Magnolia Manor - Rock Hill

In the surveyor’s words

From the most serious findings on record at Magnolia Manor - Rock Hill, in the surveyor’s own words.

• Immediate jeopardy, patternF686Jun 15, 2022

  Based on observation, record review, interview, and policy review, the facility failed to prevent an avoidable pressure ulcer to the right lateral calf for one Resident (R) 90 of five residents reviewed for pressure ulcer out of a total sample of 50 residents. The facility missed 24 opportunities to complete ordered skin assessments under the resident's brace and the resident sustained [MEDICAL RECORD OR PHYSICIAN ORDER] Substandard Quality of Care (SQC) was identified at 43 CFR 483.25 treatment/services to prevent/heal pressure ulcers. The facility's Administrator and Director of Nursing (DON) were informed on 06/14/22 at 7:54 PM that Immediate Jeopardy existed at F686 related to the failure to ensure R90's skin was assessed underneath the brace to her right calf. […]

• Immediate jeopardy, isolatedF600Jan 13, 2025

  Based on review of facility policy, record review and interviews, the facility failed to protect Resident (R)1 from physical, verbal, and mental abuse by Licensed Practical Nurse (LPN)1. Specifically, LPN1 used inappropriate language to address R1. Furthermore, witnesses observed LPN1 physically hit R1, as a reaction to R1 hitting LPN1. The State Agency (SA) utilizing the Reasonable Person Approach, has determined that any reasonable person in the same situation would experience adverse psychosocial harm. On 01/13/25 at 3:18 PM, the Director of Nursing was notified that the failure to protect a resident from physical and verbal abuse constituted Immediate Jeopardy (IJ) at F600. […]

• Immediate jeopardy, isolatedF600Jun 10, 2024

  Based on interview, record review, and review of facility policy, the facility failed to provide appropriate care and services to ensure Resident (R)1's quality of life, specifically Licensed Practical Nurse (LPN)1 failed to accurately assess R1, who expired approximately 30 minutes later. On [DATE] at 3:02 PM, the survey team provided the Administrator with a copy of the CMS Immediate Jeopardy (IJ) Template, informing the facility IJ existed as of [DATE]. The IJ was related to 42 CFR 483.25 - Freedom from Abuse, Neglect, and Exploitation. On [DATE] the facility provided an acceptable IJ Removal Plan. On [DATE] the survey team validated the facility's corrective actions and the immediacy of the IJ was removed as of [DATE]. […]

• Immediate jeopardy, isolatedF678Aug 24, 2023

  Based on review of the facility policy, interviews, and record review, the facility failed to provide timely cardiopulmonary resuscitation (CPR). On [DATE] at 4:44 AM, Licensed Practical Nurse (LPN)1 found Resident (R)1 unresponsive. She alerted Certified Nursing Aide (CNA)1 to find other nurses to assist with the code, but did not immediately provide compressions. Facility staff did not start compressions on R1 until a few minutes later when LPN2 and Registered Nurse (RN)1 arrived. On [DATE] at approximately 2:57 PM, the State Agency (SA) determined that the facility's non-compliance with one or more federal health, safety, and/or quality regulations has caused or was likely to cause serious injury, serious harm, serious impairment, or death. […]

• Immediate jeopardy, isolatedF726Aug 24, 2023

  Based on interview and record review, the facility failed to ensure staff competencies necessary for cardiopulmonary resuscitation (CPR). On [DATE] at 4:44 AM, Licensed Practical Nurse (LPN)1 found R1 unresponsive. She alerted Certified Nursing Aide (CNA)1 to find other nurses to assist with the code but did not immediately provide CPR. Facility did not start compressions on R1 until a few minutes later when LPN2 and Registered Nurse (RN)1 arrived. LPN1 did not have up-to-date certification in CPR, which required renewal on ,d+[DATE]. […]