Thalia Gardens Rehabilitation and Nursing

Give residents a notice of rights, rules, services and charges.

The resident has the right to receive notices in a format and a language he or she understands.

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

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.

Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.

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

Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.

Ensure each resident receives an accurate assessment.

Provide care and assistance to perform activities of daily living for any resident who is unable.

Provide safe and appropriate respiratory care for a resident when needed.

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.

Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.

Reasonably accommodate the needs and preferences of each resident.

Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.

Not hire anyone with a finding of abuse, neglect, exploitation, or theft.

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

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

Post nurse staffing information every day.

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

Have the Quality Assessment and Assurance group have the required members and meet at least quarterly

Make sure that a working call system is available in each resident's bathroom and bathing area.

Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.

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.

Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility.

Have a plan that describes the process for conducting QAPI and QAA activities.

Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.

Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.

Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.

Provide behavior health training consistent with the requirements and as determined by a facility assessment.

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

Have the Quality Assessment and Assurance group have the required members and meet at least quarterly

Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.

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.

Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.

Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

Allow resident to participate in the development and implementation of his or her person-centered plan of care.

Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.

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.

Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.

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.

Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

Ensure each resident receives an accurate assessment.

Provide care and assistance to perform activities of daily living for any resident who is unable.

Provide safe and appropriate respiratory care for a resident when needed.

Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.

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.

Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.

Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

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

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.

Ensure each resident receives an accurate assessment.

Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Provide safe and appropriate respiratory care for a resident when needed.

Provide medically-related social services to help each resident achieve the highest possible quality of life.

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.

Allow resident to participate in the development and implementation of his or her person-centered plan of care.

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.

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.

Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.

Provide care and assistance to perform activities of daily living for any resident who is unable.

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

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

Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Provide and implement an infection prevention and control program.

Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

Keep all essential equipment working safely.