Maple Grove Wellness & Rehabilitation

In the surveyor’s words

From the most serious findings on record at Maple Grove Wellness & Rehabilitation, in the surveyor’s own words.

• Actual harm, isolatedF760Jun 26, 2025

  Based on interview and record review the facility failed to prevent a significant medication error for one resident (Resident #1) of 20 sampled residents. The facility census was 81. 1. Review of the facility's undated Medication Administration policy showed: - No medication will be used for any resident other than the resident for whom it was prescribed; - Verify the resident identity before administering the medication; - Nursing staff will keep in mind the seven rights of medications when administering medications which include, right medication, right amount, the right resident, the right time, the right route, the right indication, and right outcome; - Additional considerations include the resident has the right to know what the medication does and the right to refuse the medication. […]

• No harm, potential for more than minimal, widespreadF865Aug 29, 2025

  Based on interview and record review, the facility failed to have a Quality Assurance and Performance Improvement (QAPI - a program to improve the processes for the delivery of health care and quality of life for the residents) program in place with protocols describing how the facility will identify and correct its own quality deficiencies. This deficient practice had the potential to affect all residents in the facility. The facility census was 86.Review of the facility's QAPI Program policy, revised 10/24/22, showed:- The purpose is to ensure that all services provided by the facility to resident meet quality standards;- The facility implements and maintains an ongoing, facility-wide Quality Assurance and Performance Improvement Program designed to monitor and evaluate the quality of… […]

• No harm, potential for more than minimal, widespreadF867Aug 29, 2025

  Based on interview and record review, the facility failed to ensure the Quality Assessment and Assurance/Quality Assurance Performance Improvement (QAA/QAPI) committee developed and implemented an appropriate plan of action to correct identified quality deficiencies. This had the potential to affect all residents in the facility. The facility census was 86. Review of the facility's QAPI Program policy, revised 10/24/22, showed:- The purpose is to ensure that all services provided by the facility to residents meet quality standards;- Goals are: to provide a means to identify and resolve present and potential negative outcomes related to resident care and safety; to reinforce and build upon effective systems of services and positive care measures; to provide a structure and process to… […]

• No harm, potential for more than minimal, widespreadF812May 7, 2024

  Based on observation and interview, the facility failed to repair the convection oven, stove top burners, flat top grill, and oven. This had the potential to affect all residents. The facility failed to ensure outside food stored in residents' personal refrigerators was stored at least 40 degrees or below, failed to ensure expired foods were thrown away and refrigerators were cleaned regularly. This deficient practice affected three residents (Resident #64, #69, and #444) out of 19 sampled residents and one resident (Resident #43) outside the sample and had the potential to affect all residents with personal refrigerators. The facility census was 92. […]

• No harm, potential for more than minimal, widespreadF865May 7, 2024

  Based on interview and record review, the facility failed to develop a Quality Assurance and Performance Improvement Plan (QAPI - a written plan containing the process that will guide the facility's efforts in assuring care and services are maintained at acceptable levels of performance and continually improved.) The facility census was 92. Review of the facility's policy, Quality Assurance and Performance Improvement Program, revised February 2020, showed: - The QAPI committee oversees implementation of our QAPI plan, which is the written component describing the specifics of the QAPI program, how the facility will conduct its QAPI functions, and the activities of the QAPI committee; - The QAPI plan describes the process for identifying and correcting quality deficiencies. […]