Miller's Merry Manor

Based on observation, record review and interview, the facility failed to update a resident's Care Plan timely related to activities for 1 of 2 residents reviewed for activities. (Resident 8) Finding includes: During an observation on 6/23/2025 at 9:38 A.M., Resident 8 was seated in front of the nurses station, alone and talking to herself. During an observation on 6/24/2025 at 10:40 A.M., Resident 8 was alone in her room, seated in her wheel chair and was talking to herself. A record review was completed on 6/26/2025 at 10:00 A.M., Resident 8's diagnoses included but were not limited to: dementia, hearing loss of both ears, dysphagia, major depressive disorder and contrature of the right hand. A Significant Change Minimum Data Set (MDS) dated , 1/3/2025, indicated Resident 8 was unable to complete a cognitive assessment, had moderate difficulty hearing, was able to understand others sometimes and was able to make herself understood to others sometimes. Resident 8's preferences were listed as: somewhat important to do favorite activities, somewhat important to have books, newspapers…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, interview and record review, the facility failed to provide an ongoing resident centered activities program for 2 of 2 residents reviewed for activities. (Residents 36 and 8) Findings include: 1. A record review completed on 6/24/2025 at 2:30 P.M. indicated Resident 36's diagnoses included, but were not limited to, dementia, generalized anxiety disorder and cognitive communication deficit. An Annual Minimum Data Set (MDS) assessment, dated 5/6/2025, indicated Resident 36's cognition was severely impaired and activity preferences included listening to music, attending religious activities and doing things with groups of people. She had no functional deficits and used a wheelchair. A current Care Plan initiated on 5/24/2024, indicated Resident 36 was still capable of making decisions about activity involvement. During interviews, the family indicated the resident enjoys music, going outside, animals, family visits, and that religion was important to her. Activity documentation indicated in the month of April 2025 the resident had attended the following group…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on interview and record review, the facility failed to complete a post dialysis assessment for 1 of 1 residents reviewed for dialysis. (Resident 17) Finding includes A record review completed on 6/25/2025, for Resident 17, indicated diagnoses of: type 2 diabetes mellitus, end-stage renal disease and dependence on renal dialysis. A Quarterly Minimum Data Set (MDS) assessment, dated 6/13/2025, indicated Resident 17's cognition was intact and she received dialysis. A Physician Order, dated 1/16/2025, indicated Resident 17 received hemo-dialysis three times a week on Tuesdays, Thursdays and Saturdays. A current Care Plan, initiated on 6/13/2024 indicated Resident 17 received dialysis three times a week due to end stage renal failure. Staff was to assess the bruit and thrill (A bruit was a whooshing sound that could be heard with a stethoscope over the access site, while a thrill was a vibration that could be felt by touch.) at the fistula site in her left arm. The clinical record indicated post-dialysis assessments were missing for 5/27/2025, 6/14/2025 and 6/19/2025. During an…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, interview and record review, the facility failed to follow infection control standards regarding glove usage and isolation procedures for 2 of 3 residents. (Residents 20 & 7) Findings include: 1. During an observation of Resident 20's catheter care on 6/25/2025 at 10:03 A.M., CNA 3 cleaned the resident's catheter and genitals but did not change her gloves before she helped the resident roll onto her side for wound care. CNA 3 also helped remove the resident's brief, repositioned the resident's clothing and straightened the resident's blankets before she removed her contaminated gloves. During an interview on 6/25/2025 at 10:22 A.M., CNA 3 indicated she had not changed her gloves after washing the resident's catheter. She indicated she should have changed her gloves before she dried the resident's catheter and genital area. During an interview on 6/25/2025 at 2:10 P.M., the Director of Nursing indicated the facility did not have a policy with on all the steps of providing catheter care but the facility followed the standard of care when providing catheter care.…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, interview, and record review the facility failed to ensure a resident was assisted with personal hygiene for 1 of 2 records reviewed for Activities of Daily Living (ADL) (Resident 2) Finding includes: During an observation and interview on 8/14/2024 at 10:21A.M., Resident 2 indicated the facility staff help sometimes with shaving. During an observation and interview on 8/15/2024 at 9:47 A.M., Resident 2 indicated he used to shave himself and he liked to shave every 2 days, that as he did in the past. During an observation on 8/16/2024 at 9:07 A.M., the Resident 2 was unshaven. During an observation and interview on 8/19/2024 at 9:07 A.M., Resident 2 was unshaven and he indicated no one had offered to shave him. He indicated he would have shaved himself, but they took his razors away from him. A record review was completed for Resident 2, on 8/15/2024 at 4:03 P.M. Diagnoses included, but not limited to: hemiplegia, unspecified affecting right dominant side, aphasia, wrist