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Deficiency Records for Great Lakes Rehab Center

A list of the most recent deficiencies for Great Lakes Rehab 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 Great Lakes Rehab 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 2023-12-21 2024-01-12 Y
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Health 2023-12-05 2024-01-08 N
PASARR screening for Mental disorders or Intellectual Disabilities Health 2023-12-05 2024-01-08 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 2023-12-05 2024-01-08 N
Provide appropriate treatment and care according to orders, resident?s preferences and goals. Health 2023-12-05 2024-01-08 N
Provide enough food/fluids to maintain a resident's health. Health 2023-12-05 2024-01-08 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 2023-12-05 2024-01-08 N
Post nurse staffing information every day. Health 2023-12-05 2024-01-08 N
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Health 2023-12-05 2024-01-08 N
Ensure medication error rates are not 5 percent or greater. Health 2023-12-05 2024-01-08 N
Ensure that residents are free from significant medication errors. Health 2023-12-05 2024-01-08 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 2023-12-05 2024-01-08 N
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. Health 2023-12-05 2024-01-08 N
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Health 2023-12-05 2024-01-08 N
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. Health 2023-12-05 2024-01-08 N
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data. Health 2023-12-05 2024-01-08 N
Develop and maintain an Emergency Preparedness Program (EP). Fire Safety 2023-12-04 2024-01-08 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 2023-12-04 2024-01-08 N
Inspect, test, and maintain automatic sprinkler systems. Fire Safety 2023-12-04 2024-01-08 N
Have restrictions on the use of portable space heaters. Fire Safety 2023-12-04 2024-01-08 N
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Health 2022-09-19 2022-11-25 N
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. Health 2022-09-19 2022-11-25 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 2022-09-19 2022-11-25 N
Provide appropriate pressure ulcer care and prevent new ulcers from developing. Health 2022-09-19 2022-11-25 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 2022-09-19 2022-11-25 N
Provide safe, appropriate dialysis care/services for a resident who requires such services. Health 2022-09-19 2022-11-25 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 2022-09-19 2022-11-25 N
Obtain a doctor's order to admit a resident and ensure the resident is under a doctor's care. Health 2022-09-19 2022-11-25 N
Ensure that the resident and his/her doctor meet face-to-face at all required visits. Health 2022-09-19 2022-11-25 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 2022-09-19 2022-11-25 N
Ensure each resident?s drug regimen must be free from unnecessary drugs. Health 2022-09-19 2022-11-25 N
Ensure medication error rates are not 5 percent or greater. Health 2022-09-19 2022-11-25 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 2022-09-19 2022-11-25 N
Provide or obtain dental services for each resident. Health 2022-09-19 2022-11-25 N
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Health 2022-09-19 2022-11-25 N
Provide and implement an infection prevention and control program. Health 2022-09-19 2022-11-25 N
Provide and implement an infection prevention and control program. Health 2022-10-20 2022-11-25 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 2022-09-13 2022-11-18 N
Provide properly protected cooking facilities. Fire Safety 2022-09-13 2022-11-18 N
Have approved installation, maintenance and testing program for fire alarm systems. Fire Safety 2022-09-13 2022-11-18 N
Install an approved automatic sprinkler system. Fire Safety 2022-09-13 2022-11-18 N
Inspect, test, and maintain automatic sprinkler systems. Fire Safety 2022-09-13 2022-11-18 N
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours. Fire Safety 2022-09-13 2022-11-18 N
Have properly installed electrical wiring and gas equipment. Fire Safety 2022-09-13 2022-11-18 N
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Health 2021-10-01 2021-11-19 N
Assess the resident when there is a significant change in condition Health 2021-10-01 2021-11-19 N
Ensure each resident receives an accurate assessment. Health 2021-10-01 2021-11-19 N
Provide appropriate treatment and care according to orders, resident?s preferences and goals. Health 2021-10-01 2021-11-19 N
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2021-10-01 2021-11-19 N
Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services. Health 2021-10-01 2021-11-19 N
Provide safe and appropriate respiratory care for a resident when needed. Health 2021-10-01 2021-11-19 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 2021-10-01 2021-11-19 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 2021-10-04 2021-11-19 N
Have generator or other power source capable of supplying service within 10 seconds. Fire Safety 2021-10-04 2021-11-19 N
Ensure proper usage of power strips and extension cords. Fire Safety 2021-10-04 2021-11-19 N

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