Hickory Manor

In the surveyor’s words

From the most serious findings on record at Hickory Manor, in the surveyor’s own words.

• No harm, potential for more than minimal, widespreadF814Jan 11, 2024

  Based on observation, interview, and record review, the facility failed to ensure the dumpster was maintained to keep pests out and/or to keep the garbage contained in the dumpster. This failure had the potential to affect all residents. The facility census was 35. Review of the facility's policy titled, Food-Related Garbage and Refuse Disposal, revised October 2017, showed the outside dumpsters provided by the garbage pickup services will be kept closed and free of surrounding litter. 1. […]

• No harm, potential for more than minimal, widespreadF812Mar 3, 2022

  Based on record review, observation, and interview, the facility failed to store and prepare food in accordance with professional standards of practice and protect food from possible contamination when staff did not maintain clean surfaces, stored scoops in the dry food storage bins, and staff did not wear proper facial hair coverings. The facility census was 32. 1. Record review of the 2013 Food Code, issued by the Food and Drug Administration, showed the following: -Food employees shall wear hair restraints such as hats, hair coverings or nets, beard restraints, and clothing that covers body hair, that are designed and worn to effectively keep their hair from contacting exposed food; clean equipment, utensils, and linens; and unwrapped single-service and single-use articles. […]

• No harm, potential for more than minimal, patternF607Jan 23, 2025

  Based on interview and record review, the facility failed to follow their policy and procedure to complete Criminal Background Checks (CBC) for four of the ten sampled staff prior to hire and to check the Nurses Aide (NA) Registry for all new staff before the employment date to ensure they did not have a Federal Indicator (a marker given by the federal government to individuals who have committed abuse/neglect) for seven of the ten sampled staff. The facility census was 37. Review of the facility's policy titled, Abuse Prevention, dated September 2021, showed: - Background checks will be done at the time of hire in accordance with the facility background check policy. […]

• No harm, potential for more than minimal, patternF880Mar 3, 2022

  Based on record review and interview, the facility failed to follow facility policy to ensure staff completed employee [CONDITION(S)] (TB-a potentially serious infectious bacterial disease that mainly affects the lungs) screenings test on hire for five staff members (Registered Nurse (RN) D, Maintenance Supervisor, Certified Medication Technician (CMT) I, Certified Nursing Assistant (CNA) J, and CNA M), and failed to monitor resident [CONDITION(S)] screening tests on admission for three residents (Resident #5, Resident #21, and Resident #33). […]

• No harm, potential for more than minimal, isolatedF582Apr 30, 2026

  Based on interview and record review, the facility failed to issue a Skilled Nursing Facility Advanced Beneficiary Notice (SNF ABN) and Notice of Medicare Non-Coverage (NOMNC) to the resident and/or the resident's representative in writing at least two calendar days before discharge from skilled services. This notice informs the beneficiary about potential non-coverage and the option to continue services with the beneficiary accepting the financial liability for those services. This practice affected one resident (Resident #31) out of two sampled residents. […]