Nhc Healthcare, Milan

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on policy review, job description review, medical record review, observation, and interview, the facility failed to ensure the environment was free from accident hazards when hot water temperatures ranging from 120 degrees Fahrenheit (F) to 138 degrees F were found in 23 of 92 (Resident #2, #11, #13, #23, #27, #28, #33, #46, #58, #63, #65, #66, #71, #76, #77, #82, #84, #87, #88, #90, #95, #105 and #106) Residents' bathrooms. Eleven Residents who were physically and/or cognitively impaired (Residents #11, #27, #28, #33, #46, #63, #65, #66, #71, #77, and #95) resided in a room with elevated hot water temperatures and nine of the cognitively impaired residents were able to access the hot water in their rooms. The findings include: 1. Review of the undated facility policy titled, Water Quality Management Program, revealed .committed to providing a safe environment for our patients. Review of the undated TELS [(The Equipment Lifecycle System) - a platform used to promote a safer environment]: Test and Log the…

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 policy review, resident trust account review, medical record review, and interview, the facility failed to refund the residents' funds within 30 days of death or discharge for 2 of 52 sampled residents (Resident #109 and #110) reviewed for trust fund account statements. The findings include: 1. Review of the facility policy titled, Patient Trust, dated 10/2010, revealed .The balance remaining for a patient's trust fund account should be refunded as soon as all transactions are fully accounted for after a patient is discharged or deceased .the funds should be refunded within 30 days of death or discharge. 2. Review of the medical record revealed Resident #109 was admitted to the facility on [DATE], with diagnoses including Hemiplegia, Pneumonia, Dysphagia, and Dementia. Review of the Nurse's Note dated [DATE], revealed .Death pronounced at this time . Review of Resident #109's Quarterly Trust Fund statement from [DATE] through [DATE], revealed an account balance of $3,843.98. 3. Review of the medical…

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 policy review, record review, observation, and interview, the facility failed to provide care and services for residents with a percutaneous enteral gastrostomy (PEG) tube (a tube inserted through the skin and into the stomach to administer medications and supplements) when staff failed to administer the ordered enteral feeding and failed to check the residual volume for 2 of 2 residents (Resident #4 and #97) reviewed for tube feedings. The findings include: 1. Review of the facility policy titled, Peg tube medication administration, dated 12/2019, revealed .Check to see if the exit of the tube [PEG tube] was marked upon initial insertion. If tube was not marked check gastric residual volume unless the patient is able to verbalize discomfort such as nausea/vomiting, bloating. 2. Review of the medical record revealed Resident #4 was admitted to the facility on [DATE], with diagnoses including Aphasia, Dysphagia, Diabetes, and Heart Failure. Review of the quarterly Minimum Data Set (MDS) assessment dated…

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 record review, observation, and interview, the facility failed to maintain emergency supplies at bedside for 2 of 2 (Resident #4 and #97) sampled residents reviewed for tracheostomy care. The findings include: 1. Review of the medical record revealed Resident #4 was admitted to the facility on [DATE], with diagnoses including Hemiplegia, Tracheostomy, Chronic Respiratory failure, Chronic Obstructive Pulmonary Disease, Dysphagia, and Heart Failure. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE], revealed a Brief Interview for Mental Status (BIMS) was not completed due to Resident #4 was unable to be interviewed. Resident #4 was dependent on staff for activities of daily living (ADLs) and received Tracheostomy care. Review of the Care Plan dated [DATE], revealed .He [Resident #4] will not exhibit s/s [signs and symptoms] of complications r/t [related to] presence of tracheostomy . Observations in Resident #4's on [DATE] at 10:25 AM and [DATE] at 8:05 AM, in Resident #4's room,…

