Maple Glen Center

In the surveyor’s words

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

• No harm, potential for more than minimal, widespreadF838Sep 2, 2025

  Based on observation, interviews, and a review of facility documentation, it was determined that the facility failed to ensure that a facility wide assessment was reviewed and updated to identify the required services and procedures necessary to protect the health, safety, and welfare of all residents to ensure adequate facility resources to provide resident care and services. These failures had the potential to affect all 122 residents who currently live in the facility during the time of the survey. […]

• No harm, potential for more than minimal, widespreadF919Sep 2, 2025

  Based on observations and interviews on 8/27/25 and 8/28/25 in the presence of the Senior Maintenance Director (SMD) and Maintenance Director (MD), it was determined that the facility failed to ensure that the resident call bell system was properly functioning in all areas. This deficient practice had the potential to affect all (122) residents and was evidenced by the following:Observations on 8/27/25 from 12:44 PM to 12:50 PM, revealed:The call bell system failed to activate for room [ROOM NUMBER] when tested by the MD. The light outside of the room did not turn on, and no audible or visual notification was given at the nurse's station.The call bell system failed to activate for room [ROOM NUMBER] when tested by the MD. […]

• No harm, potential for more than minimal, patternF880Nov 9, 2021

  Based on observation, interview, and record review, it was determined that the facility failed to: a.) implement the appropriate infection control precautions and personal protective equipment (PPE) for a resident actively treated for [MEDICAL RECORD OR PHYSICIAN ORDER] # 47); b.) ensure proper use of personal protective equipment (PPE) for 1 of 4 staff in accordance with the Centers for Disease Control and Prevention guidelines for infection control; c.)perform hand hygiene appropriately for 4 of 11 staff; and d.) ensure that residents were offered and provided hand hygiene before and after meals. This deficient practice was evidenced by the following: According to the U.S. […]

• No harm, potential for more than minimal, isolatedF584Sep 2, 2025

  Based on observation, interview, and record review, it was determined that the facility failed to maintain residents' environment in a safe, clean, comfortable, and homelike surrounding. This deficient practice was identified for 2 of 4 nursing units (Units 2 and 3) observed during environment tour. This deficient practice was evidenced by: 1.On 8/27/25 at 11:35 AM, Surveyor #1 (S#1) with Licensed Practical Nurse #1 (LPN#1) went inside Resident room [ROOM NUMBER] (RR#208) and observed the following: The dresser top area with used coffee cup and plastic wrappers. The 1st drawer of the dresser near the window with peeled wood and there was a coffee cup that was mixed with resident's unfolded clothes. […]

• No harm, potential for more than minimal, isolatedF640Sep 2, 2025

  REPEAT DEFICIENCYBased on interview and record review, it was determined that the facility failed to submit the Minimum Data Set (MDS) assessments in a timely manner for 2 of 27 residents reviewed (Resident # 74 and Resident #109).The deficient practice was evidenced by the following:On 8/29/25 at 10:16 AM, the surveyor reviewed the most recent MDS's, an assessment tool used to facilitate the management of care, for the timeliness of submission for three system-selected residents.Information in the electronic medical record and additional information provided by the facility revealed the following for two of the residents:1. Resident #74 had a discharge (d/c) MDS with an Assessment Reference Date (ARD) of 3/28/25. The MDS was completed but had not been submitted.2. […]