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Deficiency Records for Glenhaven
A list of the most recent deficiencies for Glenhaven. 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 Glenhaven. 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? |
|---|---|---|---|---|
| Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Health | 2023-11-30 | 2023-12-30 | 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 | 2023-11-30 | 2023-12-30 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-11-30 | 2023-12-30 | N |
| Provide and implement an infection prevention and control program. | Health | 2023-11-30 | 2023-12-30 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2023-11-30 | 2023-12-30 | Y |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2023-11-29 | 2023-12-20 | N |
| Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data. | Health | 2023-11-30 | 2023-06-30 | N |
| Respond appropriately to all alleged violations. | Health | 2023-03-22 | 2023-04-05 | Y |
| Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Health | 2023-03-22 | 2023-04-05 | Y |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2022-10-18 | 2023-01-30 | N |
| Have stairways and smokeproof enclosures used as exits that meet safety requirements. | Fire Safety | 2022-10-18 | 2022-11-21 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2022-10-18 | 2022-11-21 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2022-10-18 | 2022-11-21 | N |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2022-10-20 | 2022-11-18 | N |
| PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2022-10-20 | 2022-11-18 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2022-10-20 | 2022-11-18 | 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 | 2022-10-20 | 2022-11-18 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2022-10-20 | 2022-11-18 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-10-20 | 2022-11-18 | N |
| Provide and implement an infection prevention and control program. | Health | 2022-10-20 | 2022-11-18 | 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 | 2021-08-12 | 2021-09-08 | N |
| Have stairways and smokeproof enclosures used as exits that meet safety requirements. | Fire Safety | 2021-08-12 | 2021-09-08 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2021-08-12 | 2021-09-08 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2021-08-12 | 2021-09-08 | N |
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