Manawa Com Nur CTR

In the surveyor’s words

From the most serious findings on record at Manawa Com Nur CTR, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Oct 22, 2024

  Based on staff interview and record review, the facility did not ensure adequate assistance to prevent falls was provided for 2 residents (R) (R3 and R5) of 5 sampled residents. On 8/19/24, Certified Nursing Assistant (CNA)-E transferred R3 without a gait belt which was required per R3's plan of care. R3 fell and sustained a 4 centimeter (cm) forehead laceration and a subdural hematoma that required steri-strips and neurological monitoring. CNA-E was not provided education prior to returning to work on 8/24/24 (which was before the facility's investigation was completed.) On 8/24/24, CNA-E was observed transferring R5 without a mechanical lift which was required per R5's plan of care. […]

• Actual harm, isolatedF689Mar 12, 2024

  Based on observation, resident and staff interview, and record review, the facility did not provide adequate supervision to prevent further abuse following a visitor-to-resident altercation for 1 Resident (R) (R3) of 2 residents. Assisted Living Resident (ALR)-G visited ALR-G's spouse (R4) in the facility and had a known history of physical aggression. On 2/13/24, R3 was struck in the face by ALR-G during an altercation. Following the incident, the facility did not implement measures to supervise ALR-G while ALR-G was in the facility. […]

• No harm, potential for more than minimal, widespreadF812Jul 22, 2026

  Based on observation, interview, and record review, the facility did not ensure food was not stored and prepared in a safe and sanitary manner. This practice had the potential to affect all 20 residents residing in the facility.Food was not dated when opened.The temperature of the ice cream freezer was not monitored.Quaternary (Quat) sanitizing solution was not tested at the correct temperature to ensure the solution reached the correct parts per million (PPM) for effectiveness.Findings include:Undated/Expired Food:The facility's Food Storage policy, dated 12/19/17, indicates: Dry storage: .Label and date all storage containers as follows: 1. The received date should already be on it. 2. Date opened. 3. […]

• No harm, potential for more than minimal, widespreadF801Apr 30, 2025

  Based on staff interview and record review, the facility did not designate a person to serve as the food and nutrition services director who was a certified dietary manager, had a national certification for food service management and safety from a national accrediting body, or had an associates or higher level degree in food service management or hospitality. This practice had the potential to affect all 23 residents residing in the facility. Dietary Manager (DM)-H did not complete an approved dietary manager or food service manager certification course or other related education. Findings include: On 4/28/25 at 8:42 AM, Surveyor began an initial kitchen tour with DM-H who indicated DM-H was enrolled in a certified dietary manager (CDM) course. […]

• No harm, potential for more than minimal, widespreadF803Apr 30, 2025

  Based on observation, staff and resident interview, and record review, the facility did not ensure menus met the nutritional needs of residents in accordance with established national guidelines. This practice had the potential to affect all 23 residents residing in the facility. The facility did not implement an extended menu that delineated the differences between diet types and portion sizes for residents. Findings include: The facility's Standard Portions policy, dated 12/19/17, indicates: Uniform food portions shall be established for each diet and served to all patients .Recipes and menus will have appropriate portions noted. […]