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 observations and interviews, the facility failed to ensure posted Daily Staffing information was accurate for dates 8/26/2025 and 8/27/2025. The findings include: Observations in the hallway at the North Wing nurse's station and the South Wing nurse's station on 8/26/2025 at 7:31 AM, 10:10 AM, and 1:22 PM, revealed the posted Daily Staffing information was dated 8/25/2025. Observations in the hallway at the North Wing nurse's station and the South Wing nurse's station on 8/27/2025 at 9:00 AM and 10:35 AM, revealed the Daily Staffing information was dated 8/26/2025. During an interview on 8/27/2025 at 10:37 AM, the Assistant Director of Nursing (ADON) confirmed that she was responsible for posting the Daily Staffing at the North Wing nurse's station and the South Wing nurse's station, and the Daily Staffing should be posted first thing in the morning. During an interview and observation at the North Wing nurses' station on 8/27/2025 at 10:46 AM, the ADON confirmed the Daily Staffing posted was dated 8/26/2025.

Based on the Refrigerator Temperature Log review, observation, and interview the facility failed to ensure medications were properly stored when 1of 3 (South Wing) medication refrigerator temperature logs had no documentation for 13 out of 26 days. The findings include: 1. Review of the facility's Refrigerator Temperature Log, dated 8/2025, revealed .Proper medication refrigerator temperature range is between 36 [degrees] - (and) 46 [degrees] Fahrenheit. 2. Observation in the South Wing Medication Storage Room on 8/27/2025 at 9:36 AM, revealed the Refrigerator Temperature Log dated 8/2025, revealed there was no documentation for the refrigerator temperature on 8/3/2025-8/5/2025, 8/9/2025, 8/10/2025, 8/12/2025, 8/14/2025, 8/16/2025, 8/17/2025, 8/20/2025, and 8/22/2025-8/24/2025. 3. During an interview on 8/27/2025 at 3:50 PM, the Director of Nursing (DON) was asked how often the medication refrigerator temperatures should be checked and logged. The DON stated, Daily. The DON confirmed that staff would not be able to ensure refrigerated medications were being stored at the proper…

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 policy review, medical record review, observation, and interview, the facility failed to ensure proper infection control practices were followed when 1 of 1 staff members (Registered Nurse (RN) B) failed to wear personal protective equipment (PPE) and failed to perform hand hygiene during medication administration for 1 of 5 (Resident #11) sampled residents. The findings include: 1. Review of the undated facility policy titled, Hand Washing and Hand Sanitizer, revealed .Hand Hygiene is the primary means to prevent the spread of infection.Wash or sanitize hands after contact with patient .removal of gloves. Review of the facility policy titled, .Enhanced Barrier Precautions, dated 2/2025, revealed .Enhanced Barrier Precautions (EBP) refers to an infection control intervention designed to reduce transmission of multidrug-resistant organisms .that employs targeted gown and glove use during high contact activities .Providers and partners must wear gloves and a gown for the following.Device care or use…

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 policy review, job description review, record review, observations, and interview, the facility failed to ensure each resident's environment was safe when 1 of 64 resident rooms on the 100 Hall was a vacant and being renovated. The unlocked and unattended 100 Hall room contained hazardous chemicals and materials including paint, an uncovered bucket with a mixture of paint and water liquid used to clean paint rollers, caulking, nails, screws, and sheetrock mud, and was accessible by residents. The findings include: 1. Review of the undated facility policy titled NHC Storage of Hazardous Chemicals, revealed Hazardous chemicals are to be stored out of the reach of patients . 2. Review of the Administrator's job description signed and dated 12/8/2022, revealed .The Administrator has complete administrative and managerial responsibilities within the health care center .Ability to interpret and implement regulations (state and federal) .Promote safety awareness .Assures compliance with State and Federal…

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 review of the Partner Handbook and Social Work Services Manual, observation, and interview, the facility failed to maintain or enhance resident dignity and respect when 4 of 18 staff members (Certified Nursing Assistant (CNA) #1, #5, #6, and #7) failed to knock before entering a resident's room and did not use courtesy titles to address residents. The findings include: Review of the facility's undated handbook titled, [Named company] Partner Handbook, revealed .CARING IN A BETTER WAY DAY BY DAY .combines the best clinical care with the best customer satisfaction for patients .Respect your privacy, dignity . Review of the facility's Social Work Services Manual, revised 6/2006, revealed .The Guarantee of rights that depends on the actions of PARTNERS are requirements for personnel .The right to respect and dignity are requirements for the partners . Observation in Resident #44's room during dining on 6/28/21 at 11:41 AM, revealed CNA #1 stated, .she is a feeder, within hearing distance of the resident.…

