Magnolia Square Nursing and Rehab

In the surveyor’s words

From the most serious findings on record at Magnolia Square Nursing and Rehab, in the surveyor’s own words.

• Immediate jeopardy, patternF689Feb 14, 2025

  Based on observation, interview, and record review, the facility failed to ensure an environment free from accident hazards, when hot water at the in room hand sinks of seven residents (Residents #24, #44, #46, #48, #54, #65, and #72), of 18 sampled residents on the Special Care Unit measured between 123.2 degrees Fahrenheit (F) and 129.9 degrees F. The residents were cognitively impaired and unable to regulate water temperatures. The facility census was 97. The Administrator was notified on 02/10/25, at 7:47 P.M., of an Immediate Jeopardy (IJ) which began on 01/14/25. […]

• No harm, potential for more than minimal, widespreadF812Dec 14, 2023

  Based on observation, interview, and record review, the facility failed to ensure food was stored, prepared, and distributed in a manner to prevent possibly contamination when staff failed to maintain failed to properly label and cover food in the walk-in cooler and failed to keep the stove hood, the cooler fans, and the vents above the dish area clean and free from debris. This had the potential to affect all residents who consumed food from the facility kitchen. The facility census was 100. 1. […]

• No harm, potential for more than minimal, patternF921Dec 14, 2023

  Based on observation, interview, and record review, the facility failed to provide a sanitary and comfortable environment for residents, staff and the public, when staff failed too keep light fixtures throughout the facility clean and free from dead bugs and debris. The facility census was 100. 1. Observations on 12/12/23, beginning at 1:35 P.M., showed the following: -Ceiling light fixtures throughout the common areas of the facility had dead bugs and debris in them; -On the 100 upper hall (rooms 100 to 112) large bugs, dust, and debris were observed in five of the ten hall ceiling light fixtures; -In the back area of the main dining room (MDR) there were four of the five light fixtures with debris in them; -In the MDR there were 16 of the 16 light fixtures that had dust and debris in… […]

• No harm, potential for more than minimal, patternF561Apr 6, 2022

  Based on record review and interview, the facility failed to have staff provide routine showers/baths to f residents (Resident #1, #3, #4, and #5) as care planned and failed to care plan one resident's (Resident #2) shower/bathing preference. These residents were dependent on staff for help with showers. The facility census was 80. Record review showed the facility did not provide a shower schedule for residents. 1. Record review of Resident #1's face sheet (a one-page summary of important information about a resident) showed the following: -admitted [DATE]; -diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . […]

• No harm, potential for more than minimal, isolatedF600Jan 15, 2026

  Based on record review and interview, the facility failed to protect the resident's right to be free from verbal and emotional abuse when one staff member (Certified Nurse Aide (CNA) B) spoke to one resident (Resident #1) in an aggressive manner, continued care when the resident said it hurt, and degraded the resident by telling the resident they would have to use a bed pan. The facility census was 89.Review of the facility's policy titled, Report Abuse, not dated, showed the following: -The facility will not condone resident abuse by anyone, including staff members, physicians, consultants, volunteers, staff of other agencies serving the residents, family members, other residents, etc.-Abuse is defined as the willful infliction of injury; unreasonable confinement, intimidation, or… […]