Mansfield Nursing Center

In the surveyor’s words

From the most serious findings on record at Mansfield Nursing Center, in the surveyor’s own words.

• No harm, potential for more than minimal, patternF558Aug 13, 2025

  Based on record review, observation, and interviews, the facility failed to accommodate the needs of 1(#8) of 20 sampled residents. The facility failed to ensure the resident was reassessed for the use assist rails.Review of Resident #8's medical record revealed Resident #8 was admitted [DATE], with a readmission date of 07/28/2025. Resident #8's diagnoses included hemiplegia and hemiparesis following cerebral infarction affecting left-non dominate side and lack of coordination. Review of Resident #8's Quarterly MDS (Minimum Data Set) dated 06/08/2025 revealed Resident #8 had a BIMS (Brief Interview of Mental Status) score of 13/15, indicating intact cognition. Resident #8 had limited range of motion for both upper and lower extremities on one side. […]

• No harm, potential for more than minimal, patternF628Aug 13, 2025

  Based on record reviews and interviews, the facility failed to: provide to the resident and/or the resident's responsible party (RP) written notice which specified the reason for transfer, effective date, location and statement of the resident's appeal rights, and duration of the bed hold policy for 1 (#74) of 2 (#74, #76) residents reviewed for transfer/discharge, and notify the State's Long Term Care Ombudsman of discharges in writing for 2 (#74, #76) of 2 (#74, #76) residents reviewed for discharge requirements. […]

• No harm, potential for more than minimal, patternF880Aug 13, 2025

  Based on record review, observations, and interviews the facility failed to ensure infection control measures were practiced to provide a safe, sanitary environment and help prevent the development and transmission of infection for 3 (#10, #13, #79) of 3 (#10, #13, #79) sampled residents requiring EBP (enhanced barrier precautions). The facility failed to:1. Post clear signage outside Resident #10, #13 and #79's room indicating the type of precautions, required personal protective equipment and high contact resident care activities that require the use of gown and gloves,2. Have gowns, gloves and alcohol-based hand rub available outside the room for Resident #10, #13 and #79 and 3. Obtain an order for EBP for Resident #79. […]

• No harm, potential for more than minimal, patternF600Mar 19, 2025

  Based on record reviews and interview, the facility failed to protect the resident's right to be free from abuse of misappropriation of property and exploitation by staff for 1 (#1) of 3 (#1, #2, #3) sampled residents. S2 CNA (Certified Nursing Assistant) transferred money from Resident #1's bank account via [NAME] (bank to bank transfer) to her personal bank account. The facility implemented corrective actions which were completed prior to the State Agency's investigation entry on 03/17/2025, thus it was determined to be a Past Noncompliance Citation. […]

• No harm, potential for more than minimal, patternF577Aug 14, 2024

  Based on observations and interview the facility failed to ensure the most recent survey results were posted in a place readily accessible to the residents, family members or anyone to review. Findings: Observation on 08/12/2024 at 10:00 a.m. failed to reveal the most recent survey results were posted in a place that was readily accessible for review. Observation on 08/12/2024 at 10:00 a.m. with S1 Administrator revealed the most recent survey results were not posted in a place that was readily available for review. During an interview on 08/12/2024 at 11:45 a.m. S1 Administrator confirmed the most recent survey results should have been posted for residents, family and anyone to review.