drop, right wrist and seizures. A current Care Plan, initiated 2/16/2024, indicated…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, record review and interview, the facility failed to ensure the physician was notified timely of significant changes in condition for 3 of 13 residents reviewed. (Residents 2, 5 and 38) Findings include: 1. The clinical record for Resident 38 was reviewed on 7/25/2023 at 2:19 P.M. Resident 38 was admitted to the facility with diagnoses including, but not limited to: osteomyelitis of the vertebra, sacral and sacrococcygeal region, gout, idiopathic peripheral autonomic neuropathy, stage 4 pressure ulcer of the sacral region, chronic kidney disease stage 3B, glaucoma, age related osteoporosis, hypothyroidism, hypertension, cognitive communication deficit, hypokalemia, hyperlipidemia and abnormality of albumin. The admission MDS (Minimum Data Set) assessment, completed on 6/13/2023, indicated the resident was mildly cognitively impaired, had little pleasure, felt down, had little energy, trouble sleeping and poor appetite for the past 7 - 13 days. It was somewhat important to her to have snacks in between meals, had not transferred out of bed for the assessment…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review and interview, the facility failed to ensure a baseline care plan was completed and a summary was shared with the resident and/or her representative for 1 of 1 new residents reviewed for baseline care plans. (Resident 38) Finding includes: The clinical record for Resident 38 was reviewed on 7/25/2023 at 2:19 P.M. Resident 38 was admitted to the facility on [DATE] with diagnoses included, but not limited to: osteomyelitis of the vertebra, sacral and sacrococcygeal region, gout, idiopathic peripheral autonomic neuropathy, stage 4 pressure ulcer of the sacral region, chronic kidney disease stage 3B, glaucoma, age related osteoporosis, hypothyroidism, hypertension, cognitive communication deficit, hypokalemia, hyperlipidemia and abnormality of albumin. The admission MDS assessment, completed on 6/13/2023, indicated the resident was mildly cognitively impaired, had little pleasure, felt down, had little energy, trouble sleeping and poor appetite for the past 7 - 13 days. It was…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review and interviews, the facility failed to ensure a care plan meeting was conducted after an admission assessment was completed for 1 of 13 residents reviewed. (Resident 38) The facility also failed to ensure a care plan was revised and updated regarding safety measures for 1 of 3 residents reviewed for accidents. (Resident 5) Findings include: 1. The clinical record for Resident 38 was reviewed on 7/25/2023 at 2:19 P.M. Resident 38 was admitted to the facility on [DATE] with diagnoses included, but not limited to: osteomyelitis of the vertebra, sacral and sacrococcygeal region, gout, idiopathic peripheral autonomic neuropathy, stage 4 pressure ulcer of the sacral region, chronic kidney disease stage 3B, glaucoma, age related osteoporosis, hypothyroidism, hypertension, cognitive communication deficit, hypokalemia, hyperlipidemia and abnormality of albumin. The admission MDS Assessment, completed on 6/13/2023 indicated the resident was mildly cognitively impaired, had little…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review, and interview, the facility failed to ensure the medication regimen was adequately monitored for 1 of 5 residents reviewed for unnecessary medications. (Resident 21) Finding includes: The record for Resident 21, reviewed on 7/26/2023 at 9:01 A.M., indicated the resident was admitted to the facility on [DATE] with diagnoses which included, but were not limited to: Alzheimer's disease late onset, chronic systolic congestive heart failure, localization related symptomatic epilepsy and epileptic syndromes, hypertensive heart and chronic kidney disease and hypothyroidism. The current Physician Orders for medications, included an order for Levothyroxine Sodium tablet 125 mcg (microgram), one table by mouth one time a day for low thyroid hormone. The current Physician Orders for laboratory testing indicated the resident was to have a TSH (Thyroid Stimulating Hormone) level test (a test utilized to determine correct effectiveness of thyroid medication), along with other testing,…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on record review and interview, the facility failed to ensure laboratory culture results were received before initiating an antibiotic for 3 of 4 residents reviewed for antibiotic stewardship. (Residents 5, 30, and 32) Findings include: 1. During a record review, completed on 7/28/2023 at 9:00 A.M., Resident 5 returned from the ER (Emergency Room) with an order for cephalexin 500 mg (milligrams) every 8 hours for 5 days for a UTI (urinary tract infection). A C&S (culture and sensitivity) report could not be found in the record. 2. During a record review, completed on 7/28/2023 at 9:20 A.M., Resident 30 was noted to have a fall on 4/18/2023 and her urine had a foul odor. A C&S was done on 4/18/2023 and the physician ordered Macrobid 100 mg twice a day for 7 days on the same day. The results from the C&S were not received until 4/21/2023. 3. During a record review, completed on 7/28/2023 at 9:43 A.M., Resident 32 was sent to the ER and returned with an order for cephalexin 500 mg 3 times a day for 7 days. A C&S could not be found in the record. During an interview, on 7/28/2023…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.