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Deficiency Records for Highland Manor of Mesquite Rehabilitation LLC

A list of the most recent deficiencies for Highland Manor of Mesquite Rehabilitation 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 Highland Manor of Mesquite Rehabilitation 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?
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Health 2024-04-25 2024-06-08 N
Develop and implement policies and procedures to prevent abuse, neglect, and theft. Health 2024-04-25 2024-06-08 N
Respond appropriately to all alleged violations. Health 2024-04-25 2024-06-08 N
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. Health 2024-04-25 2024-06-08 N
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. Health 2024-04-25 2024-06-08 N
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Health 2024-04-25 2024-06-08 N
Inspect, test, and maintain automatic sprinkler systems. Fire Safety 2024-04-18 2024-06-08 N
Properly select, install, inspect, or maintain portable fire extinguishes. Fire Safety 2024-04-18 2024-06-08 N
Have properly installed electrical wiring and gas equipment. Fire Safety 2024-04-18 2024-06-08 N
Protect each resident from separation (from other residents, his/her room, or confinement to his/her room). Health 2023-03-09 2023-05-18 N
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. Health 2023-03-09 2023-05-18 N
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. Health 2023-03-09 2023-05-18 N
Ensure each resident receives an accurate assessment. Health 2023-03-09 2023-05-18 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 2023-03-09 2023-05-18 N
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2023-03-09 2023-05-18 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 2023-03-09 2023-05-18 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 2023-03-09 2023-05-18 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 2023-03-16 2023-04-13 N
Have approved installation, maintenance and testing program for fire alarm systems. Fire Safety 2023-03-16 2023-04-13 N
Have properly installed electrical wiring and gas equipment. Fire Safety 2023-03-16 2023-04-13 N
Have simulated fire drills held at unexpected times. Fire Safety 2023-03-16 2023-04-13 N
Ensure that testing and maintenance of electrical equipment is performed. Fire Safety 2022-05-20 2022-06-30 N
Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations and emergencies. Health 2022-05-20 2022-06-14 N
Conduct risk assessment and an All-Hazards approach. Fire Safety 2022-05-20 2022-06-09 N
Develop Emergency Preparedness policies and procedures. Fire Safety 2022-05-20 2022-06-09 N
Establish policies and procedures including evacuation. Fire Safety 2022-05-20 2022-06-09 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 2022-05-20 2022-06-09 N
Install an approved automatic sprinkler system. Fire Safety 2022-05-20 2022-06-09 N
Inspect, test, and maintain automatic sprinkler systems. Fire Safety 2022-05-20 2022-06-09 N
Ensure smoke barriers are constructed to a 1 hour fire resistance rating. Fire Safety 2022-05-20 2022-06-09 N
To conduct inspection, testing and maintenance of fire doors by qualified individuals. Fire Safety 2022-05-20 2022-06-09 N

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