Meridian Rehabilitation and Health Care Center

Inspectors wroteBased 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 wroteBased on record review and staff interview, the facility failed to ensure comprehensive assessments were fully completed when staff failed to complete Care Area Assessments (CAA) that addressed the individual underlying causes, contributing factors and risk factors for Resident (R) 1, R2, R3, R4, R5, R7, R9, R10, R12, R15, R22, R28, R61, R71 R91, R98.

Inspectors wroteBased on observation, record review and interviews, the facility failed to provide Resident (R)2 with a dignified existence by allowing his leg urinary catheter bag to remain on his lower leg, without a dignity bag or cover.

Inspectors wroteBased on interviews and record review, the facility failed to ensure residents received the opportunity to participate in the care planning process when staff failed to invite Residents (R) 10 and R11 or their responsible party to care plan meetings.

Inspectors wroteBased on observation, record review, and interviews, the facility failed to ensure Resident (R) 100's call light was within her reach.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a safe, functional, sanitary, and comfortable environment in Resident (R) 87's bathroom. Findings Included:- On 04/27/2026 at 11:41 AM, an environmental tour with Maintenance Staff UU revealed the following concerns in R87's bathroom and handwashing area:Approximate four-foot section of loose baseboard to the left of and behind the toilet. Black substance on the wall and floor behind the loose baseboard to the left of and behind the toilet. Approximate three-inch crack in the toilet seat. Empty Hand Soap dispenser hanging from the wall above the handwashing sink with exposed lag bolt fasteners. On 04/27/2026 at 11:41 AM, Maintenance Staff UU confirmed the above findings and stated the soap dispenser did not work. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to accurately complete assessments to reflect the resident's status for four residents: Resident (R) 2 related to incontinence of urine and dependence on the staff for activities of daily living (ADL), R3 related to restraints, R9 related to falls, and R10 related to Hospice services.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a summary of the baseline care plan to Resident (R) 100.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide appropriate activity of daily living (ADL) assistance to Resident (R)2 regarding changing clothing.

Inspectors wroteBased on observation, interview, and record review, the facility failed to prevent the development of and promote the healing of pressure ulcers when staff failed to ensure R101 received necessary interventions including a low air loss mattress, heels were offloaded, and a consistent repositioning plan.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure an environment free from accident hazards when staff failed to utilize appropriate foot pedals when propelling Resident (R) 2 in his wheelchair causing his feet to not remain safely on the foot pedals during transportation.

Inspectors wroteBased on interview and record review, the facility failed to ensure Residents (R)28 remained free from unnecessary medications when staff failed to administer as needed (PRN) bowel medication for constipation.

Inspectors wroteBased on observation, interview, and record review, the facility failed to dispose of garbage and refuse properly by failing to ensure the lid of the dumpster was kept closed.

Inspectors wroteBased on observation and interview, the facility failed to ensure a safe and sanitary environment in the facility laundry.

Inspectors wroteThe facility reported a census of 96 residents with seven residents reviewed for abuse, neglect, exploitation and/or misappropriation of resident property. Based on observation, interview and record review, the facility failed to send completed investigation reports to the State Agency (SA) within five working days of the alleged incident(s) as required.

Inspectors wroteThe facility reported a census of 96 residents. Based on observation, interview, and record review, the facility failed to prevent the neglect of cognitively impaired Resident (R)53, who had mental health disorder diagnoses, anger related to living in the facility, and a history of exit seeking, and the facility staff did not respond to his suicidal ideation statements after his elopement (when a cognitively impaired resident leaves the facility without the knowledge or supervision of staff). On [DATE], R53 eloped from the facility. When staff returned R53 to the facility, they placed a Wander Guard (a bracelet that sets off an alarm when residents wearing one attempt to exit the building without an escort) on R53, and he reported he would never eat again. On [DATE] at 04:00 PM, R53 made statements such as give me a gun so I can shoot myself. [...]

