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Deficiency Records for Renaissance Rehabilitation and Nursing Care Center
A list of the most recent deficiencies for Renaissance Rehabilitation and Nursing 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 Renaissance Rehabilitation and Nursing 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? |
|---|---|---|---|---|
| Conduct testing and exercise requirements. | Fire Safety | 2024-09-26 | 2024-11-22 | N |
| Have properly located and lighted "Exit" signs. | Fire Safety | 2024-09-26 | 2024-11-22 | 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 | 2024-09-26 | 2024-11-22 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2024-09-26 | 2024-11-22 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2024-09-26 | 2024-11-22 | N |
| Have power receptacles that are properly grounded. | Fire Safety | 2024-09-26 | 2024-11-22 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2024-09-26 | 2024-11-22 | N |
| Ensure equipment listed for use in oxygen-enriched atmospheres are correctly labeled. | Fire Safety | 2024-09-26 | 2024-11-22 | N |
| Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | Health | 2024-09-13 | 2024-11-15 | 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 | 2024-09-13 | 2024-11-15 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2024-09-13 | 2024-11-15 | N |
| Notify the resident or the resident?s representative in writing how long the nursing home will hold the resident?s bed in cases of transfer to a hospital or therapeutic leave. | Health | 2024-09-13 | 2024-11-15 | 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 | 2024-09-13 | 2024-11-15 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2024-09-13 | 2024-11-15 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2024-09-13 | 2024-11-15 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2024-09-13 | 2024-11-15 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2024-09-13 | 2024-11-15 | 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 | 2024-09-13 | 2024-11-15 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2024-09-13 | 2024-11-15 | 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 | 2024-09-13 | 2024-11-15 | N |
| Provide and implement an infection prevention and control program. | Health | 2024-09-13 | 2024-11-15 | N |
| Implement a program that monitors antibiotic use. | Health | 2024-09-13 | 2024-11-15 | N |
| Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | Health | 2024-09-13 | 2024-11-15 | N |
| Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | Health | 2024-09-13 | 2024-11-15 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2024-09-13 | 2024-11-15 | Y |
| Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2024-09-13 | 2024-11-15 | Y |
| Respond appropriately to all alleged violations. | Health | 2024-09-13 | 2024-11-15 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2024-09-13 | 2024-11-15 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2024-09-13 | 2024-11-15 | Y |
| Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2024-09-13 | 2024-11-15 | Y |
| Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | Health | 2024-09-13 | 2024-11-15 | Y |
| Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | Health | 2024-09-13 | 2024-11-15 | Y |
| Observe each nurse aide's job performance and give regular training. | Health | 2024-09-13 | 2024-11-15 | Y |
| Ensure that residents are free from significant medication errors. | Health | 2024-09-13 | 2024-11-15 | Y |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2024-09-13 | 2024-11-15 | Y |
| Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility. | Health | 2024-09-13 | 2024-11-15 | Y |
| Have a plan that describes the process for conducting QAPI and QAA activities. | Health | 2024-09-13 | 2024-11-15 | Y |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2024-09-13 | 2024-11-15 | Y |
| Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation. | Health | 2024-09-13 | 2024-11-15 | Y |
| Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention. | Health | 2024-09-13 | 2024-11-15 | Y |
| Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | Health | 2023-06-22 | 2023-08-18 | Y |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2023-06-22 | 2023-08-18 | Y |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2023-06-22 | 2023-08-18 | Y |
| Ensure that residents are free from significant medication errors. | Health | 2023-06-22 | 2023-08-18 | Y |
| Include a process for Emergency Preparedness collaboration. | Fire Safety | 2022-10-12 | 2022-12-09 | N |
| Conduct testing and exercise requirements. | Fire Safety | 2022-10-12 | 2022-12-09 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2022-10-12 | 2022-12-09 | N |
| Install proper backup exit lighting. | Fire Safety | 2022-10-12 | 2022-12-09 | 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 | 2022-10-12 | 2022-12-09 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2022-10-12 | 2022-12-09 | N |
| Properly provide smoke detection systems in areas open to corridors. | Fire Safety | 2022-10-12 | 2022-12-09 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2022-10-12 | 2022-12-09 | N |
| Install smoke barrier doors that can resist smoke for at least 20 minutes. | Fire Safety | 2022-10-12 | 2022-12-09 | N |
| Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2022-10-12 | 2022-12-09 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2022-10-12 | 2022-12-09 | N |
| Ensure that building systems meet requirements determined by risk assessment procedures performed by qualified personnel. | Fire Safety | 2022-10-12 | 2022-12-09 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2022-10-12 | 2022-12-09 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2022-10-12 | 2022-12-09 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2022-10-12 | 2022-12-09 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-10-12 | 2022-11-04 | 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 | 2022-10-12 | 2022-11-04 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2022-10-12 | 2022-11-04 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2022-10-12 | 2022-11-04 | N |
| Obtain a doctor's order to admit a resident and ensure the resident is under a doctor's care. | Health | 2022-10-12 | 2022-11-04 | N |
| Observe each nurse aide's job performance and give regular training. | Health | 2022-10-12 | 2022-11-04 | N |
| Ensure meals and snacks are served at times in accordance with resident?s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. | Health | 2022-10-12 | 2022-11-04 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-10-12 | 2022-11-04 | 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 | 2022-10-12 | 2022-11-04 | Y |
| Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | Health | 2022-10-12 | 2022-11-04 | Y |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2022-10-12 | 2022-11-04 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2022-10-12 | 2022-11-04 | Y |
| Respond appropriately to all alleged violations. | Health | 2022-05-04 | 2022-05-26 | Y |
| Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | Health | 2022-05-04 | 2022-05-26 | Y |
| Ensure that residents are free from significant medication errors. | Health | 2022-05-04 | 2022-05-26 | Y |
| Reasonably accommodate the needs and preferences of each resident. | Health | 2022-03-04 | 2022-04-18 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-03-04 | 2022-04-18 | Y |
| Make sure that a working call system is available in each resident's bathroom and bathing area. | Health | 2022-03-04 | 2022-04-18 | Y |
| Have stairways and smokeproof enclosures used as exits that meet safety requirements. | Fire Safety | 2019-03-29 | 2019-05-27 | N |
| Properly provide smoke detection systems in areas open to corridors. | Fire Safety | 2019-03-29 | 2019-05-27 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2019-03-29 | 2019-05-27 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2019-03-29 | 2019-05-27 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2019-03-29 | 2019-05-27 | N |
| Ensure that testing and maintenance of electrical equipment is performed. | Fire Safety | 2019-03-29 | 2019-05-27 | N |
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