| Facility failed to meet the following Requirement(s): | Corrected Date | Level of Harm | Residents Affected |
| |
| | |
| General Requirements - Other
List in the REMARKS section any LSC Section 18.1 and 19.1 General Requirements that are not addressed by the provided K-tags, but are deficient. This information, along with the applicable Life Safety Code or NFPA standard citation, should be included on Form CMS-2567. |
1/12/2023
| No actual Harm with potential for More than minimal harm that is not immediate jeopardy | Many |
| General Requirements - Other
List in the REMARKS section any LSC Section 18.1 and 19.1 General Requirements that are not addressed by the provided K-tags, but are deficient. This information, along with the applicable Life Safety Code or NFPA standard citation, should be included on Form CMS-2567. |
1/12/2023
| No actual Harm with potential for More than minimal harm that is not immediate jeopardy | Many |
| General Requirements - Other
List in the REMARKS section any LSC Section 18.1 and 19.1 General Requirements that are not addressed by the provided K-tags, but are deficient. This information, along with the applicable Life Safety Code or NFPA standard citation, should be included on Form CMS-2567. |
1/12/2023
| No actual Harm with potential for More than minimal harm that is not immediate jeopardy | Many |
| General Requirements - Other
List in the REMARKS section any LSC Section 18.1 and 19.1 General Requirements that are not addressed by the provided K-tags, but are deficient. This information, along with the applicable Life Safety Code or NFPA standard citation, should be included on Form CMS-2567. |
1/12/2023
| No actual Harm with potential for More than minimal harm that is not immediate jeopardy | Many |
| General Requirements - Other
List in the REMARKS section any LSC Section 18.1 and 19.1 General Requirements that are not addressed by the provided K-tags, but are deficient. This information, along with the applicable Life Safety Code or NFPA standard citation, should be included on Form CMS-2567. |
1/12/2023
| No actual Harm with potential for More than minimal harm that is not immediate jeopardy | Many |
| General Requirements - Other
List in the REMARKS section any LSC Section 18.1 and 19.1 General Requirements that are not addressed by the provided K-tags, but are deficient. This information, along with the applicable Life Safety Code or NFPA standard citation, should be included on Form CMS-2567. |
1/12/2023
| No actual Harm with potential for More than minimal harm that is not immediate jeopardy | Many |
| General Requirements - Other
List in the REMARKS section any LSC Section 18.1 and 19.1 General Requirements that are not addressed by the provided K-tags, but are deficient. This information, along with the applicable Life Safety Code or NFPA standard citation, should be included on Form CMS-2567. |
1/12/2023
| No actual Harm with potential for More than minimal harm that is not immediate jeopardy | Many |
| General Requirements - Other
List in the REMARKS section any LSC Section 18.1 and 19.1 General Requirements that are not addressed by the provided K-tags, but are deficient. This information, along with the applicable Life Safety Code or NFPA standard citation, should be included on Form CMS-2567. |
1/12/2023
| No actual Harm with potential for More than minimal harm that is not immediate jeopardy | Many |
| General Requirements.
(E) No section of the building shall present a fire hazard. I/II
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1/12/2023
| | |