Mapleton Community Home

In the surveyor’s words

From the most serious findings on record at Mapleton Community Home, in the surveyor’s own words.

• No harm, potential for more than minimal, widespreadF812Jul 10, 2024

  Based on observation, interview, and document review, the facility failed to ensure dietary staff followed appropriate infection control practices when handling cups during food service in the dining room. This had potential to affect all 47 residents who resided in the facility. Findings include: During an observation on 7/9/24 at 12:00 p.m., when filling cups with juice for residents seated at tables, dietary aide (DA)-A was observed holding the small, clear plastic tumblers by the rim of the cup with bare hands, and when setting the cup on the table. During an observation on 7/9/24 at 12:05 p.m., when filling beverages for residents, observed DA-B pour milk and orange juice into two small, clear plastic tumblers. With bare hands, DA-B set the cups on the table by holding the rim. […]

• No harm, potential for more than minimal, widespreadF880Jul 10, 2024

  Based on observation, interview, and record review the facility failed to use appropriate infection prevention and control practices for 1 of 2 residents (R28) who was dependent on staff for pressure ulcer wound care. In addition, the facility to ensure a mechanical transfer lift was cleaned after resident use for 2 of 2 residents (R7 and R14) observed for infection control practices and proper infection prevention practices was observed when sorting soiled laundry. Findings include: R28's facesheet printed on 7/10/24, included diagnoses of pressure ulcer of the sacral region and urinary incontinence. R28's annual Minimum Data Set (MDS) assessment dated [DATE], indicated R28 is cognitively intact, could understand and be understood. […]

• No harm, potential for more than minimal, widespreadF880Sep 21, 2023

  Based on observation and interview, the facility failed to follow Centers for Medicare and Medicaid Services (CMS) and Centers for Disease Control (CDC) guidelines to prevent the spread of Covid-19, when during a Covid-19 outbreak, residents and visitors were observed not wearing appropriate personal protective equipment (PPE), specifically masks, for 9 of 41 resident (R2, R5, R8, R10, R14, R22, R24, R25, R35) not in transmission based precautions (TBP). In addition, the facility failed to offer hand-hygiene prior to meals for 4 of 4 residents (R2, R6, R8, R37). Lastly, the facility failed to ensure staff wore wear proper PPE specifically eye protection, when entering the room for 1 of 6 residents (R29) on TPB. This had the potential to affect all 47 residents who resided in the facility. […]

• No harm, potential for more than minimal, isolatedF641Jun 30, 2026

  Based on interviews and document review the facility failed to ensure the Minimum Data Set (MDS) accurately reflected the resident's fall history for 2 of 3 residents (R2 and R10) reviewed for falls. Findings include: R2's significant change Minimum Data Set (MDS) assessment dated [DATE], indicated impaired cognition, no behaviors or rejection of care, use of wheelchair, one fall with no injury, one fall with minor injury, and diagnoses of non-traumatic brain dysfunction, high blood pressure, and Alzheimer's disease. R2's care plan dated 11/2/23, indicated at risk for falls related to poor balance, assistive devices for mobility, psychotropic medication use, history of falls. […]

• No harm, potential for more than minimal, isolatedF657Jun 30, 2026

  Based on interview, observation, and document review, the facility failed to revise and update the comprehensive care to include new fall interventions implemented for 3 of 3 residents (R2, R3, and R10) reviewed for falls. Findings include: R10's quarterly Minimum Data Set (MDS) assessment dated [DATE], indicated R10 had no cognitive impairment, utilized a walker, independent with walking, diagnoses included Non-Alzheimer's Dementia, repeated falls, chronic pain, had falls since admission or the prior assessment, one fall with no injury and one fall with injury (except major). […]