Maple Manor Village

In the surveyor’s words

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

• No harm, potential for more than minimal, patternF602Nov 20, 2025

  Based on interviews, observations, and record review, the facility failed to ensure medications were not diverted for 5 of 5 residents reviewed (Residents #1, #2, #3 #4 and #5). Resident #1, #3, #4, and #5 all had a narcotic pain pill missing from one of the facility's medication cart's controlled substance locked drawer. Resident #2's Controlled Substance card was missing when the count was checked. The medication card contained clonazepam (Klonipin) (an antianxiety medication) that was to be administered daily at noon. The card that was to be counted showed this once a day medication was given at 7:40 a.m. This card also showed there was 1 pill missing. There was no reason documented that showed this resident received the medication early. […]

• No harm, potential for more than minimal, isolatedF637Feb 18, 2026

  Based on clinical record review, Resident Assessment Instrument (RAI) manual, and staff interview the facility failed to complete a significant change Minimum Data Set (MDS) assessment within 14 days of a status change for 1 of 2 residents reviewed for hospice care (Resident #41). The facility reported a census of 36 residents. Findings include:Resident #41's MDS dated [DATE] lacked a completion date. Resident #41's Hospice admission Consent form, Medicare Hospice Benefit Election form and the Election of Medicaid Hospice Benefit form were signed and dated on 12/5/2025. Resident #41's Progress Note written 12/5/25 at 10:00 AM documented they would be admitted to hospice later that day. […]

• No harm, potential for more than minimal, isolatedF658Nov 20, 2025

  Based on observations, interviews and record review, the facility failed to discontinue medication per discharging hospital physician's orders for 1 out of 3 residents reviewed (Resident #1). Resident #1 received 4 doses of Eliquis (an anticoagulant medication (treats and prevents blood clots)) after returning to the facility following a hospitalization. The orders from the hospital were to no longer administer Eliquis. The facility reported a census of 34. Findings include: A Minimum Data Set (MDS) dated [DATE], documented that diagnoses for Resident #1 included anemia and anxiety. A Brief Interview for Mental Status (BIMS), documented a score of 15 out of 15, indicating Resident #1 had intact cognition. The resident was always incontinent of stool. […]

• No harm, potential for more than minimal, isolatedF641Feb 20, 2025

  Based on record review and staff interviews the facility failed to accurately code the Minimum Data Set (MDS) assessment for 2 of 5 residents reviewed (Resident #8 and #16). The facility documented the residents received insulin during the look back period when they did not. The facility reported a census of 32. Findings include: 1. Resident #8's MDS assessment dated [DATE] included a diagnosis of type 2 diabetes mellitus (a chronic condition where the body does not use insulin effectively or does not produce enough insulin to regulate blood sugar levels). The MDS reflected Resident #8 received one insulin injection during the lookback period. Resident #8's February 2025 Treatment Administration Record (TAR) lacked an order for insulin. […]

• No harm, potential for more than minimal, isolatedF740Feb 20, 2025

  Based on observation, clinical record review, and staff interviews, the facility failed to develop and implement behavioral health concerns on the Care Plan for 1 of 1 resident sampled (Resident #2). The facility reported a census of 32 residents. Findings include: Resident #2's Minimum Data Set (MDS) assessment dated [DATE] identified he had short- and long-term memory problems and had severely impaired cognitive skills for daily decision making. He could recall the staff names and faces. The assessment indicated he had inattention continuously present, and it didn't fluctuate. […]