Deficiency Records for Jackson Creek Post Acute

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Updated as of August 01, 2024

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Deficiency Records for Jackson Creek Post Acute

A list of the most recent deficiencies for Jackson Creek Post Acute. 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 Jackson Creek Post Acute. 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 safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. Health 2024-05-07 2024-06-15 N
Ensure services provided by the nursing facility meet professional standards of quality. Health 2024-05-07 2024-06-15 N
Provide activities to meet all resident's needs. Health 2024-05-07 2024-06-15 N
Provide safe, appropriate dialysis care/services for a resident who requires such services. Health 2024-05-07 2024-06-15 N
Provide care or services that was trauma informed and/or culturally competent. Health 2024-05-07 2024-06-15 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 2024-05-07 2024-06-15 N
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Health 2024-05-07 2024-06-15 N
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Health 2024-05-07 2024-06-15 N
Have a policy regarding use and storage of foods brought to residents by family and other visitors. Health 2024-05-07 2024-06-15 N
Provide and implement an infection prevention and control program. Health 2024-05-07 2024-06-15 N
Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame. Health 2024-05-07 2024-06-15 N
PASARR screening for Mental disorders or Intellectual Disabilities Health 2024-05-07 2024-06-15 Y
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2024-05-07 2024-06-15 Y
Address patient/client population and determine types of services needed. Fire Safety 2024-05-07 2024-06-15 N
Address subsistence needs for staff and patients. Fire Safety 2024-05-07 2024-06-15 N
Establish policies and procedures including evacuation. Fire Safety 2024-05-07 2024-06-15 N
Create arrangements with other facilities to receive patients. Fire Safety 2024-05-07 2024-06-15 N
List the names and contact information of those in the facility. Fire Safety 2024-05-07 2024-06-15 N
Have exits that are accessible at all times. Fire Safety 2024-05-07 2024-06-15 N
Provide properly protected cooking facilities. Fire Safety 2024-05-07 2024-06-15 N
Have properly installed hallway dispensers for alcohol-based hand rub. Fire Safety 2024-05-07 2024-06-15 N
Have approved installation, maintenance and testing program for fire alarm systems. Fire Safety 2024-05-07 2024-06-15 N
Inspect, test, and maintain automatic sprinkler systems. Fire Safety 2024-05-07 2024-06-15 N
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours. Fire Safety 2024-05-07 2024-06-15 N
Have proper medical gas storage and administration areas. Fire Safety 2024-05-07 2024-06-15 N
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2023-06-14 2023-06-14 Y
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Health 2023-01-26 2023-03-01 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 2022-08-10 2022-12-31 N
Ensure services provided by the nursing facility meet professional standards of quality. Health 2022-08-10 2022-09-23 N
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2022-08-10 2022-09-23 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 2022-08-10 2022-09-23 N
Ensure each resident?s drug regimen must be free from unnecessary drugs. Health 2022-08-10 2022-09-23 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 2022-08-10 2022-09-23 N
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Health 2022-08-10 2022-09-23 N
Address subsistence needs for staff and patients. Fire Safety 2022-08-10 2022-09-23 N
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours. Fire Safety 2022-08-10 2022-09-23 N
Meet Health Care Facilities Code mechanical requirements. Fire Safety 2022-08-10 2022-09-23 N
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. Fire Safety 2022-08-10 2022-09-23 N
Have generator or other power source capable of supplying service within 10 seconds. Fire Safety 2022-08-10 2022-09-23 N
Provide and implement an infection prevention and control program. Health 2022-08-10 2022-09-14 N
Install emergency lighting that can last at least 1 1/2 hours. Fire Safety 2022-08-10 2022-08-26 N
Properly select, install, inspect, or maintain portable fire extinguishes. Fire Safety 2022-08-10 2022-08-10 N
Provide safe, appropriate dialysis care/services for a resident who requires such services. Health 2019-11-05 2019-12-17 N
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Health 2019-11-05 2019-12-17 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 2019-11-05 2019-12-17 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 2019-11-05 2019-12-17 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 2019-11-05 2019-12-17 N
Provide and implement an infection prevention and control program. Health 2019-11-05 2019-12-17 N

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