Inspectors wroteThe facility reported a census of 96 residents and the facility identified five residents at risk for elopement. Based on observation, interview, and record review the facility failed to provide adequate supervision to cognitively impaired, independently mobile Resident (R)53, identified as a high risk for elopement. On 06/29/24 at approximately 07:15 AM, staff were unable to locate R53 in the facility. On 06/29/24 at approximately 08:30 AM, staff located R53 approximately two miles away from the facility. R53 walked down busy residential areas with a 35 mile per hour speed limit and would have crossed 20 cross walks and crossed over two river bridges. This deficient practice placed R53 in immediate jeopardy. Furthermore, the facility failed to keep R54 safe, related to fall hazards in R54's room.

Inspectors wroteThe facility reported a census of 96 residents. The sample included 20 residents. Based on observation, interview, and record review, the facility failed to ensure the appropriate treatment and services to attain the highest practicable mental and psychosocial well-being of cognitively impaired Resident (R)53, who had a mental health disorder diagnoses, portrayed anger related to living in the facility, a history of exit seeking, and the facility staff did not respond to his suicidal ideation statements after his elopement (when a cognitively impaired resident leaves the facility without the knowledge or supervision of staff). On [DATE], R53 eloped from the facility. [...]

Inspectors wroteThe facility reported a census of 96 residents. Based on interview and record review, the facility failed to provide direct care staff annual evaluations/performance reviews for five of the five certified nursing assistants sampled, to determine strengths and weaknesses in providing resident care.

Inspectors wroteThe facility reported a census of 96 residents. Based on interview and record review, the facility failed to develop, implement, and maintain an in-service training program to ensure staff completed the required 12-hour in-service education for five of the five Certified Nurse Assistants (CNA) sampled, who were employed by the facility for at least one year. This deficient practice placed the residents at risk of decreased quality of care.

Inspectors wroteThe facility reported a census of 96 residents. Based on interview and record review, the facility failed to develop, implement, and maintain an effective training program for all staff, which included, at a minimum, training on behavioral health care and services that was appropriate and effective. This failure placed all 96 residents at risk of not reaching their highest practicable well-being.

Inspectors wrote- The Physician Orders dated 04/01/24 revealed the following diagnoses for Resident (R) 81 had diagnoes that included diabetes mellitus (when the body cannot use glucose, not enough insulin made, or the body cannot respond to the insulin) and end stage renal disease (a terminal disease because of irreversible damage to vital tissues or organs). The Significant Change Minimum Data Set (MDS) dated [DATE] revealed a Brief Interview for Mental Status (BIMS) score of 14, indicating intact cognition. Review of the functional abilities and goals indicated R 81 required substantial/maximal assistance with bathing. The Quarterly MDS dated 06/12/24 revealed no changes in memory or abilities. Review of the Care Plan dated 05/07/23 regarding Care/Activities of daily living (ADL) preferences indicated R 81 preferred a shower two times a week as tolerated, revised on 12/02/23. [...]

Inspectors wroteThe facility reported a census of 96 residents which included 28 residents that smoked. The facility Identified three designated smoking areas of the facility. Based on observation, interview, and record review, the facility failed to provide a safe, functional, sanitary, and comfortable environment for 28 residents that smoked in three of the three designated smoking areas and the service hallway the residents had travel through to the southeast smoking area that was in need of cleaning and/or repairs. Findings Included: - On 07/30/24 at 08:00 AM, on entrance to the facility at the Northeast entrance, noted a stale musty odor prevalent odor throughout the facility during the initial tour. On 07/30/24 at 10:10 AM, Resident (R)54 and R 26, residents of the men's memory care unit (400 hall), were observed smoking on the courtyard adjacent to the locked unit. [...]

Inspectors wroteThe facility reported a census of 96 residents with 20 residents selected for review. Based on observation, interview, and record review, the facility failed to accurately complete the Minimum Data Set (MDS) for five of the sampled residents. Resident (R) 28 and R(47) related inaccurate documentation of medications. R (41), R(54) and R(82) related inaccurate documentation on falls. These deficient practices had the potential to lead to uncommunicated need for care and services to meet each individual resident's needs.

Inspectors wroteThe facility reported a census of 96 residents. The sample of 20 residents included four dependent residents sampled for choices/preferences related to bathing, and two residents reviewed for accident/falls. Based on observation, interview, and record review, the facility failed to review and revise the care plan for four Residents (R)92, R73, R 74, R 81 related to bathing preferences/choices and R 54 and R 41 related to accidents/falls to prevent further falls.