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 review of the Centers for Disease Control (CDC) and Prevention guidance, policy review, observation, and interview, the facility failed to food was served under sanitary conditions when 6 of 18 staff members (Certified Nursing Assistant (CNA) #1, #2, #3, #5, #6, and #7) failed to don appropriate personal protective equipment (PPE) when entering a contact isolation room, failed to perform hand hygiene after touching potentially contaminated objects before serving residents meals, used their bare hands to handle a resident's food, failed to perform hand hygiene before and after glove use, failed to perform hand hygiene between serving residents, and used long acrylic nails to open a carton of milk. The findings include: Review of the facility's specialized CNA training titled, 000 Training revised 2/11/2013, revealed .MEAL DELIVERY - DINING ROOM .HANDS SHOULD BE WASHED ANYTIME YOU COME IN CONTACT WITH PATIENT OR EQUIPMENT . Review of the facility's policy titled, .TRANSMISSION-BASED PROCEDURES…

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 medical record review, observation, and interview, the facility failed to ensure a resident's indwelling urinary catheter bag did not touch the floor for 1 of 2 sampled residents (Resident #13) reviewed with indwelling urinary catheters. The findings include: Review of the medical record, revealed Resident #13 was admitted to the facility on [DATE] with diagnoses of Epilepsy, Chronic Respiratory Failure, Neuromuscular Dysfunction of Bladder, Anoxic Brain Damage, Tracheostomy, and Gastrostomy. Review of the admission Minimum Data Set (MDS) assessment dated [DATE] revealed that Resident #13 had an indwelling urinary catheter. Review of the Physician Order dated 5/18/2021, revealed .Indwelling Catheter . Observation in Resident #13's room on 6/28/2021 at 10:56 AM and 4:45 PM, revealed that the indwelling urinary catheter bag was lying on the floor. During an interview on 6/30/2021 at 12:34 PM, the Director of Nursing (DON) confirmed that the indwelling urinary catheter bag should not be in the floor.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on policy review, medical record review, and interview, the facility failed to thoroughly investigate an allegation of abuse for 1 of 2 (Resident #84) abuse incidents reviewed. The findings include: The facility's Patient Protection and Response Policy for Allegations/Incidents of Abuse, Neglect, Misappropriation of Property and Exploitation policy revised 12/11/17 documented, .INTERNAL INVESTIGATION POLICY .All events reported as possible abuse, neglect, or misappropriation of patient property will be investigated to determine whether the alleged abuse, neglect, misappropriation of patient property or exploitation did or did not take place. The Administrator or Director of Nurses will determine the direction of the investigation once notified of alleged incident .The investigation is conducted immediately under the following circumstances .When it is identified that an alleged incident may have occurred .When there is a question as to whether to conduct an investigation, it is best to do so . Medical…

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 policy review, Infection Control Manual review, medical record review, observation, and interview, the facility failed to maintain infection control practices for 1 of 2 (Resident #60) sampled residents reviewed for urinary catheters and failed to provide effective dialysis communication for 1 of 2 (Resident #340) sampled residents reviewed for isolation. The findings include: 1. The facility's undated USE OF FOLEY CATHETER policy documented, .Follow the Physician Order for use of the foley catheter .decrease risk of infection related to retention of urine in the bladder . 2. Medical record review revealed Resident #60 was admitted to the facility on [DATE] with diagnoses of Parkinson's Disease, Dementia, Chronic Kidney Disease, Diabetes, Depression, Neuromuscular Dysfunction of Bladder, Retention of Urine, and Benign Prostatic Hyperplasia. A physician's order dated 6/4/19 documented, .Indwelling Catheter change every month due to Neurogenic Bladder/Urinary Retention . 3. Observations in Resident #60's…

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.