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Deficiency Records for Stevens Point Health Services
A list of the most recent deficiencies for Stevens Point Health Services. 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 Stevens Point Health Services. 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 care and assistance to perform activities of daily living for any resident who is unable. | Health | 2024-08-13 | 2024-09-06 | Y |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2024-08-13 | 2024-09-06 | Y |
| Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2024-05-07 | 2024-08-01 | N |
| Conduct risk assessment and an All-Hazards approach. | Fire Safety | 2024-05-07 | 2024-06-21 | N |
| Provide family notifications of emergency plan. | Fire Safety | 2024-05-07 | 2024-06-21 | N |
| Have exits that are accessible at all times. | Fire Safety | 2024-05-07 | 2024-06-21 | 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 | 2024-05-07 | 2024-06-21 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2024-05-07 | 2024-06-21 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2024-05-07 | 2024-06-21 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2024-05-07 | 2024-06-21 | N |
| Have power receptacles that are properly grounded. | Fire Safety | 2024-05-07 | 2024-06-21 | N |
| Meet requirements for the use of electrical equipment. | Fire Safety | 2024-05-07 | 2024-06-21 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2024-05-08 | 2024-06-05 | N |
| Develop and implement policies and procedures for flu and pneumonia vaccinations. | Health | 2024-05-08 | 2024-06-05 | N |
| Provide safe, appropriate pain management for a resident who requires such services. | Health | 2024-05-08 | 2024-06-03 | Y |
| Keep residents' personal and medical records private and confidential. | Health | 2024-05-08 | 2024-06-03 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2024-05-08 | 2024-06-03 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2024-05-08 | 2024-06-03 | 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 | 2024-05-08 | 2024-06-03 | N |
| Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | Health | 2024-05-08 | 2024-06-03 | N |
| Provide and implement an infection prevention and control program. | Health | 2024-05-08 | 2024-06-03 | N |
| Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | Health | 2024-05-08 | 2024-06-03 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2024-05-08 | 2024-06-03 | Y |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2024-02-12 | 2024-03-06 | Y |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2024-02-12 | 2024-03-05 | Y |
| Respond appropriately to all alleged violations. | Health | 2024-02-12 | 2024-03-05 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2024-01-08 | 2024-02-01 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2024-01-08 | 2024-02-01 | Y |
| 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 | 2024-01-08 | 2024-01-15 | Y |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2023-11-22 | 2023-12-15 | Y |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2023-06-21 | 2023-07-18 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-06-21 | 2023-07-18 | Y |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2023-06-21 | 2023-07-18 | Y |
| Respond appropriately to all alleged violations. | Health | 2023-05-03 | 2023-05-25 | Y |
| Provide care or services that was trauma informed and/or culturally competent. | Health | 2023-05-03 | 2023-05-25 | 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 | 2023-04-19 | 2023-05-11 | N |
| Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2023-04-19 | 2023-05-11 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2023-04-19 | 2023-05-11 | N |
| Ensure that residents are fully informed and understand their health status, care and treatments. | Health | 2023-04-18 | 2023-05-05 | N |
| Allow resident to participate in the development and implementation of his or her person-centered plan of care. | Health | 2023-04-18 | 2023-05-05 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2023-04-18 | 2023-05-05 | 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 | 2023-04-18 | 2023-05-05 | N |
| Provide and implement an infection prevention and control program. | Health | 2023-04-18 | 2023-05-05 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2023-04-18 | 2023-05-05 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-04-18 | 2023-05-05 | Y |
| Ensure that the resident and his/her doctor meet face-to-face at all required visits. | Health | 2023-04-18 | 2023-05-05 | Y |
| Provide and implement an infection prevention and control program. | Health | 2022-06-01 | 2022-06-27 | Y |
| Ensure each resident receives an accurate assessment. | Health | 2022-04-05 | 2022-05-05 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2022-04-05 | 2022-05-05 | 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 | 2022-04-05 | 2022-05-05 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2022-04-05 | 2022-05-05 | N |
| Have an enclosure around a vertical opening shaft. | Fire Safety | 2022-04-04 | 2022-05-05 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-04-04 | 2022-05-05 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2022-04-04 | 2022-05-05 | N |
| Install smoke barrier doors that can resist smoke for at least 20 minutes. | Fire Safety | 2022-04-04 | 2022-05-05 | N |
| Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2022-04-04 | 2022-05-05 | N |
| Meet requirements for the installation and maintenance of electrical systems. | Fire Safety | 2022-04-04 | 2022-05-05 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2022-04-04 | 2022-05-05 | N |
| Have proper fire barriers, ventilation and signs for the transfilling of oxygen. | Fire Safety | 2022-04-04 | 2022-05-05 | N |
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