident when there is a significant change in condition Health 2022-07-20 2022-08-22 N
Assure that each resident?s assessment is updated at least once every 3 months. Health 2022-07-20 2022-08-22 N
Encode each resident?s assessment data and transmit these data to the State within 7 days of assessment. Health 2022-07-20 2022-08-22 N
Ensure each resident receives an accurate assessment. Health 2022-07-20 2022-08-22 N
Provide appropriate treatment and care according to orders, resident?s preferences and goals. Health 2022-07-20 2022-08-22 N
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2022-07-20 2022-08-22 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 2022-07-20 2022-08-22 N
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. Health 2022-07-20 2022-08-22 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 2022-07-20 2022-08-22 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 2022-07-20 2022-08-22 N
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Health 2022-07-20 2022-08-22 N
Dispose of garbage and refuse properly. Health 2022-07-20 2022-08-22 N
Provide and implement an infection prevention and control program. Health 2022-07-20 2022-08-22 N
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Health 2022-07-20 2022-08-22 N
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Health 2022-07-20 2022-08-22 Y
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Health 2022-07-20 2022-08-22 Y
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted Health 2022-07-20 2022-08-22 Y
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Health 2022-07-20 2022-08-22 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 2022-07-20 2022-08-22 Y
Plan the resident's discharge to meet the resident's goals and needs. Health 2022-07-20 2022-08-22 Y
Provide appropriate pressure ulcer care and prevent new ulcers from developing. Health 2022-07-20 2022-08-22 Y
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Health 2022-07-20 2022-08-22 Y
Provide properly protected cooking facilities. Fire Safety 2022-07-19 2022-08-22 N
Have properly installed electrical wiring and gas equipment. Fire Safety 2022-07-19 2022-08-22 N
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Health 2022-03-04 2022-03-31 Y
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Health 2022-03-04 2022-03-31 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 2021-04-26 2021-05-25 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 2021-04-26 2021-05-25 N
PASARR screening for Mental disorders or Intellectual Disabilities Health 2021-04-26 2021-05-25 N
Ensure services provided by the nursing facility meet professional standards of quality. Health 2021-04-26 2021-05-25 N
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. Health 2021-04-26 2021-05-25 N
Provide care and assistance to perform activities of daily living for any resident who is unable. Health 2021-04-26 2021-05-25 N
Provide appropriate treatment and care according to orders, resident?s preferences and goals. Health 2021-04-26 2021-05-25 N
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2021-04-26 2021-05-25 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 2021-04-26 2021-05-25 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 2021-04-26 2021-05-25 N
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Health 2021-04-26 2021-05-25 N
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Health 2021-04-26 2021-05-25 N
Keep aisles, corridors, and exits free of obstruction in case of emergency. Fire Safety 2021-04-12 2021-05-20 N
Install proper backup exit lighting. Fire Safety 2021-04-12 2021-05-20 N
Install emergency lighting that can last at least 1 1/2 hours. Fire Safety 2021-04-12 2021-05-20 N
Have properly located and lighted "Exit" signs. Fire Safety 2021-04-12 2021-05-20 N
Provide properly protected cooking facilities. Fire Safety 2021-04-12 2021-05-20 N
Ensure that waiting areas, nurse?s stations, gift shops, and cooking facilities, open to the corridor are properly protected. Fire Safety 2021-04-12 2021-05-20 N
Ensure smoke barriers are constructed to a 1 hour fire resistance rating. Fire Safety 2021-04-12 2021-05-20 N
Install smoke barrier doors that can resist smoke for at least 20 minutes. Fire Safety 2021-04-12 2021-05-20 N
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Fire Safety 2021-04-12 2021-05-20 N
Have restrictions on the use of highly flammable decorations. Fire Safety 2021-04-12 2021-05-20 N
Meet requirements for the installation and maintenance of electrical systems. Fire Safety 2021-04-12 2021-05-20 N
Have a battery powered remote alarm panel in a location accessible by operating personnel. Fire Safety 2021-04-12 2021-05-20 N
Have generator or other power source capable of supplying service within 10 seconds. Fire Safety 2021-04-12 2021-05-20 N
Ensure proper usage of power strips and extension cords. Fire Safety 2021-04-12 2021-05-20 N

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