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Deficiency Records for Vierra Falls Church
A list of the most recent deficiencies for Vierra Falls Church. 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 Vierra Falls Church. 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? |
|---|---|---|---|---|
| Provide and implement an infection prevention and control program. | Health | 2024-06-04 | 2024-07-12 | Y |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2024-06-04 | 2024-05-31 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2024-02-22 | 2024-04-01 | Y |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2024-02-22 | 2024-04-01 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2024-02-22 | 2024-04-01 | Y |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2024-02-22 | 2024-04-01 | Y |
| Obtain a doctor's order to admit a resident and ensure the resident is under a doctor's care. | Health | 2024-02-22 | 2024-04-01 | Y |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2024-02-22 | 2024-04-01 | Y |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2023-11-29 | 2023-11-27 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-11-29 | 2023-11-27 | Y |
| Let each resident or the resident's legal representative access or purchase copies of all the resident's records. | Health | 2023-09-08 | 2023-10-13 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2023-09-08 | 2023-10-13 | Y |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2023-09-08 | 2023-10-13 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2023-09-08 | 2023-10-13 | Y |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2022-08-04 | 2022-09-12 | N |
| Honor the resident's right to receive visitors of his or her choosing, at the time of his or her choosing. | Health | 2022-08-04 | 2022-09-12 | 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 | 2022-08-04 | 2022-09-12 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-08-04 | 2022-09-12 | 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 | 2022-08-04 | 2022-09-12 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2022-08-04 | 2022-09-12 | N |
| Provide activities to meet all resident's needs. | Health | 2022-08-04 | 2022-09-12 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-08-04 | 2022-09-12 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2022-08-04 | 2022-09-12 | 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 | 2022-08-04 | 2022-09-12 | 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 | 2022-08-04 | 2022-09-12 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-08-04 | 2022-09-12 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2022-08-04 | 2022-09-12 | N |
| Provide and implement an infection prevention and control program. | Health | 2022-08-04 | 2022-09-12 | N |
| Ensure staff are vaccinated for COVID-19 | Health | 2022-08-04 | 2022-09-12 | N |
| Address subsistence needs for staff and patients. | Fire Safety | 2022-08-04 | 2022-09-12 | N |
| Establish policies and procedures for medical documentation. | Fire Safety | 2022-08-04 | 2022-09-12 | N |
| Establish policies and procedures for volunteers. | Fire Safety | 2022-08-04 | 2022-09-12 | N |
| Create arrangements with other facilities to receive patients. | Fire Safety | 2022-08-04 | 2022-09-12 | N |
| Implement emergency and standby power systems. | Fire Safety | 2022-08-04 | 2022-09-12 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2022-01-14 | 2022-05-18 | 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 | 2022-01-14 | 2022-05-18 | N |
| Provide sliding doors free of hazards, operable without special knowledge or effort, and meet weight requirements to set door in motion. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
| Have ramps, exits, fire escape ladders, steps, and areas of refuge that meet safety requirements. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
| Install resident room doors of proper design and width. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
| Have exits that are accessible at all times. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
| Install proper backup exit lighting. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
| Have properly located and lighted "Exit" signs. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
| Install a fire alarm system that can be heard throughout the facility. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
| Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
| Provide a written emergency evacuation plan. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
| Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
| Ensure that smoke control systems are tested and documented in accordance with established engineering principles. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
| Ensure that building systems meet requirements determined by risk assessment procedures performed by qualified personnel. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
| Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
| Have proper power supply for life support equipment. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
| Have a battery powered remote alarm panel in a location accessible by operating personnel. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
| Ensure electrical receptacles or cover plates have distinctive color or marking. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2022-01-14 | 2022-05-18 | N |
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