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Deficiency Records for Kadima Rehabilitation and Nursing at Campbelltown
A list of the most recent deficiencies for Kadima Rehabilitation and Nursing at Campbelltown. 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 Kadima Rehabilitation and Nursing at Campbelltown. 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? |
|---|---|---|---|---|
| Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | Health | 2024-07-18 | 2024-09-18 | N |
| Develop and implement policies and procedures for flu and pneumonia vaccinations. | Health | 2024-07-18 | 2024-09-18 | N |
| Develop and maintain an Emergency Preparedness Program (EP). | Fire Safety | 2024-07-30 | 2024-09-18 | N |
| Conduct risk assessment and an All-Hazards approach. | Fire Safety | 2024-07-30 | 2024-09-17 | N |
| Meet other general requirements. | Fire Safety | 2024-07-30 | 2024-09-17 | N |
| Have horizontal exits used in accordance with safety requirements. | Fire Safety | 2024-07-30 | 2024-09-17 | 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 | 2024-07-30 | 2024-09-17 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2024-07-30 | 2024-09-17 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2024-07-30 | 2024-09-17 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2024-07-30 | 2024-09-17 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2024-07-30 | 2024-09-17 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2024-07-30 | 2024-09-17 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2024-07-30 | 2024-09-17 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2024-07-30 | 2024-09-17 | 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 | 2024-07-18 | 2024-08-26 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2024-07-18 | 2024-08-26 | 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 | 2024-07-18 | 2024-08-26 | N |
| Ensure each resident receives an accurate assessment. | Health | 2024-07-18 | 2024-08-26 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2024-07-18 | 2024-08-26 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2024-07-18 | 2024-08-26 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2024-07-18 | 2024-08-26 | N |
| Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2024-07-18 | 2024-08-26 | N |
| Post nurse staffing information every day. | Health | 2024-07-18 | 2024-08-26 | 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 | 2024-07-18 | 2024-08-26 | 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 | 2024-07-18 | 2024-08-26 | N |
| Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | Health | 2024-07-18 | 2024-08-26 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2024-05-02 | 2024-06-10 | Y |
| 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 | 2024-05-02 | 2024-06-10 | Y |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2024-05-02 | 2024-06-10 | Y |
| 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 | 2024-05-02 | 2024-06-10 | Y |
| Satisfy building requirements after a repair, renovation, modification, or change of user/occupancy. | Fire Safety | 2024-04-09 | 2024-05-30 | Y |
| 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 | 2024-01-13 | 2024-02-16 | Y |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2024-01-13 | 2024-02-16 | Y |
| 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 | 2023-08-30 | 2023-10-23 | N |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2023-08-30 | 2023-10-23 | N |
| Ensure each resident receives an accurate assessment. | Health | 2023-08-30 | 2023-10-23 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2023-08-30 | 2023-10-23 | N |
| Provide appropriate foot care. | Health | 2023-08-30 | 2023-10-23 | 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 | 2023-08-30 | 2023-10-23 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-08-30 | 2023-10-23 | 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 | 2023-08-30 | 2023-10-23 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2023-08-30 | 2023-10-23 | N |
| Provide special eating equipment and utensils for residents who need them and appropriate assistance. | Health | 2023-08-30 | 2023-10-23 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-08-30 | 2023-10-23 | N |
| Provide and implement an infection prevention and control program. | Health | 2023-08-30 | 2023-10-23 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2023-08-02 | 2023-09-09 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2023-08-02 | 2023-09-09 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2023-08-02 | 2023-09-09 | 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 | 2023-06-28 | 2023-08-06 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-05-08 | 2023-06-08 | Y |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-11-07 | 2022-12-12 | Y |
| Use approved construction type or materials. | Fire Safety | 2022-09-19 | 2022-11-14 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2022-09-19 | 2022-11-14 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2022-09-19 | 2022-11-14 | 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 | 2022-09-19 | 2022-11-14 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-09-19 | 2022-11-14 | N |
| Install smoke barrier doors that can resist smoke for at least 20 minutes. | Fire Safety | 2022-09-19 | 2022-11-14 | N |
| Meet other general requirements. | Fire Safety | 2022-09-19 | 2022-11-14 | N |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2022-09-01 | 2022-10-24 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-09-01 | 2022-10-24 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-09-01 | 2022-10-24 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-09-01 | 2022-10-24 | N |
| Dispose of garbage and refuse properly. | Health | 2022-09-01 | 2022-10-24 | 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 | 2022-04-07 | 2022-05-23 | Y |
| 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 | 2022-04-07 | 2022-05-23 | Y |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-04-07 | 2022-05-23 | Y |
| Post nurse staffing information every day. | Health | 2022-01-15 | 2022-02-24 | Y |
| 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 | 2022-01-15 | 2022-02-24 | Y |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-01-15 | 2022-02-24 | Y |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2022-01-15 | 2022-02-24 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2021-11-24 | 2021-12-10 | Y |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2021-11-16 | 2021-12-10 | Y |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2021-11-16 | 2021-12-10 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2021-11-08 | 2021-12-10 | Y |
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