Glenwood Springs Healthcare

Resident Rights Deficiencies

Reasonably accommodate the needs and preferences of each resident.

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Smoke Deficiencies

Inspect, test, and maintain automatic sprinkler systems.

Services Deficiencies

Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

Miscellaneous Deficiencies

To conduct inspection, testing and maintenance of fire doors by qualified individuals.

Services Deficiencies

Have an externally vented heating system.

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.

Smoke Deficiencies

Provide properly protected cooking facilities.

Resident Rights Deficiencies

Honor the resident's right to organize and participate in resident/family groups in the facility.

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Nutrition and Dietary Deficiencies

Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

Egress Deficiencies

Keep aisles, corridors, and exits free of obstruction in case of emergency.

Resident Assessment and Care Planning Deficiencies

Ensure services provided by the nursing facility meet professional standards of quality.

Quality of Life and Care Deficiencies

Provide activities to meet all resident's needs.

Egress Deficiencies

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.

Smoke Deficiencies

Have an enclosure around a vertical opening shaft.

Smoke Deficiencies

Install properly constructed windows in hallway walls or doors.

Miscellaneous Deficiencies

Provide a written emergency evacuation plan.

Gas, Vacuum, and Electrical Systems Deficiencies

Have proper medical gas storage and administration areas.

Gas, Vacuum, and Electrical Systems Deficiencies

Have proper fire barriers, ventilation and signs for the transfilling of oxygen.

Nursing and Physician Services Deficiencies

Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

Quality of Life and Care Deficiencies

Provide enough food/fluids to maintain a resident's health.

Quality of Life and Care Deficiencies

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

Nutrition and Dietary Deficiencies

Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

Resident Rights Deficiencies

Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.

Resident Assessment and Care Planning Deficiencies

Ensure services provided by the nursing facility meet professional standards of quality.

Resident Assessment and Care Planning Deficiencies

Provide care by qualified persons according to each resident's written plan of care.

Smoke Deficiencies

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

Miscellaneous Deficiencies

Have simulated fire drills held at unexpected times.

Quality of Life and Care Deficiencies

Provide activities to meet all resident's needs.

Quality of Life and Care Deficiencies

Assist a resident in gaining access to vision and hearing services.

Quality of Life and Care Deficiencies

Provide care or services that was trauma informed and/or culturally competent.

Quality of Life and Care Deficiencies

Provide or obtain dental services for each resident.

Services Deficiencies

Have properly installed electrical wiring and gas equipment.

Egress Deficiencies

Install emergency lighting that can last at least 1 1/2 hours.

Smoke Deficiencies

Have approved installation, maintenance and testing program for fire alarm systems.

Smoke Deficiencies

Inspect, test, and maintain automatic sprinkler systems.

Smoke Deficiencies

Install corridor and hallway doors that block smoke.

Smoke Deficiencies

Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

Gas, Vacuum, and Electrical Systems Deficiencies

Meet requirements for the installation and maintenance of electrical systems.

Quality of Life and Care Deficiencies

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Resident Rights Deficiencies

Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.

Nutrition and Dietary Deficiencies

Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.

Egress Deficiencies

Keep aisles, corridors, and exits free of obstruction in case of emergency.

Smoke Deficiencies

Install corridor and hallway doors that block smoke.

Quality of Life and Care Deficiencies

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.

Quality of Life and Care Deficiencies

Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

Egress Deficiencies

Install emergency lighting that can last at least 1 1/2 hours.

Smoke Deficiencies

Have approved installation, maintenance and testing program for fire alarm systems.

Smoke Deficiencies

Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

Services Deficiencies

Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure proper usage of power strips and extension cords.

