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Deficiency Records for Avamere Rehabilitation at Ridgemont
A list of the most recent deficiencies for Avamere Rehabilitation at Ridgemont. 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 Avamere Rehabilitation at Ridgemont. 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? |
---|---|---|---|---|
Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2024-01-11 | 2024-01-30 | Y |
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | Health | 2023-11-08 | 2023-11-24 | Y |
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | Health | 2023-09-21 | 2023-11-05 | N |
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2023-09-21 | 2023-11-05 | N |
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2023-09-21 | 2023-11-05 | N |
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2023-09-21 | 2023-11-05 | N |
Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2023-09-21 | 2023-11-05 | 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 | 2023-09-21 | 2023-11-05 | N |
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-09-21 | 2023-11-05 | N |
Provide enough food/fluids to maintain a resident's health. | Health | 2023-09-21 | 2023-11-05 | N |
Provide safe and appropriate respiratory care for a resident when needed. | Health | 2023-09-21 | 2023-11-05 | 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 | 2023-09-21 | 2023-11-05 | N |
Ensure that residents are free from significant medication errors. | Health | 2023-09-21 | 2023-11-05 | 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 | 2023-09-21 | 2023-11-05 | N |
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-09-21 | 2023-11-05 | N |
Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2023-09-19 | 2023-10-20 | N |
Have properly installed electrical wiring and gas equipment. | Fire Safety | 2023-09-19 | 2023-10-20 | N |
Have simulated fire drills held at unexpected times. | Fire Safety | 2023-09-19 | 2023-10-20 | N |
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. | Fire Safety | 2023-09-19 | 2023-10-20 | N |
Ensure proper usage of power strips and extension cords. | Fire Safety | 2023-09-19 | 2023-10-20 | N |
Install a fire alarm system that can be heard throughout the facility. | Fire Safety | 2023-09-19 | 2023-10-06 | N |
Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2023-09-19 | 2023-10-06 | N |
Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2023-09-19 | 2023-10-06 | N |
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | Health | 2023-08-17 | 2023-09-01 | Y |
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2022-08-25 | 2022-10-12 | N |
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 | 2022-08-29 | 2022-10-11 | 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 | 2022-08-29 | 2022-10-11 | N |
Ensure each resident receives an accurate assessment. | Health | 2022-08-29 | 2022-10-11 | N |
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-08-29 | 2022-10-11 | 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 | 2022-08-29 | 2022-10-11 | N |
Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-08-29 | 2022-10-11 | 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 | 2022-08-29 | 2022-10-11 | N |
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-08-29 | 2022-10-11 | N |
Provide safe and appropriate respiratory care for a resident when needed. | Health | 2022-08-29 | 2022-10-11 | N |
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. | Health | 2022-08-29 | 2022-10-11 | 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 | 2022-08-29 | 2022-10-11 | N |
Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2022-08-29 | 2022-10-11 | 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 | 2022-08-29 | 2022-10-11 | N |
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2022-08-29 | 2022-10-11 | N |
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-08-29 | 2022-10-11 | N |
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. | Health | 2022-08-29 | 2022-10-11 | N |
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | Health | 2022-08-29 | 2022-10-11 | 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 | 2022-08-29 | 2022-10-11 | Y |
Respond appropriately to all alleged violations. | Health | 2022-08-29 | 2022-10-11 | Y |
Have simulated fire drills held at unexpected times. | Fire Safety | 2022-08-25 | 2022-09-30 | N |
To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2022-08-25 | 2022-09-29 | N |
Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2022-08-25 | 2022-09-29 | N |
Provide safe, appropriate pain management for a resident who requires such services. | Health | 2022-07-13 | 2022-08-10 | Y |
Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2022-04-04 | 2022-05-24 | Y |
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 | 2022-04-04 | 2022-05-24 | Y |
Allow residents to self-administer drugs if determined clinically appropriate. | Health | 2019-08-16 | 2019-09-30 | N |
Ensure each resident receives an accurate assessment. | Health | 2019-08-16 | 2019-09-30 | N |
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2019-08-16 | 2019-09-30 | 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 | 2019-08-16 | 2019-09-30 | N |
Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2019-08-16 | 2019-09-30 | N |
Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2019-08-16 | 2019-09-30 | 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 | 2019-08-16 | 2019-09-30 | N |
Observe each nurse aide's job performance and give regular training. | Health | 2019-08-16 | 2019-09-30 | N |
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2019-08-16 | 2019-09-30 | 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 | 2019-08-16 | 2019-09-30 | 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 | 2019-08-16 | 2019-09-30 | 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 | 2019-08-16 | 2019-09-30 | N |
Implement a program that monitors antibiotic use. | Health | 2019-08-16 | 2019-09-30 | N |
Develop and implement policies and procedures for flu and pneumonia vaccinations. | Health | 2019-08-16 | 2019-09-30 | N |
Install an approved automatic sprinkler system. | Fire Safety | 2019-08-21 | 2019-09-15 | N |
Have properly installed hallway dispensers for alcohol-based hand rub. | Fire Safety | 2019-08-21 | 2019-08-26 | N |
Ensure proper usage of power strips and extension cords. | Fire Safety | 2019-08-21 | 2019-08-22 | N |
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