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Deficiency Records for Ignite Medical Resort St Marys LLC
A list of the most recent deficiencies for Ignite Medical Resort St Marys LLC. 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 Ignite Medical Resort St Marys LLC. 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? |
|---|---|---|---|---|
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2024-08-27 | 2024-10-14 | N |
| Allow residents to self-administer drugs if determined clinically appropriate. | Health | 2024-08-27 | 2024-10-14 | 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 | 2024-08-27 | 2024-10-14 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2024-08-27 | 2024-10-14 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2024-08-27 | 2024-10-14 | 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 | 2024-08-27 | 2024-10-14 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2024-08-27 | 2024-10-14 | N |
| Provide care or services that was trauma informed and/or culturally competent. | Health | 2024-08-27 | 2024-10-14 | N |
| Ensure that the resident and his/her doctor meet face-to-face at all required visits. | Health | 2024-08-27 | 2024-10-14 | N |
| Provide medically-related social services to help each resident achieve the highest possible quality of life. | Health | 2024-08-27 | 2024-10-14 | 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 | 2024-08-27 | 2024-10-14 | 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 | 2024-08-27 | 2024-10-14 | N |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2024-08-27 | 2024-10-14 | N |
| Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | Health | 2024-08-27 | 2024-10-14 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2024-08-27 | 2024-10-14 | N |
| Have a policy regarding use and storage of foods brought to residents by family and other visitors. | Health | 2024-08-27 | 2024-10-14 | N |
| Dispose of garbage and refuse properly. | Health | 2024-08-27 | 2024-10-14 | N |
| Make sure that a working call system is available in each resident's bathroom and bathing area. | Health | 2024-08-27 | 2024-10-14 | N |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2024-08-27 | 2024-10-14 | N |
| Develop and maintain an Emergency Preparedness Program (EP). | Fire Safety | 2024-08-27 | 2024-10-14 | N |
| Address patient/client population and determine types of services needed. | Fire Safety | 2024-08-27 | 2024-10-14 | N |
| Address subsistence needs for staff and patients. | Fire Safety | 2024-08-27 | 2024-10-14 | N |
| Establish policies and procedures including evacuation. | Fire Safety | 2024-08-27 | 2024-10-14 | N |
| Create arrangements with other facilities to receive patients. | Fire Safety | 2024-08-27 | 2024-10-14 | N |
| List the names and contact information of those in the facility. | Fire Safety | 2024-08-27 | 2024-10-14 | N |
| Implement emergency and standby power systems. | Fire Safety | 2024-08-27 | 2024-10-14 | N |
| Use approved construction type or materials. | Fire Safety | 2024-08-27 | 2024-10-14 | N |
| Have ramps, exits, fire escape ladders, steps, and areas of refuge that meet safety requirements. | Fire Safety | 2024-08-27 | 2024-10-14 | N |
| Have exits that are accessible at all times. | Fire Safety | 2024-08-27 | 2024-10-14 | N |
| Install proper backup exit lighting. | Fire Safety | 2024-08-27 | 2024-10-14 | N |
| Have properly located and lighted "Exit" signs. | Fire Safety | 2024-08-27 | 2024-10-14 | N |
| Have an enclosure around a vertical opening shaft. | Fire Safety | 2024-08-27 | 2024-10-14 | 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 | 2024-08-27 | 2024-10-14 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2024-08-27 | 2024-10-14 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2024-08-27 | 2024-10-14 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2024-08-27 | 2024-10-14 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2024-08-27 | 2024-10-14 | N |
| Meet other general requirements that are deficient. | Fire Safety | 2024-08-27 | 2024-10-14 | N |
| Provide a written emergency evacuation plan. | Fire Safety | 2024-08-27 | 2024-10-14 | N |
| Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2024-08-27 | 2024-10-14 | N |
| Meet requirements for the use of electrical equipment. | Fire Safety | 2024-08-27 | 2024-10-14 | N |
| Honor the resident's right to manage his or her financial affairs. | Health | 2022-10-25 | 2022-12-09 | N |
| Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home. | Health | 2022-10-25 | 2022-12-09 | N |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2022-10-25 | 2022-12-09 | 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 | 2022-10-25 | 2022-12-09 | 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 | 2022-10-25 | 2022-12-09 | N |
| Dispose of garbage and refuse properly. | Health | 2022-10-25 | 2022-12-09 | N |
| Make sure that a working call system is available in each resident's bathroom and bathing area. | Health | 2022-10-25 | 2022-12-09 | N |
| Develop and maintain an Emergency Preparedness Program (EP). | Fire Safety | 2022-10-25 | 2022-12-09 | N |
| Include a process for Emergency Preparedness collaboration. | Fire Safety | 2022-10-25 | 2022-12-09 | N |
| Address subsistence needs for staff and patients. | Fire Safety | 2022-10-25 | 2022-12-09 | N |
| Establish policies and procedures for volunteers. | Fire Safety | 2022-10-25 | 2022-12-09 | N |
| Establish roles under a Waiver declared by secretary. | Fire Safety | 2022-10-25 | 2022-12-09 | N |
| Provide a means of sharing information on occupancy/needs. | Fire Safety | 2022-10-25 | 2022-12-09 | N |
| Implement emergency and standby power systems. | Fire Safety | 2022-10-25 | 2022-12-09 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2022-10-25 | 2022-12-09 | 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 | 2022-10-25 | 2022-12-09 | N |
| Have properly located and lighted "Exit" signs. | Fire Safety | 2022-10-25 | 2022-12-09 | N |
| Meet other general requirements that are deficient. | Fire Safety | 2022-10-25 | 2022-12-09 | N |
| Have properly installed hallway dispensers for alcohol-based hand rub. | Fire Safety | 2022-10-25 | 2022-12-09 | N |
| Construct fire resistant interior walls. | Fire Safety | 2022-10-25 | 2022-12-09 | N |
| Install a fire alarm system that can be heard throughout the facility. | Fire Safety | 2022-10-25 | 2022-12-09 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2022-10-25 | 2022-12-09 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-10-25 | 2022-12-09 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2022-10-25 | 2022-12-09 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2022-10-25 | 2022-12-09 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2022-10-25 | 2022-12-09 | N |
| Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. | Fire Safety | 2022-10-25 | 2022-12-09 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2022-10-25 | 2022-12-09 | N |
| Meet requirements for the use of electrical equipment. | Fire Safety | 2022-10-25 | 2022-12-09 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2020-01-14 | 2020-03-14 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2020-01-14 | 2020-02-27 | N |
| Honor the resident's right to manage his or her financial affairs. | Health | 2020-01-14 | 2020-02-27 | 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 | 2020-01-14 | 2020-02-27 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2020-01-14 | 2020-02-27 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2020-01-14 | 2020-02-27 | N |
| Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. | Health | 2020-01-14 | 2020-02-27 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2020-01-14 | 2020-02-27 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2020-01-14 | 2020-02-27 | N |
| Provide and implement an infection prevention and control program. | Health | 2020-01-14 | 2020-02-27 | N |
| Use approved construction type or materials. | Fire Safety | 2020-01-14 | 2020-02-27 | N |
| Install proper backup exit lighting. | Fire Safety | 2020-01-14 | 2020-02-27 | N |
| Install a fire alarm system that can be heard throughout the facility. | Fire Safety | 2020-01-14 | 2020-02-27 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2020-01-14 | 2020-02-27 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2020-01-14 | 2020-02-27 | N |
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