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Deficiency Records for Southlake Village Rehabilitation and Care Center
A list of the most recent deficiencies for Southlake Village Rehabilitation and Care 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 Southlake Village Rehabilitation and Care 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? |
|---|---|---|---|---|
| Meet other general requirements. | Fire Safety | 2024-08-08 | 2024-09-01 | 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 | 2024-08-08 | 2024-09-01 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2024-08-08 | 2024-09-01 | N |
| Meet other general requirements that are deficient. | Fire Safety | 2024-08-08 | 2024-09-01 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2024-08-08 | 2024-09-01 | N |
| Ensure that testing and maintenance of electrical equipment is performed. | Fire Safety | 2024-08-08 | 2024-09-01 | N |
| Meet requirements for the use and maintenance of medical gas equipment. | Fire Safety | 2024-08-08 | 2024-09-01 | N |
| Implement emergency and standby power systems. | Fire Safety | 2023-08-03 | 2023-09-07 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2023-08-03 | 2023-09-07 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2023-08-03 | 2023-09-07 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2023-08-03 | 2023-09-07 | N |
| Meet requirements for the use of electrical equipment. | Fire Safety | 2023-08-03 | 2023-09-07 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2023-08-03 | 2023-09-07 | N |
| Meet requirements for the use and maintenance of medical gas equipment. | Fire Safety | 2023-08-03 | 2023-09-07 | N |
| Provide and implement an infection prevention and control program. | Health | 2023-08-03 | 2023-09-01 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2023-01-25 | 2023-03-14 | Y |
| Provide safe, appropriate pain management for a resident who requires such services. | Health | 2023-01-25 | 2023-03-14 | Y |
| Ensure that residents are free from significant medication errors. | Health | 2023-01-25 | 2023-03-14 | Y |
| 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 | 2023-01-25 | 2023-03-14 | Y |
| Provide and implement an infection prevention and control program. | Health | 2022-08-24 | 2022-09-26 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2022-05-12 | 2022-06-21 | N |
| Ensure each resident receives an accurate assessment. | Health | 2022-05-12 | 2022-06-21 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-05-12 | 2022-06-21 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-05-12 | 2022-06-21 | 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 | 2022-05-12 | 2022-06-21 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2022-05-12 | 2022-06-21 | N |
| Provide safe, appropriate pain management for a resident who requires such services. | Health | 2022-05-12 | 2022-06-21 | 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 | 2022-05-12 | 2022-06-21 | N |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2022-05-12 | 2022-06-21 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-05-12 | 2022-06-21 | N |
| Implement emergency and standby power systems. | Fire Safety | 2022-05-12 | 2022-06-21 | 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 | 2022-05-12 | 2022-06-21 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2022-05-12 | 2022-06-21 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-05-12 | 2022-06-21 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2022-05-12 | 2022-06-21 | N |
| Meet other general requirements that are deficient. | Fire Safety | 2022-05-12 | 2022-06-21 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2022-05-12 | 2022-06-21 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2022-05-12 | 2022-06-21 | N |
| Ensure that testing and maintenance of electrical equipment is performed. | Fire Safety | 2022-05-12 | 2022-06-21 | N |
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