Willow Tree Care Center

Inspection Results

Nursing Homes Colorado Delta Willow Tree Care Center

Willow Tree Care Center has been cited for a total of 80 deficiencies since we began saving each survey. We believe it is worthwhile to show how things are and were. Some improve and some get worse. Rather than a snapshot, we take s longer view than most. A longer view, we believe, paints a better and more worthwhile picture. We start from them most recent and go back as you scroll down.

Tip: Surveys happen throughout the year and you may want to check with the location or here to see if more recent data is available for Willow Tree Care Center.

Since we bagan longer term (multi year tracking, numbers will naturally be higher than 3 (or so surverys).
There are 228 nursing homes in Colorado with a total of 10,232 deficiencies resulting in an average of 44.88 deficiencies per nursing home.

The following table describes how deficiencies are scored. An easy way to remember the severity of a deficiency's scope is that the further along in the alphabet (A through L) the scope value is, the more severe the deficiency is.
Additionally, A through F means no actual harm has happened.

Table describing the severity and scope of deficiencies

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Deficiency Cited, Scope, survery date, stems from a complaint, and Date of Correction

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

Category:

Resident Rights Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Resident Rights Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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.

Category:

Resident Rights Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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.

Category:

Resident Rights Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-12-23

Ensure each resident receives an accurate assessment.

Category:

Resident Assessment and Care Planning Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

Provide activities to meet all resident's needs.

Category:

Quality of Life and Care Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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.

Category:

Quality of Life and Care Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Quality of Life and Care Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Quality of Life and Care Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Quality of Life and Care Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Quality of Life and Care Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Nursing and Physician Services Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.

Category:

Quality of Life and Care Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-12-23

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

Category:

Pharmacy Service Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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.

Category:

Pharmacy Service Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Administration Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Administration Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

Provide and implement an infection prevention and control program.

Category:

Infection Control Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.

Category:

Infection Control Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Infection Control Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.

Category:

Nursing and Physician Services Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Resident Rights Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Resident Rights Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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.

Category:

Resident Rights Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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.

Category:

Resident Rights Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-12-23

Ensure each resident receives an accurate assessment.

Category:

Resident Assessment and Care Planning Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

Provide activities to meet all resident's needs.

Category:

Quality of Life and Care Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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.

Category:

Quality of Life and Care Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Quality of Life and Care Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Quality of Life and Care Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Quality of Life and Care Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Quality of Life and Care Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Nursing and Physician Services Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.

Category:

Quality of Life and Care Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-12-23

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

Category:

Pharmacy Service Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

Category:

Pharmacy Service Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Administration Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Administration Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

Provide and implement an infection prevention and control program.

Category:

Infection Control Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.

Category:

Infection Control Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Infection Control Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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

Category:

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.

Category:

Nursing and Physician Services Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2022-10-05

Corrected:

2022-11-09

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.

Category:

Resident Rights Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2021-06-24

Corrected:

2021-07-30

PASARR screening for Mental disorders or Intellectual Disabilities

Category:

Resident Assessment and Care Planning Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2021-06-24

Corrected:

2021-07-30

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

Category:

Resident Assessment and Care Planning Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2021-06-24

Corrected:

2021-07-30

Category:

Pharmacy Service Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2021-06-24

Corrected:

2021-07-30

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.

Category:

Pharmacy Service Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2021-06-24

Corrected:

2021-07-30

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.

Category:

Resident Rights Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2021-06-24

Corrected:

2021-07-30

PASARR screening for Mental disorders or Intellectual Disabilities

Category:

Resident Assessment and Care Planning Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2021-06-24

Corrected:

2021-07-30

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

Category:

Resident Assessment and Care Planning Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2021-06-24

Corrected:

2021-07-30

Category:

Pharmacy Service Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2021-06-24

Corrected:

2021-07-30

Category:

Pharmacy Service Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2021-06-24

Corrected:

2021-07-30

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

Category:

Resident Rights Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2021-01-14

Corrected:

2021-02-05

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

Category:

Resident Rights Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2021-01-14

Corrected:

2021-02-05

Ensure that residents are fully informed and understand their health status, care and treatments.

Category:

Resident Rights Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2019-08-08

Corrected:

2019-09-04

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.

Category:

Resident Rights Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2019-08-08

Corrected:

2019-09-04

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

Category:

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2019-08-08

Corrected:

2019-09-04

Respond appropriately to all alleged violations.

Category:

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2019-08-08

Corrected:

2019-09-04

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

Category:

Resident Rights Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2019-08-08

Corrected:

2019-09-04

Ensure each resident receives an accurate assessment.

Category:

Resident Assessment and Care Planning Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2019-08-08

Corrected:

2019-09-04

Plan the resident's discharge to meet the resident's goals and needs.

Category:

Resident Assessment and Care Planning Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2019-08-08

Corrected:

2019-09-04

Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.

Category:

Quality of Life and Care Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2019-08-08

Corrected:

2019-09-04

Category:

Pharmacy Service Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2019-08-08

Corrected:

2019-09-04

Provide and implement an infection prevention and control program.

Category:

Infection Control Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2019-08-08

Corrected:

2019-09-04

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

Category:

Infection Control Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2019-08-08

Corrected:

2019-09-04

Ensure that residents are fully informed and understand their health status, care and treatments.

Category:

Resident Rights Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2019-08-08

Corrected:

2019-09-04

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.

Category:

Resident Rights Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2019-08-08

Corrected:

2019-09-04

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

Category:

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2019-08-08

Corrected:

2019-09-04

Respond appropriately to all alleged violations.

Category:

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2019-08-08

Corrected:

2019-09-04

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

Category:

Resident Rights Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2019-08-08

Corrected:

2019-09-04

Ensure each resident receives an accurate assessment.

Category:

Resident Assessment and Care Planning Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2019-08-08

Corrected:

2019-09-04

Plan the resident's discharge to meet the resident's goals and needs.

Category:

Resident Assessment and Care Planning Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2019-08-08

Corrected:

2019-09-04

Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.

Category:

Quality of Life and Care Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2019-08-08

Corrected:

2019-09-04

Category:

Pharmacy Service Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2019-08-08

Corrected:

2019-09-04

Provide and implement an infection prevention and control program.

Category:

Infection Control Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2019-08-08

Corrected:

2019-09-04

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

Category:

Infection Control Deficiencies

Scope:

From Complaint:

Standard:

Survey Date:

2019-08-08

Corrected:

2019-09-04

Learn more about Willow Tree Care Center at the following resources

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Willow Tree Care Center

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