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Deficiency Records for Leisure Village Health Care Center
A list of the most recent deficiencies for Leisure Village Health 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 Leisure Village Health 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? |
|---|---|---|---|---|
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2024-08-23 | 2024-09-26 | N |
| Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | Health | 2024-08-23 | 2024-09-26 | 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 | 2024-08-23 | 2024-09-26 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2024-08-23 | 2024-09-26 | 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 | 2024-08-23 | 2024-09-26 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2024-08-23 | 2024-09-26 | N |
| Provide and implement an infection prevention and control program. | Health | 2024-08-23 | 2024-09-26 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2024-06-19 | 2024-08-14 | 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 | 2024-06-19 | 2024-08-14 | Y |
| Provide and implement an infection prevention and control program. | Health | 2024-06-19 | 2024-08-14 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2024-07-15 | 2024-07-15 | Y |
| Respond appropriately to all alleged violations. | Health | 2023-12-13 | 2024-01-10 | Y |
| 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 | 2023-12-13 | 2024-01-10 | Y |
| Protect each resident from the wrongful use of the resident's belongings or money. | Health | 2023-07-20 | 2023-09-06 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-07-20 | 2023-09-06 | N |
| Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | Health | 2023-07-20 | 2023-09-06 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2023-07-20 | 2023-09-06 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2023-07-20 | 2023-09-06 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2023-07-20 | 2023-09-06 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2023-07-20 | 2023-09-06 | Y |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2023-07-20 | 2023-09-06 | Y |
| Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law. | Health | 2023-07-20 | 2023-09-06 | Y |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2022-12-28 | 2023-01-31 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2022-12-28 | 2023-01-31 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2022-01-18 | 2022-03-03 | Y |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2022-01-18 | 2022-03-03 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-01-18 | 2022-03-03 | Y |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2022-01-18 | 2022-03-03 | 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 | 2022-01-18 | 2022-03-03 | Y |
| Reasonably accommodate the needs and preferences of each resident. | Health | 2020-03-05 | 2020-04-08 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2020-03-05 | 2020-04-08 | 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 | 2020-03-05 | 2020-04-08 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2020-03-05 | 2020-04-08 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2020-03-05 | 2020-04-08 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2020-03-05 | 2020-04-08 | N |
| Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | Health | 2020-03-05 | 2020-04-08 | 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 | 2020-03-05 | 2020-04-08 | 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 | 2020-03-05 | 2020-04-08 | N |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2020-03-05 | 2020-04-08 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2020-03-05 | 2020-04-08 | N |
| Provide and implement an infection prevention and control program. | Health | 2020-03-05 | 2020-04-08 | 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 | 2020-03-04 | 2020-03-18 | 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 | 2020-03-04 | 2020-03-18 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2020-03-04 | 2020-03-18 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2020-03-04 | 2020-03-18 | N |
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