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Deficiency Records for Town Hall Estates Arlington Inc
A list of the most recent deficiencies for Town Hall Estates Arlington Inc. 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 Town Hall Estates Arlington Inc. 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? |
|---|---|---|---|---|
| Conduct risk assessment and an All-Hazards approach. | Fire Safety | 2024-06-20 | 2024-07-26 | N |
| Address patient/client population and determine types of services needed. | Fire Safety | 2024-06-20 | 2024-07-26 | N |
| Conduct testing and exercise requirements. | Fire Safety | 2024-06-20 | 2024-07-26 | N |
| Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector. | Fire Safety | 2024-06-20 | 2024-07-25 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2024-06-20 | 2024-07-25 | N |
| Develop and maintain an Emergency Preparedness Program (EP). | Fire Safety | 2024-06-20 | 2024-07-24 | 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 | 2024-06-20 | 2024-07-21 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2024-06-20 | 2024-07-21 | N |
| Install smoke barrier doors that can resist smoke for at least 20 minutes. | Fire Safety | 2024-06-20 | 2024-07-21 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2024-06-20 | 2024-07-20 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2024-06-20 | 2024-07-20 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2024-06-20 | 2024-07-20 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2024-06-20 | 2024-07-20 | 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 | 2024-06-20 | 2024-07-20 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2024-06-20 | 2024-07-20 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2024-06-20 | 2024-07-20 | 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 | 2024-06-20 | 2024-07-20 | Y |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2024-06-20 | 2024-07-20 | Y |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2024-06-20 | 2024-07-18 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2024-06-20 | 2024-07-18 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2024-06-20 | 2024-07-12 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2024-06-20 | 2024-06-24 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2024-04-17 | 2024-05-15 | Y |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2024-03-08 | 2024-04-05 | Y |
| Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged. | Health | 2024-03-08 | 2024-04-05 | Y |
| 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 | 2024-03-08 | 2024-04-05 | Y |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2024-03-08 | 2024-04-05 | Y |
| 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 | 2023-12-13 | 2024-01-09 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2023-10-03 | 2023-10-27 | Y |
| Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. | Health | 2023-10-03 | 2023-10-27 | Y |
| 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 | 2023-05-12 | 2023-06-12 | N |
| Keep residents' personal and medical records private and confidential. | Health | 2023-05-11 | 2023-06-02 | N |
| Observe each nurse aide's job performance and give regular training. | Health | 2023-05-11 | 2023-06-02 | N |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2023-05-11 | 2023-06-02 | N |
| Provide and implement an infection prevention and control program. | Health | 2023-05-11 | 2023-06-02 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2023-05-12 | 2023-06-02 | 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 | 2023-05-12 | 2023-06-02 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2023-05-12 | 2023-06-02 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2023-05-12 | 2023-06-02 | N |
| Install smoke barrier doors that can resist smoke for at least 20 minutes. | Fire Safety | 2023-05-12 | 2023-06-02 | N |
| Ensure that building systems meet requirements determined by risk assessment procedures performed by qualified personnel. | Fire Safety | 2023-05-12 | 2023-06-02 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2023-05-12 | 2023-06-02 | 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 | 2023-02-25 | 2023-03-17 | Y |
| 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 | 2023-02-25 | 2023-03-17 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-09-22 | 2022-10-18 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-07-29 | 2022-07-28 | Y |
| 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 | 2022-04-19 | 2022-05-12 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2022-04-19 | 2022-05-12 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-04-19 | 2022-05-12 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2022-04-19 | 2022-05-12 | N |
| Install smoke barrier doors that can resist smoke for at least 20 minutes. | Fire Safety | 2022-04-19 | 2022-05-12 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2022-04-19 | 2022-05-12 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2021-12-27 | 2022-02-02 | Y |
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