Memorial Health Care Center

In the surveyor’s words

From the most serious findings on record at Memorial Health Care Center, in the surveyor’s own words.

• No harm, potential for more than minimal, patternF585Aug 21, 2025

  Based on observation, interview, and record review, the facility failed to provide information to resident's and their representatives on their rights related to filing grievances or concerns for 10 of 42 confidential residents. The facility failed to ensure 10 confidential residents were provided, the Grievance Procedure, information in regards to who the facility grievance officer was, their contact information, how to file an anonymous grievance. This failure could place the residents at risk of unresolved grievances and decreased quality of life. […]

• No harm, potential for more than minimal, patternF656Aug 21, 2025

  Based on interview, and record review, the facility failed to develop and implement a comprehensive person-centered care plan for each resident, consistent with the resident rights, that include measurable objectives and timeframes to meet a resident's medical, nursing, mental, and psychosocial needs that were identified in the comprehensive assessment for 4 of 16 residents (Resident #29, Resident #36, Resident #39, and Resident #42) reviewed for care plans. The facility failed to develop a care plan for Resident #29's, Resident #36's, Resident #39's and Resident #42's advanced directives. These failures could place residents at risk of not receiving the care required to meet their individualized needs. […]

• No harm, potential for more than minimal, patternF813Aug 21, 2025

  Based on observations, interviews, and record review, the facility failed to ensure the personal food policy was followed to maintain safe and sanitary storage of residents' food items for 4 of 16 residents rooms reviewed for food safety (room [ROOM NUMBER]A, #16B, #19B, and #21B) in that: The refrigerators located in room [ROOM NUMBER]A, #16B, #19B, and #21B were not being monitored for internal temperature and expiration/used by dates. These failures could place residents at risk for food borne illnesses. Findings include: During an observation on 08/19/2025 at 11:34 AM, Resident room [ROOM NUMBER]B contained a personal refrigerator. […]

• No harm, potential for more than minimal, patternF880Aug 21, 2025

  Based on observation, interview, and record review, the facility failed to establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections for 2 of 3 residents (Residents #39 and #29) reviewed for infection control.1. CNA A failed to utilize proper hand hygiene between glove changes and failed to change gloves when going from dirty to clean when providing incontinence care and catheter care for Resident #39. 2. CNA A and RN B failed to follow enhanced barrier precautions (EBP) and wear a gown when providing incontinence care and catheter care for Resident #39. 3. […]

• No harm, potential for more than minimal, patternF940Aug 21, 2025

  Based on record reviews and interviews the facility failed to develop, implement, and maintain an effective training program for all new and existing staff; individuals providing services under a contractual arrangement; and volunteers, consistent with their expected roles for 6 out of 6 employees (RN F, CNA A, LVN H, CNA G, CNA I, and CNA J) reviewed for required training. The facility failed to ensure staff were properly trained in Fall Prevention, HIV, Restraints, Emergency Procedures and Dementia for 6 of 6 employees (RN F, CNA A, LVN H, CNA G, CNA I, and CNA J) reviewed for training at hire and annually. […]