Based on observation, it was determined that the facility failed to arrange and maintain the vertical openings in accordance with Life Safety Code Section 19.3.11.laundry chute is not protected19.3.1 Protection of Vertical Openings.Any vertical opening shall be enclosed or protected in accordance with Section 8.6, unless otherwise modifi.. This tag is informational only and represents the facility' s general characteristics. This survey was conducted in accordance with the Federal Register at Section 42 CFR 483.70(a).The facility is a one-story wood-framed structure, Type V (111), construction; there is a partial basement used for support services only and is not used by residents. &.. Through document review during the survey, it was determined that the facility failed to maintain the electrical systems in accordance with NFPA 99. This was evidenced by:1. Receptacle Testing (99 6.3.4.1): Partially done, not completeNFPA 996.3.4.1.1Where hospital-grade receptacles are required at patient bed locations and in locations w.. Through document review during the survey, it was determined that the facility failed to meet the protection requirements in accordance with NFPA 101. This was evidenced by:1. Fire Safety Plan (101 19.7.2.2): Not available per NFPA 101 requirementsNFPA 101 19.7.1 Evacuation and Relocation Plan and Fire Drills.19.7.1.1 The administration of.. Through document review during the survey, it was determined that the facility failed to meet the protection requirements in accordance with NFPA 101. This was evidenced by:1.need to address storage of items on heaters in all rooms19.5.2 Heating, Ventilating, and Air-Conditioning.19.5.2.1 Heating, ventilating, and air-conditioning shall comp.. Through observation during the survey, it was determined that the facility failed to maintain doors in accordance with NFPA 101. This was evidenced by:1.400 hall exterior delayed egress door is encroaching on the egress pathway2.100 hall exterior egress door does not open fully to a 90-degreeNFPA 101 7.1.10.1* General.Means of egress shall be conti.. Through observation during the survey, it was determined that the facility failed to meet the protection requirements in accordance with NFPA 99 and NFPA 55. This was evidenced by:1.The oxygen trans filling room needs mechanical ventilation 0-12" from the floor.NFPA 99 9.3.7.4 Transfilling area shall be provided with ventilation in accordance wit.. Through observation during the survey, it was determined that the facility failed to meet the protection requirements in accordance with NFPA 99. This was evidenced by:1.Oxygen Transfilling containers need proper labeling of empty and full containersNFPA 99 11.6.5.2 If empty and full cylinders are stored within the same enclosure, empty cylinder.. Through observation during the survey, it was determined that the facility failed to meet the protection requirements in accordance with NFPA 101. This was evidenced by:1. 100 hall exterior egress door missing delayed egress signageNFPA 101 19.2.2.2.4Doors within a required means of egress shall not be equipped with a latch or lock that re.. Through observation during the survey, it was determined that the facility failed to meet the protection requirements in accordance with NFPA 101. This was evidenced by:1. 100 wings transfer grill installed in corridor ceiling needs to be removedNFPA 101 19.3.6.4.1 Transfer grilles, regardless of whether they are protected by fusible link–operated dam..

A recertification survey with complaint #CO37578, #CO37932 and Incident #37862 and #37871 was completed on 10/14/24 to 10/17/24. Nine deficiencies were cited. An Emergency Preparedness survey was conducted from 10/14/24 to 10/17/24. No deficiencies were cited. Based on interviews and record review, the facility failed to ensure the resident environment remained as free of accident hazards as possible for four of ten resident rooms and one (#6) of two residents reviewed for accidents out of 26 sample residents, received adequate supervision to decrease and/or prevent risk for accident hazards.Specifically.. Based on observation and interviews, the facility failed to ensure one (#12) of one of 26 sample residents received treatment and care in accordance with professional standards of practice.Specifically, the facility failed to ensure Resident #12' s blood pressure was measured appropriately in accordance with medical standards of practice.Findings .. Based on observations, record review and interviews, the facility failed to ensure one (#6) of three residents reviewed out of 26 sample residents received the care and services necessary to meet their nutrition needs and to maintain their highest level of physical well-being.Specifically, the facility failed to:-Accurately obtain and document Resident.. Based on observations, record review and interviews, the facility failed to ensure one (#15) of three residents reviewed for activities out of 26 sample residents received individualized activities in accordance with standards of care.Specifically, the facility failed to offer Resident #15 activities in Spanish, which was his preferred language.Find.. Based on observations, record review and interviews, the facility failed to store, prepare, distribute and serve food in a sanitary manner in the main kitchen. Specifically, the facility failed to:-Ensure safe and appropriate storage of food items in the pantry; and,-Ensure hand hygiene was conducted appropriately.Findings include:I. Failure to store food i.. Based on record review and interviews, the facility failed to maintain an infection control program designed to provide a safe, sanitary and comfortable environment to help prevent the possible developement and transmission of infectious diseases. Specifically, the facility failed to offer COVID-19 vaccinations and provide COVID-19 vaccination i.. Based on record review and interviews, the facility failed to provide sufficient nursing staff to ensure the residents received the care and services they required in a timely manner.Specifically, the facility failed to answer call lights in a timely manner for residents requesting staff assistance.Findings include:I. Facility policyThe Staffing policy, revise.. Based on record review and resident interviews, the facility failed to promptly address and attempt to resolve resident group complaints and grievances concerning issues of resident care and life in the facility that were important to the residents.Specifically, the facility failed to ensure residents felt their concerns with call light timeliness resulting in l.. Based on resident interviews, staff interviews, and observations, the facility failed to ensure residents were provided with food cooked and served in a manner that conserved nutritive value, flavor, appearance, texture and at an appetizing temperature. Specifically, the facility failed to consistently serve foods at a palatable texture. Fin..

A complaint survey, prompted by #CO36932 and Incident #CO36976 was conducted on 7/30/24 to 7/31/24. One deficiency was cited. This Citation text meets this visualizations limit for 32,000 characters, please reach out to CDPHE HFEMSD Records Team for the full citation text at cdphe_hfemsd_records@state.co.us. Within your email, please include Facility Name, Inspection ID and Citation Code.

A survey prompted by complaint #CO37137 was completed on 7/30/24 to 7/31/24. One deficiency was cited. This Citation text meets this visualizations limit for 32,000 characters, please reach out to CDPHE HFEMSD Records Team for the full citation text at cdphe_hfemsd_records@state.co.us. Within your email, please include Facility Name, Inspection ID and Citation Code.