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Deficiency Records for Avamere at Pacific Ridge
A list of the most recent deficiencies for Avamere at Pacific Ridge. 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 at Pacific Ridge. 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 that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2024-07-19 | 2024-08-26 | 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 | 2024-04-26 | 2024-05-29 | 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 | 2024-04-26 | 2024-05-29 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2024-04-26 | 2024-05-29 | 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 | 2024-04-26 | 2024-05-29 | N |
| Ensure each resident receives an accurate assessment. | Health | 2024-04-26 | 2024-05-29 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2024-04-26 | 2024-05-29 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2024-04-26 | 2024-05-29 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2024-04-26 | 2024-05-29 | 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 | 2024-04-26 | 2024-05-29 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2024-04-26 | 2024-05-29 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2024-04-26 | 2024-05-29 | 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 | 2024-04-26 | 2024-05-29 | 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 | 2024-04-26 | 2024-05-29 | N |
| Make sure that a working call system is available in each resident's bathroom and bathing area. | Health | 2024-04-26 | 2024-05-29 | N |
| Establish emergency prep training and testing. | Fire Safety | 2024-04-23 | 2024-05-28 | N |
| Establish staff and initial training requirements. | Fire Safety | 2024-04-23 | 2024-05-28 | N |
| Meet other general requirements. | Fire Safety | 2024-04-23 | 2024-05-28 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2024-04-23 | 2024-05-28 | 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 | 2024-04-23 | 2024-05-28 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2024-04-23 | 2024-05-28 | N |
| Follow proper procedures when the fire alarm was out of service for more than 4 hours. | Fire Safety | 2024-04-23 | 2024-05-28 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2024-04-23 | 2024-05-28 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2024-04-23 | 2024-05-28 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2024-04-23 | 2024-05-28 | N |
| Install smoke barrier doors that can resist smoke for at least 20 minutes. | Fire Safety | 2024-04-23 | 2024-05-28 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2024-04-23 | 2024-05-28 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2024-04-23 | 2024-05-28 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2024-04-23 | 2024-05-28 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2024-04-23 | 2024-05-28 | N |
| Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services. | Health | 2023-09-28 | 2023-10-30 | Y |
| Plan the resident's discharge to meet the resident's goals and needs. | Health | 2023-06-06 | 2023-07-11 | Y |
| Reasonably accommodate the needs and preferences of each resident. | Health | 2023-03-21 | 2023-05-09 | 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 | 2023-03-21 | 2023-05-09 | 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 | 2023-03-21 | 2023-05-09 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2023-03-21 | 2023-05-09 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2023-03-21 | 2023-05-09 | 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 | 2023-03-21 | 2023-05-09 | N |
| Assess the resident when there is a significant change in condition | Health | 2023-03-21 | 2023-05-09 | N |
| PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2023-03-21 | 2023-05-09 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2023-03-21 | 2023-05-09 | 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 | 2023-03-21 | 2023-05-09 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2023-03-21 | 2023-05-09 | N |
| Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | Health | 2023-03-21 | 2023-05-09 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2023-03-21 | 2023-05-09 | N |
| Provide activities to meet all resident's needs. | Health | 2023-03-21 | 2023-05-09 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-03-21 | 2023-05-09 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-03-21 | 2023-05-09 | 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 | 2023-03-21 | 2023-05-09 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2023-03-21 | 2023-05-09 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2023-03-21 | 2023-05-09 | N |
| Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2023-03-21 | 2023-05-09 | 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 | 2023-03-21 | 2023-05-09 | N |
| Observe each nurse aide's job performance and give regular training. | Health | 2023-03-21 | 2023-05-09 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2023-03-21 | 2023-05-09 | N |
| Provide or obtain dental services for each resident. | Health | 2023-03-21 | 2023-05-09 | N |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2023-03-21 | 2023-05-09 | N |
| Provide and implement an infection prevention and control program. | Health | 2023-03-21 | 2023-05-09 | N |
| Develop and implement policies and procedures for flu and pneumonia vaccinations. | Health | 2023-03-21 | 2023-05-09 | N |
| Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. | Health | 2023-03-21 | 2023-05-09 | N |
| Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention. | Health | 2023-03-21 | 2023-05-09 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-03-10 | 2023-04-17 | Y |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2023-03-15 | 2023-04-17 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2023-03-15 | 2023-04-17 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2023-03-15 | 2023-04-17 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-08-04 | 2022-09-15 | Y |
| Ensure that residents are free from significant medication errors. | Health | 2022-08-04 | 2022-09-15 | Y |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2022-07-01 | 2022-08-01 | Y |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2021-12-07 | 2021-12-30 | Y |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2021-12-07 | 2021-12-30 | Y |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2021-07-29 | 2021-10-27 | N |
| Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. | Fire Safety | 2021-07-29 | 2021-10-27 | N |
| Ensure that testing and maintenance of electrical equipment is performed. | Fire Safety | 2021-07-29 | 2021-10-27 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2021-07-29 | 2021-10-11 | N |
| Ensure that residents are fully informed and understand their health status, care and treatments. | Health | 2021-08-06 | 2021-09-15 | 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 | 2021-08-06 | 2021-09-15 | N |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2021-08-06 | 2021-09-15 | 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 | 2021-08-06 | 2021-09-15 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2021-08-06 | 2021-09-15 | N |
| PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2021-08-06 | 2021-09-15 | 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 | 2021-08-06 | 2021-09-15 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2021-08-06 | 2021-09-15 | N |
| Post nurse staffing information every day. | Health | 2021-08-06 | 2021-09-15 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2021-08-06 | 2021-09-15 | 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 | 2021-08-06 | 2021-09-15 | 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 | 2021-08-06 | 2021-09-15 | N |
| Provide or obtain dental services for each resident. | Health | 2021-08-06 | 2021-09-15 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2021-08-06 | 2021-09-15 | N |
| Provide and implement an infection prevention and control program. | Health | 2021-08-06 | 2021-09-15 | N |
| Develop and implement policies and procedures for flu and pneumonia vaccinations. | Health | 2021-08-06 | 2021-09-15 | N |
| Conduct testing and exercise requirements. | Fire Safety | 2021-07-29 | 2021-08-20 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2021-07-29 | 2021-08-20 | N |
| Have properly located and lighted "Exit" signs. | Fire Safety | 2021-07-29 | 2021-08-20 | N |
| Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke. | Fire Safety | 2021-07-29 | 2021-08-20 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2021-07-29 | 2021-08-20 | N |
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