Maristhill Nursing & Rehabilitation Center

In the surveyor’s words

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

• Immediate jeopardy, isolatedF726Jul 25, 2022

  Based on records reviewed and interviews for two of four sampled residents (Resident #1 and Resident #2), the Facility failed to ensure nursing staff were competent related to 1) Medication Reconciliation for new admissions and 2) Medication Administration. 1) Resident #1 who was newly diagnosed in February 2022 with [CONDITION(S)] (CML, a slowly progressing and uncommon type of blood-cell cancer), he/she began [CONDITION(S)] treatment as an outpatient, but due to severe adverse effects of [MEDICATION(S)] and [MEDICATION(S)] ([CONDITION(S)] medications) he/she required admission to the Hospital, and his/her [CONDITION(S)] medications were discontinued at the time. […]

• Immediate jeopardy, isolatedF760Jul 25, 2022

  Based on records reviewed and interviews for two of four sampled residents (Resident #1 and Resident #2), the Facility failed to ensure they were free from significant medication errors that adversely impacted their health. 1) Resident #1 who was newly admitted to the Facility in [DATE], and due to a medication reconciliation error upon admission, he/she was administered [MEDICATION(S)], a [CONDITION(S)] medication, that had been discontinued during his/her Hospital admission secondary to severe adverse side effects. Resident #1 was administered [MEDICATION(S)] two times a day for his/her entire stay at the Facility (11 days). […]

• Actual harm, isolatedF689Feb 24, 2025

  Based on records reviewed and interviews, for one of three sampled residents, (Resident #1), who required assistance from staff with personal hygiene, the Facility failed to ensure that during the provision of personal care that staff took necessary steps to maintain his/her safety to prevent an incident resulting in an injury, when on 01/22/25, a Certified Nurse Aide (CNA) used an electric curling iron to curl Resident #1's hair, he/she sustained a second-degree burn (partial thickness, involves both the outer (epidermis) and underlying layer (dermis) of skin, they cause pain, redness, swelling, and blistering) to the upper left side of his/her forehead, which required treatment. […]

• No harm, potential for more than minimal, patternF695Nov 25, 2025

  Based on observations, interviews and record review, the facility failed to ensure that respiratory care and services, consistent with professional standards of practice, were provided for 5 Residents (#56, #82, #62, #73 and #2) out of sample of 30 residents. Specifically,1. For Resident #56, the facility failed to set oxygen as ordered by the physician.2.For Resident #82, the facility failed to clean the concentrator filter as ordered by the physician.3. For Resident #62, the facility failed to clean the concentrator filter.4. For Resident #73, the facility failed to clean the concentrator filter, keep the water bottle off the floor and keep an oxygen cannula clean.5. […]

• No harm, potential for more than minimal, patternF761Nov 25, 2025

  Based on observation, record review and interview, the facility failed to ensure medications were labeled and stored in accordance with acceptable professional standards on three of three units. Specifically,1.The facility failed to ensure medications were labeled in accordance with acceptable professional standards, to include open dates on medications with shortened expiration dates in three medication carts on three of three units.2. The facility failed to secure and lock an unattended medication cart on the first-floor unit.Findings include:Review of the facility policy titled medication Storage, dated revised 5/9/25, indicated that all medications requiring refrigeration are stored in refrigerators located in the pharmacy and at each mediation room. 1a. On 9/30/25 at 2:50 P.M. […]