Medicalodges Independence

Inspectors wroteThe facility reported a census of 43 residents. Based on observation, record review, and interview, the facility failed to prepare and serve food under sanitary conditions, to prevent the potential for food borne bacteria in one of one kitchen and one of one kitchenettes. This placed the residents of the facility at risk for food borne illness.

Inspectors wroteThe facility reported a census of 43 residents; the sample included 14 residents. Based on observation, interview, and record review, the facility failed to verify advanced directives (legal documents in which a person specifies what actions should be taken for their health if they are no longer able to make decisions for themselves) to ensure the outside of hospital Do Not Resuscitate Directive form (DNR- or no code, a legal document or order that means the person does not desire cardiopulmonary resuscitation [CPR] in the event of cardiac arrest) were accurate and legal to reflect Resident (R) 4, R27, and R40's advance directives. This deficient practice placed the residents at risk for impaired rights related to end-of-life care.

Inspectors wroteThe facility reported a census of 43 residents. The sample included 14 residents. Based on interview, observation, and record review, the facility failed to protect and promote the privacy, including during telephone use, for Resident (R) 145, R19 and R44. This deficient practice placed the residents at risk for negative psychosocial effects due to impaired privacy.

Inspectors wroteThe facility had a census of 43 residents. The sample included 14 residents with one resident reviewed for hospitalization. Based on interview and record review, the facility failed to issue written notification as soon as practicable for transfer for Resident (R) 2. The facility additionally failed to notify the Office of the Long Term Care Ombudsman (LTCO). This placed the resident at risk for impaired rights related to returning to the facility.

Inspectors wroteThe facility identified a census of 43 residents. The sample included 14 residents with five residents sampled for quality of care. Based on observation, interview, and record review, the facility failed to provide care and services to monitor medications for Resident (R) 11 when staff failed to monitor for effectiveness and side effects of an antibiotic and failed to follow instructions to discontinue mediations that had potential for increased adverse effects due to the antibiotic. This deficient practice placed R11 at risk for prolonged infection and adverse side effects.

Inspectors wroteThe facility identified a census of 43 residents. The sample included 14 residents with one resident reviewed for pressure ulcers (localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear and/or friction). Based on observations, interviews, and record reviews, the facility failed to provide ordered treatments to prevent pressure ulcers and promote healing for Resident (R) 16. This deficient practice placed the resident at risk of developing pressure injuries and delayed wound healing.

Inspectors wrote- R21's Electronic Health Record (EHR) revealed a diagnosis of diabetes mellitus (DM-when the body cannot use glucose, not enough insulin is made, or the body cannot respond to the insulin). R21's 04/17/25 Significant Change Minimum Data Set (MDS) documented a Brief Interview for Mental Status (BIMS) of 15, indicating intact cognition. R21 consumed a therapeutic, regular textured diet. R21 received insulin (a hormone that lowers the level of glucose in the blood) daily. R21's Care Plan documented on 02/08/25 she was at risk for hyperglycemia (high blood sugar) and hypoglycemia ( low blood sugar) related to a diabetes diagnosis and the use of insulin. The plan documented R21 needed to have her insulin administered per physician orders. R21's Physician's Order noted an order for Admelog SoloStar (fast-acting insulin). [...]

Inspectors wroteThe facility reported a census of 36 residents. Based on observation, record review, and interview, the facility failed to prepare and serve food under sanitary conditions, to the residents of the facility appropriately to prevent the potential for food borne bacteria.

Inspectors wroteThe facility reported a census of 36 residents with 15 selected for review which included one resident reviewed for dignity. Based on observation, interview and record review, the facility failed to provide cares to maintain one sampled resident's dignity, Resident (R)92.

Inspectors wroteThe facility reported a census of 36 residents with 15 residents included in the sample. Based on observation, record review, and interview, the facility failed to review and revise the care plan for one of the residents sampled, Resident (R)27 regarding staff instruction on utilizing a gait belt during transfers.

Inspectors wroteThe facility reported a census of 36 residents with 15 selected for review which included two residents reviewed for pressure ulcers. Based on observation, interview and record review the facility failed to ensure staff provided measures for pressure ulcer treatment/prevention for one Resident #92, of the two residents reviewed for pressure ulcers.

Inspectors wroteThe facility reported a census of 36 residents with 15 residents sampled, including three residents reviewed for accidents. Based on observation, interview, and record review, the facility failed to properly reposition one dependent Resident (R)4, failed to lower the bed into the low position for one dependent R 32, and failed to utilize a gait belt while transferring one dependent R 27 from her wheelchair to her bed.

Inspectors wroteThe facility reported a census of 36 residents with 15 selected for review which included five residents reviewed for unnecessary medications. Based on observation, interview and record review, the facility failed to ensure monitoring for adverse effects of psychotropic medications for two of the five sampled residents, Residents (R) 10 and R13, to ensure no unnecessary medication usage.

Inspectors wroteThe facility reported a census of 36 residents with 15 selected for review which included one resident reviewed for antibiotic usage. Based on observation, interview and record review, the facility failed ensure appropriate antibiotic use for one Resident (R)35 resident.

Inspectors wroteThe facility reported a census of 40 residents. Based on record review and interview, the facility failed to maintain an accurate accounting system of the residents' controlled narcotic medications, to enable an accurate reconciliation (a system of record keeping that ensures an accurate inventory of medications by accounting for controlled medications that have been received, dispensed, administered, and/or, including the process of disposition) and to prevent potential loss or diversion of the narcotic medications. The facility failure to maintain this system resulted in one card with 31 tablets of Resident (R)1's MS Contin (morphine narcotic medication) missing from the facility. The failure has the potential to affect all residents that recieved controlled medications. Findings Included: [...]

Inspectors wroteThe facility reported a census of 31 residents. Based on observation, interview, and record review, the facility failed to ensure ongoing antibiotic stewardship to ensure appropriate antibiotic use.

Inspectors wroteThe facility reported a census of 31 residents with 16 residents sampled, including two residents reviewed for bowel and bladder. Based on observation, interview and record review, the facility failed to care for the urinary catheter (insertion of a catheter into the bladder to drain the urine into a collection bag) in a clean manner to prevent urinary tract infections for one of the sampled Residents (R)21.