American Lutheran Home-Mondovi

In the surveyor’s words

From the most serious findings on record at American Lutheran Home-Mondovi, in the surveyor’s own words.

• No harm, potential for more than minimal, widespreadF812Feb 14, 2024

  Based on observation, interview and record review, the facility did not ensure proper glove use with ready to eat foods and hand hygiene was performed in accordance with professional standards for food service safety, when food was prepared and served to the residents (R). This affected 16 of 18 residents (R10, R9, R73, R16, R15, R3, R11, R12, R72, R13, R5, R14, R7, R2, R18, and R6). This is evidenced by: The facility policy, entitled Dietary Department, states: .Dietary staff practice proper food handling procedures, including but not limited to hand washing .using utensils to reduce hand contact with food, wearing disposable gloves to perform certain food handling tasks . On 02/12/24 at 11:37 AM, Surveyor observed lunch service in the dining room served by Chef I. […]

• No harm, potential for more than minimal, widespreadF812Sep 29, 2021

  Based on observation and interview, the facility did not ensure that kitchen surfaces and dishes were properly sanitized. This had the potential to affect all 22 residents. On 09/27/21, at 08:50 a.m., during an initial kitchen tour, Surveyor asked Culinary Supervisor (CS) E to test the sanitizing solution used to fill the three compartment sink and wipe down the kitchen counters and kitchen surfaces which included the carts used to transport food to the resident rooms. A test strip is used to check the parts per millimeter (ppm) of the sanitizing solution, after it is added from the pre-measured dispenser. A bucket is marked with a line, indicating the amount of water to be added, to ensure the correct amount of sanitizing agent and water are accurate. […]

• No harm, potential for more than minimal, patternF689Feb 14, 2024

  Based on observation, interview and record review, the facility did not ensure the resident environment remains as free of accident hazards as is possible to prevent accidents. Water temperatures were recorded above a safe temperature of 110 - 115 degrees for 4 of 4 residents (R2, R10, R11, and R12). This is evidenced by: The facility document, entitled Legionella and other water pathogens monitoring control measures, states: .Weekly water temps taken in three rooms, per wing, per week. Temp (Temperature) range 105-120 degrees . […]

• No harm, potential for more than minimal, isolatedF880May 7, 2026

  Based on observation, interview, and record review, the facility did not utilize enhanced barrier precautions (EBP) for 1 of 2 sampled residents (R9). R9 had a Jackson Pratt (JP) drain placed prior to his admission to the facility on [DATE]. The facility did not implement EBP to reduce the transmission of infections.Findings include: Facility policy titled, Enhanced Barrier Precautions, dated 03/12/26 reads in part, Enhanced barrier precautions (EBPs) are utilized to prevent the spread of multi-drug-resistant organisms (MDROs) to residents. Examples of high-contact resident care activities requiring the use of gown and gloves for EBPs include: g. device care or use (central line, urinary catheter, feeding tube tracheostomy/ventilator, etc.). 2. […]

• No harm, potential for more than minimal, isolatedF656Mar 12, 2025

  Based on observation, interview and record review, the facility did not develop and implement a comprehensive care plan for each resident (R) to meet medical, nursing, and psychosocial needs identified for 2 of 12 sampled residents (R3 and R9). R3 did not have a depression care plan developed when R3 was prescribed an antidepressant medication for depressive disorder. R9 did not have a risk of bleeding care plan developed when R9 was prescribed an anticoagulant medication. This is evidenced by: R3 was admitted on [DATE] with diagnoses of polymyalgia, weakness, major depressive disorder, cerebral infarction, and mood affective disorder. […]