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Deficiency Records for Glenhaven Healthcare
A list of the most recent deficiencies for Glenhaven Healthcare. 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 Healthcare. 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 a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2023-11-30 | 2023-12-22 | N |
| Ensure that residents are fully informed and understand their health status, care and treatments. | Health | 2023-11-30 | 2023-12-22 | N |
| Ensure each resident receives an accurate assessment. | Health | 2023-11-30 | 2023-12-22 | N |
| PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2023-11-30 | 2023-12-22 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2023-11-30 | 2023-12-22 | 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 | 2023-11-30 | 2023-12-22 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2023-11-30 | 2023-12-22 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-11-30 | 2023-12-22 | N |
| Provide medically-related social services to help each resident achieve the highest possible quality of life. | Health | 2023-11-30 | 2023-12-22 | 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 | 2023-12-22 | N |
| Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. | Health | 2023-11-30 | 2023-12-22 | 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 | 2023-12-07 | 2023-12-22 | N |
| Construct fire resistant interior walls. | Fire Safety | 2023-12-07 | 2023-12-22 | N |
| Follow proper procedures when the fire alarm was out of service for more than 4 hours. | Fire Safety | 2023-12-07 | 2023-12-22 | N |
| Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours. | Fire Safety | 2023-12-07 | 2023-12-22 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2022-11-22 | 2022-12-19 | Y |
| Protect each resident from separation (from other residents, his/her room, or confinement to his/her room). | Health | 2022-11-17 | 2022-12-14 | Y |
| Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder. | Health | 2022-11-17 | 2022-12-14 | Y |
| Ensure that residents are fully informed and understand their health status, care and treatments. | Health | 2022-02-11 | 2022-03-17 | N |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2022-02-11 | 2022-03-17 | N |
| Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy. | Health | 2022-02-11 | 2022-03-17 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-02-11 | 2022-03-17 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-02-11 | 2022-03-17 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2022-02-11 | 2022-03-17 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-02-11 | 2022-03-17 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2022-02-11 | 2022-03-17 | N |
| Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | Health | 2022-02-11 | 2022-03-17 | 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 | 2022-02-11 | 2022-03-17 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-02-11 | 2022-03-17 | N |
| Provide and implement an infection prevention and control program. | Health | 2022-02-11 | 2022-03-17 | N |
| Implement a program that monitors antibiotic use. | Health | 2022-02-11 | 2022-03-17 | N |
| Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. | Health | 2022-02-11 | 2022-03-17 | N |
| Provide emergency officials' contact information. | Fire Safety | 2022-02-11 | 2022-03-11 | N |
| Construct fire resistant interior walls. | Fire Safety | 2022-02-11 | 2022-03-11 | N |
| Have a complete alarm system manually initiated and initiated by fire sprinkler system connection. | Fire Safety | 2022-02-11 | 2022-03-11 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2022-02-11 | 2022-03-11 | N |
| Properly install and monitor supervisory attachments on automatic sprinkler systems. | Fire Safety | 2022-02-11 | 2022-03-11 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2022-02-11 | 2022-03-11 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2022-02-09 | 2022-02-24 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-02-09 | 2022-02-24 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2022-02-09 | 2022-02-24 | Y |
| Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | Health | 2019-05-31 | 2019-06-25 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2019-05-31 | 2019-06-25 | N |
| Provide activities to meet all resident's needs. | Health | 2019-05-31 | 2019-06-25 | 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 | 2019-05-31 | 2019-06-25 | 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 | 2019-05-31 | 2019-06-25 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2019-05-31 | 2019-06-25 | N |
| Provide and implement an infection prevention and control program. | Health | 2019-05-31 | 2019-06-25 | N |
| Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. | Health | 2019-05-31 | 2019-06-25 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2019-05-28 | 2019-06-25 | N |
| Have properly located and lighted "Exit" signs. | Fire Safety | 2019-05-28 | 2019-06-25 | 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 | 2019-05-28 | 2019-06-25 | N |
| Construct fire resistant interior walls. | Fire Safety | 2019-05-28 | 2019-06-25 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2019-05-28 | 2019-06-25 | N |
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