Magnolia Creek Skilled Nursing and Therapy

In the surveyor’s words

From the most serious findings on record at Magnolia Creek Skilled Nursing and Therapy, in the surveyor’s own words.

• No harm, potential for more than minimal, patternF687Jan 28, 2026

  Based on observation, record review, and interview, the facility failed to provide toenail care for 1 (#7) of 1 sampled resident reviewed for foot care.The administrator identified 72 residents resided in the facility. Findings:On 01/20/26 at 1:49 p.m., Resident #7's toenails were observed to be thick, overgrown, and were half an inch long.A significant change assessment, dated 12/03/25, showed Resident #7's cognition was intact with a brief interview for mental status score of 13. […]

• No harm, potential for more than minimal, patternF580Jun 21, 2024

  Based on observation, record review, and interview, the facility failed to notify the physician of a severe weight gain of 36 pounds (17.24 %) for one (#45) of two sampled residents reviewed for weights. The facility census was 77. Findings: A Dining Services Policies and Procedures Weight List, revised 07/09/08, read in part .Residents' weights are routinely and systematically monitored .Residents with a weight loss or gain of five percent or more, within one month, should be re-weighed and entered into PCC by the 15th of the month. […]

• No harm, potential for more than minimal, patternF677Jun 21, 2024

  Based on observation record review and interview, the facility failed to provide assistance with care in a timely manner for three (#12, 18 and #36) of three sampled residents reviewed. The director of nursing identified 25 residents who were totally dependent on two staff for care. Findings: 1. Resident #12 had diagnosis to include dementia, anxiety, major depression, hypertension and hyperlipidemia. Resident #12 care plan, last revised 01/24/24, read in part, .I am at risk for pressure ulcer D/T my incontinence .provide incontinent care every 2 hours as needed . A quarterly assessment, dated 04/2024, documented Resident #12 was not able to complete the brief interview for mental status interview to determine cognition, and was always incontinent of bowel and bladder. […]

• No harm, potential for more than minimal, patternF684Jun 21, 2024

  Based on observation, record review, and interview, the facility failed to assess and monitor a resident with a severe weight gain of 36 pounds (17.24 %) for one (#45) of two sampled residents reviewed for weights. The facility census was 77. Findings: A Dining Services Policies and Procedures Weight List, revised 07/09/08, read in part .Residents' weights are routinely and systematically monitored .Residents with a weight loss or gain of five percent or more, within one month, should be re-weighed and entered into PCC by the 15th of the month. […]

• No harm, potential for more than minimal, patternF725Jun 21, 2024

  Based on observation, record review, and interview, the facility failed to ensure they had sufficent staff to provide care to residents. The facility ceneus was 77. Findings: A review of the stafing sheets for 06/07/24 through 06/21/24 documentd the 6:00 p.m. to 6:00 a.m., shift had one nurse and two aides for the long term care side on the following dates: 06/15/24; 06/16/24; 06/18/24, 06/19/24, and 06/20/24. 1. Resident #12 had diagnosis to include dementia, anxiety, major depression, hypertension and hyperlipidemia. Resident #12 care plan, last revised 01/24/24, read in part, .I am at risk for pressure ulcer D/T my incontinence .provide incontinent care every 2 hours as needed . […]