Madison Carriage Cove Short Stay Rehabilitation

In the surveyor’s words

From the most serious findings on record at Madison Carriage Cove Short Stay Rehabilitation, in the surveyor’s own words.

• Actual harm, isolatedF689Jan 23, 2025

  Based on policy review, I&A review, record review, and staff interview, it was determined the facility failed to ensure adequate supervision and implement interventions to prevent falls. This was true for 1 of 1 resident, (Resident #24) whose records were reviewed for falls. This resulted in harm to Resident #24. Findings include: The State Operation Manual, Appendix PP, dated 8/8/24, defined Avoidable Accident as an accident occurred because the facility failed to: Identify environmental hazards and/or assess individual resident risk of an accident, including the need for supervision and/or assistive devices. The facility's Accidents and Supervision policy revised 12/20/24, defines supervision/adequate supervision as an intervention and means of mitigating risk of an accident. […]

• No harm, potential for more than minimal, widespreadF812Jan 23, 2025

  Based on observation, interview, policy review, and review of the Idaho Food Code, the facility failed to appropriately store, label, and serve foods. This deficient practice had the potential to affect all residents who received meals from the facility kitchen served in the dining room and resident rooms. This placed residents at risk for potential contamination and use of spoiled foods, and adverse health outcomes, including food-borne illnesses. Findings include: Review of the Idaho Food Code, revised February 2021, stated ,d+[DATE].17 Ready-to-Eat, Time/Temperature Control for Safety Food, Date Marking . […]

• No harm, potential for more than minimal, widespreadF812Oct 7, 2022

  Based on observation, staff interview, review of refrigerator temperature logs, and policy review, it was determined the facility failed to ensure food was stored at acceptable temperatures and the temperature of the refrigerators were monitored regularly. This was true for 2 of 2 food storage refrigerators in the nursing units and 1 of 2 food storage refrigerators in the facility's kitchen and had the potential to affect all residents residing in the facility. This failure created the potential for harm should residents experience adverse effects related to food which was stored at unsafe temperatures, for example, food poisoning, abdominal discomfort, nausea, vomiting, and diarrhea. […]

• No harm, potential for more than minimal, patternF812Jan 28, 2026

  Based on the FDA Food Code, policy review, observation, and interview, the facility failed to ensure food was appropriately stored, distributed, and labeled. This deficient practice had the potential to affect all residents who received meals prepared in the facility's kitchen. This placed residents at risk for potential contamination and use of spoiled foods, and adverse health outcomes including food-borne illnesses. Findings include:The FDA Food Code 2022, 3-501.17 documented, Ready-to-Eat, Time/Temperature Control for Safety Food, Date Marking . […]

• No harm, potential for more than minimal, patternF880Jan 28, 2026

  Based on policy review, observation, and staff interview, it was determined the facility failed to ensure infection control prevention practices were maintained when 1) residents consumed meals prepared in the facility kitchen, and 2) residents received insulin injections to manage their diabetes. These failures put residents at risk for adverse outcomes including potential infections or food-borne illness due to cross contamination. Findings include:The facility's Handwashing Guidelines-Dietary Employees, dated 12/8/25, documented Dietary employees shall clean their hands and exposed portions of their arms immediately before engaging in food preparation including working with exposed food, clean equipment, utensils, and unwrapped single service and single use articles and in the following… […]