Delta Oaks Post Acute

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.

Rule F0584. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Aug 26, 2026.

Provide and implement an infection prevention and control program.

Rule F0880. F: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Aug 20, 2026.

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Rule F0600. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jun 16, 2026.

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

Rule F0656. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jun 16, 2026.

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

Rule F0658. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jun 16, 2026.

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

Rule F0685. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jun 16, 2026.

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

Rule F0628. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 24, 2026.

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

Rule F0657. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 24, 2026.

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

Rule F0689. G: actual harm. From a complaint. Correction date, as CMS recorded it: Apr 18, 2026.

Ensure that residents are free from significant medication errors.

Rule F0760. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 18, 2026.

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.

Rule F0761. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 18, 2026.

Provide and implement an infection prevention and control program.

Rule F0880. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 18, 2026.

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

Rule F0609. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 24, 2026.

Respond appropriately to all alleged violations.

Rule F0610. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 24, 2026.

Assess the resident when there is a significant change in condition

Rule F0637. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 24, 2026.

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

Rule F0657. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 24, 2026.

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

Rule F0689. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Mar 6, 2026.

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

Rule F0656. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Feb 18, 2026.

Provide safe, appropriate pain management for a resident who requires such services.

Rule F0697. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Feb 18, 2026.

Ensure each resident must receive and the facility must provide necessary behavioral health care and services.

Rule F0740. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Feb 10, 2026.

Dispose of garbage and refuse properly.

Rule F0814. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Dec 8, 2025.

Ensure the transfer/discharge meets the resident’s needs/preferences and that the resident is prepared for a safe transfer/discharge.

Rule F0627. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Dec 8, 2025.

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

Rule F0550. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 27, 2025.

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

Rule F0655. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 27, 2025.

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

Rule F0656. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 27, 2025.

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.

Rule F0688. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 27, 2025.

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

Rule F0689. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 27, 2025.

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

Rule F0692. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 27, 2025.

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

Rule F0745. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 27, 2025.

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

Rule F0755. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 27, 2025.

Ensure each resident’s drug regimen must be free from unnecessary drugs.

Rule F0757. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 27, 2025.

Ensure medication error rates are not 5 percent or greater.

Rule F0759. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 27, 2025.

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.

Rule F0761. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 27, 2025.

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

Rule F0812. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 27, 2025.

Provide and implement an infection prevention and control program.

Rule F0880. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 27, 2025.

Develop and implement policies and procedures for flu and pneumonia vaccinations.

Rule F0883. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 27, 2025.

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.

Rule F0887. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 27, 2025.

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

Rule F0656. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Oct 3, 2025.

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.

Rule F0688. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Oct 3, 2025.

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.

Rule F0693. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Oct 3, 2025.

Provide and implement an infection prevention and control program.

Rule F0880. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Aug 23, 2025.

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

Rule F0689. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Aug 9, 2025.

Respond appropriately to all alleged violations.

Rule F0610. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jun 11, 2025.

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

Rule F0689. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jun 19, 2025.

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

Rule F0677. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jun 6, 2025.

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Rule F0600. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jun 10, 2025.

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

Rule F0628. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: May 16, 2025.

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

Rule F0689. G: actual harm. From a complaint. Correction date, as CMS recorded it: Apr 9, 2025.

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

Rule F0684. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Feb 28, 2025.

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

Rule F0689. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Oct 30, 2024.

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

Rule F0755. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Oct 30, 2024.

Provide and implement an infection prevention and control program.

Rule F0880. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Oct 30, 2024.

Reasonably accommodate the needs and preferences of each resident.

Rule F0558. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Nov 15, 2024.

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

Rule F0677. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Nov 15, 2024.

Ensure each resident’s drug regimen must be free from unnecessary drugs.

Rule F0757. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Nov 15, 2024.

Provide and implement an infection prevention and control program.

Rule F0880. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Nov 15, 2024.

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.

Rule F0584. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Oct 7, 2024.

Provide and implement an infection prevention and control program.

Rule F0880. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Oct 7, 2024.

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

Rule F0684. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Sep 5, 2024.

Provide and implement an infection prevention and control program.

Rule F0880. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Aug 23, 2024.

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

Rule F0550. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 12, 2024.

Reasonably accommodate the needs and preferences of each resident.

Rule F0558. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 12, 2024.

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.

Rule F0584. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 12, 2024.

PASARR screening for Mental disorders or Intellectual Disabilities

Rule F0645. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 12, 2024.

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

Rule F0656. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 12, 2024.

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

Rule F0677. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 12, 2024.

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

Rule F0689. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 12, 2024.

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

Rule F0692. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 12, 2024.

Provide for the safe, appropriate administration of IV fluids for a resident when needed.

Rule F0694. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 12, 2024.

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

Rule F0695. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 12, 2024.

Provide safe, appropriate pain management for a resident who requires such services.

Rule F0697. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 12, 2024.

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

Rule F0755. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 12, 2024.

Ensure that residents are free from significant medication errors.

Rule F0760. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 12, 2024.

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.

Rule F0761. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 12, 2024.

Provide or obtain dental services for each resident.

Rule F0791. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 12, 2024.

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

Rule F0812. F: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 12, 2024.

Have a policy regarding use and storage of foods brought to residents by family and other visitors.

Rule F0813. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 12, 2024.

Provide and implement an infection prevention and control program.

Rule F0880. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 12, 2024.

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Rule F0600. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Aug 12, 2024.

Respond appropriately to all alleged violations.

Rule F0610. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Aug 12, 2024.

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

Rule F0684. G: actual harm. From a complaint. Correction date, as CMS recorded it: Aug 7, 2024.

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

Rule F0580. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Aug 7, 2024.

Provide timely, quality laboratory services/tests to meet the needs of residents.

Rule F0770. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Aug 7, 2024.

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

Rule F0867. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Aug 7, 2024.

Let each resident or the resident’s legal representative access or purchase copies of all the resident’s records.

Rule F0573. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Aug 7, 2024.

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

Rule F0689. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jun 28, 2024.

Provide and implement an infection prevention and control program.

Rule F0880. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jun 28, 2024.

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

Rule F0689. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jun 17, 2024.

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

Rule F0609. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jun 27, 2024.

Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.

Rule F0943. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jun 27, 2024.

Reasonably accommodate the needs and preferences of each resident.

Rule F0558. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jun 2, 2024.

Ensure each resident receives and the facility provides drinks consistent with resident needs and preferences and sufficient to maintain resident hydration.

Rule F0807. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jun 2, 2024.

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

Rule F0557. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 4, 2024.

Reasonably accommodate the needs and preferences of each resident.

Rule F0558. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 4, 2024.

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.

Rule F0726. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 4, 2024.

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

Rule F0725. F: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jan 26, 2024.

Provide and implement an infection prevention and control program.

Rule F0880. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jan 26, 2024.

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

Rule F0677. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Nov 22, 2023.