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Deficiency Records for Providence St Joseph Care Center
A list of the most recent deficiencies for Providence St Joseph 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 Providence St Joseph 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 voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | Health | 2024-04-09 | 2024-04-19 | Y |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2024-04-09 | 2024-04-19 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2024-04-09 | 2024-04-19 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2024-04-09 | 2024-04-19 | Y |
| Provide primary/alternate means for communication. | Fire Safety | 2024-02-21 | 2024-03-27 | N |
| Establish emergency prep training and testing. | Fire Safety | 2024-02-21 | 2024-03-27 | N |
| Establish staff and initial training requirements. | Fire Safety | 2024-02-21 | 2024-03-27 | N |
| Meet other general requirements. | Fire Safety | 2024-02-21 | 2024-03-27 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2024-02-21 | 2024-03-27 | N |
| Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours. | Fire Safety | 2024-02-21 | 2024-03-27 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2024-02-21 | 2024-03-27 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2024-02-21 | 2024-03-27 | N |
| Provide a written emergency evacuation plan. | Fire Safety | 2024-02-21 | 2024-03-27 | N |
| Ensure that testing and maintenance of electrical equipment is performed. | Fire Safety | 2024-02-21 | 2024-03-27 | 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 | 2024-02-22 | 2024-03-22 | N |
| Provide special eating equipment and utensils for residents who need them and appropriate assistance. | Health | 2024-02-22 | 2024-03-22 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2024-02-22 | 2024-03-16 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2024-02-22 | 2024-03-15 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2024-02-22 | 2024-03-15 | N |
| Ensure that residents are free from significant medication errors. | Health | 2024-02-22 | 2024-03-15 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2024-02-22 | 2024-03-15 | N |
| Respond appropriately to all alleged violations. | Health | 2024-02-22 | 2024-03-15 | Y |
| Provide and implement an infection prevention and control program. | Health | 2024-02-22 | 2024-03-11 | 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 | 2024-02-22 | 2024-03-06 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2023-06-05 | 2023-06-20 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-03-10 | 2023-03-10 | Y |
| Provide and implement an infection prevention and control program. | Health | 2022-09-20 | 2022-10-10 | Y |
| Perform COVID19 testing on residents and staff. | Health | 2022-09-20 | 2022-10-10 | Y |
| Protect each resident from the wrongful use of the resident's belongings or money. | Health | 2022-08-04 | 2022-08-05 | Y |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2022-04-15 | 2022-05-06 | Y |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2022-04-15 | 2022-05-06 | Y |
| Respond appropriately to all alleged violations. | Health | 2022-04-15 | 2022-05-06 | Y |
| Ensure each resident must receive and the facility must provide necessary behavioral health care and services. | Health | 2022-04-15 | 2022-05-06 | Y |
| Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | Health | 2022-01-13 | 2022-02-07 | 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 | 2022-01-13 | 2022-02-07 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-01-13 | 2022-02-07 | 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 | 2022-01-13 | 2022-02-07 | Y |
| Ensure that residents are free from significant medication errors. | Health | 2022-01-07 | 2022-02-07 | Y |
| Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. | Fire Safety | 2022-01-12 | 2022-01-31 | N |
| Meet other general requirements. | Fire Safety | 2022-01-12 | 2022-01-27 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2022-01-12 | 2022-01-27 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2022-01-12 | 2022-01-27 | 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 | 2019-02-21 | 2019-04-01 | N |
| Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2019-02-21 | 2019-04-01 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2019-02-21 | 2019-04-01 | N |
| Ensure each resident receives an accurate assessment. | Health | 2019-02-21 | 2019-04-01 | N |
| PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2019-02-21 | 2019-04-01 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2019-02-21 | 2019-04-01 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2019-02-21 | 2019-04-01 | 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 | 2019-02-21 | 2019-04-01 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2019-02-21 | 2019-04-01 | N |
| Provide activities to meet all resident's needs. | Health | 2019-02-21 | 2019-04-01 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2019-02-21 | 2019-04-01 | 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 | 2019-02-21 | 2019-04-01 | 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 | 2019-02-21 | 2019-04-01 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2019-02-21 | 2019-04-01 | N |
| Provide safe, appropriate pain management for a resident who requires such services. | Health | 2019-02-21 | 2019-04-01 | 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 | 2019-02-21 | 2019-04-01 | N |
| Provide medically-related social services to help each resident achieve the highest possible quality of life. | Health | 2019-02-21 | 2019-04-01 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2019-02-21 | 2019-04-01 | 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 | 2019-02-21 | 2019-04-01 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2019-02-21 | 2019-04-01 | 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 | 2019-02-21 | 2019-04-01 | N |
| Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs. | Health | 2019-02-21 | 2019-04-01 | N |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2019-02-21 | 2019-04-01 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2019-02-21 | 2019-04-01 | 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 | 2019-02-21 | 2019-04-01 | N |
| Address subsistence needs for staff and patients. | Fire Safety | 2019-02-14 | 2019-03-15 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2019-02-14 | 2019-03-15 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2019-02-14 | 2019-03-15 | N |
| Ensure proper storage of liquid oxygen. | Fire Safety | 2019-02-14 | 2019-03-15 | N |
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