Marysville Post-Acute

In the surveyor’s words

From the most serious findings on record at Marysville Post-Acute, in the surveyor’s own words.

• Actual harm, isolatedF689Oct 9, 2024

  Based on interview and record review, the facility failed to ensure residents received supervision to prevent falls for one of four residents sampled for falls (Resident 1). Resident 1 was assessed as high risk for falls and the Interdisciplinary team (IDT) (a facility group composed of a physician, a registered nurse, a social worker and additional appointed facility staff) did not revise Resident 1's fall care plan interventions based on Resident 1's fall risk factors and resident-centered needs to include increased supervision following 14 falls between 8/7/24 and 9/13/24. […]

• No harm, potential for more than minimal, widespreadF842Jan 10, 2023

  Based on interview and record review, the facility failed to meet this requirement when four of four sampled residents' (Resident's 1, 2, 3 and 4), bathing records were incomplete, not readily available, and not part of a reportable medical record. This resulted in potentially missed showers, infection, skin breakdown and reduced quality of life. Findings: Resident 1 was admitted to the facility on [DATE] for conditions including chronic heart failure, difficulty walking, muscle weakness, chronic obstructive pulmonary disease (a lung disease that blocks the lungs) and morbid obesity. A review of Resident 1's shower record for December 2022 indicated that her scheduled shower days were Mondays and Thursdays, and that there were nine scheduled bathing days that month. […]

• No harm, potential for more than minimal, widespreadF835Aug 18, 2022

  Based on observation, interview, and record review, the facility failed to provide consistent administrative oversight to ensure the residents received the care and services to meet their needs when: 1. Pain management and Hospice services were not coordinated and monitored to meet the needs of residents. Refer to F 697, F 726 and F 849. 2. Pharmacy services related to administration, labeling, and storage did not meet standards. Refer to F 755, F 759, F 880 3. Resident council complaints were unresolved. Refer to F 565 4. Ensure safe smoking practices in the facility. Refer to F 689 Findings: A review of the facility's job description, titled Administrator, revised on [DATE], indicated: a. […]

• No harm, potential for more than minimal, patternF686Jun 25, 2025

  Based on interview and record review the facility failed to follow their wound prevention, maintenance, and wound care policies and procedures (P&P) for three out of three sampled residents (Residents 1, 2, and 3) when: 1A. Resident 1 was provided wound care without a physician's order; and 1B. Skin assessments did not consistently reflect the condition of the skin or wound, and the discharge skin assessment was not completed; and 1C. A change of condition was not documented; and 2. Residents 1, 2, and 3 were not provided with repositioning every two hours. These failures contributed to Resident 1's wound development and placed residents at an increased risk for a delay in wound healing, decline in health status, and could negatively impact their psychosocial well-being. Findings: 1A. […]

• No harm, potential for more than minimal, patternF625Apr 3, 2025

  Based on interview, record review, and facility policy review, the facility failed to provide a bed-hold notice upon transfer to the hospital or within 24 hours following an emergency transfer, which affected 2 (Resident #7 and Resident #47) of 3 residents reviewed for hospitalizations. Findings included: An undated facility document titled, Bed Hold Policy and Notification revealed, It is the policy of this facility to provide any resident that is transferred to a general acute care hospital the right to exercise the bed hold provision. 1. Resident #7's admission Record indicated the facility admitted the resident on 05/20/2023. […]