Inspectors wroteThe facility reported a census of 96 residents. The sample of 20 residents included five dependent residents sampled for personal hygiene related to bathing, nail care, hair trimming, and facial hair. Based on observation, interview, and record review, the facility failed to ensure necessary services to maintain good personal hygiene for Resident (R)92, 73, 74, 81, and R 82 related to bathing, nail care, hair care and/ or unwanted facial hair.

Inspectors wroteThe facility reported a census of 96 residents. Based on observation, interview, and record review, the facility failed to serve food that is palatable, and at a safe and appetizing temperature for the residents of the facility.

Inspectors wroteThe facility reported a census of 96 residents. Based on observation and interview, the facility failed to provide adequate ventilation in the beauty shop. The facility lacked ventilation to the outside by means of a window, mechanical vent or the combination of to promote good air circulation, as required.

Inspectors wroteThe facility reported a census of 96 residents, that included 20 residents included in the sample. Based on interview and record review, the facility failed to include Resident (R)61 in the development and planning of the resident's care plan quarterly, which placed R81 at risk of impaired care and autonomy.

Inspectors wroteThe facility reported a census of 96 residents. The sample included 20 residents with four residents selected for review related to resident rights to retain and use of their personal possessions. Based on observation, interview , and record review, the facility failed to ensure the resident right to retain and use her personal possessions for Resident (R)63 related to her motorized wheelchair and R 54's missing coat.

Inspectors wroteThe facility reported a census of 96 residents with three residents reviewed for Medicare Advance Beneficiary and Medicare Non-Coverage Notices. Based on record review and interview, the facility failed to notify one resident, Resident (R)22, ABN (provides information to beneficiaries so that they can decide if they wish to continue receiving the skilled services that may not be paid for by Medicare and assume financial responsibility before the end of a Medicare covered Party), or a NOMNC (a form given to all Medicare beneficiaries at least two days before the end of a Medicare covered part A stay or when all of Part B therapies are ending), as required.

Inspectors wroteThe facility had a census of 96 residents. The sample included 20 residents. Based on observation, interview and record review, the facility failed to provide consistent activities for two residents. Resident (R)41 and R82 were observed not to have received activities on the Memory Care Unit. This deficient practice placed the residents at risk for complications related to decreased psychosocial wellbeing.

Inspectors wroteThe facility reported a census of 96 residents with 20 residents in the sample, that included one resident reviewed for dialysis (procedure where impurities or waste were removed from the blood). Based on observation, interview, and record review, the facility failed to ensure staff obtained vital signs or the dialysis site after Resident (R)81 received dialysis (procedure where impurities or waste were removed from the blood).

Inspectors wroteThe facility reported a census of 96 residents, that included 20 residents included in the sample. The sample included six residents for unnecessary medications. Based on observation, interview, and record review, the facility failed to ensure Resident (R)61's medication was available for administration without missed doses. This deficient practice placed R61 at risk of unnecessary complications from not receiving his medication, as ordered by the physician.

Inspectors wroteThe facility had a census of 96 residents. The sample included 20 residents. Based on observations, interview and record review, the facility failed to honor a food preference for Resident (R)41. Staff served R 41 pork when documented on her meal ticked as no pork. This deficient practice placed the resident at risk for inadequate care and services.

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents, with six reviewed for accidents. Based on observation, record review, and interview, the facility failed to prevent a fall for Resident (R) 35, who fell from her wheelchair due to non-functioning brakes, and obtained a femur fracture (broken thigh bone). The facility further failed to assess R33, who was a fall risk, for the use of side rails. This placed the residents at risk for injury.

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents. Based on observation, record review, and interview, the facility failed to employ a full time Certified Dietary Manager for the 92 residents who resided in the facility and received their meals from one of one kitchen, which placed the residents at risk not to receive adequate nutrition.

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents. Based on observation, record review and interview, the facility failed to store, prepare, and serve food under sanitary conditions for meals prepared in the facility's kitchen, which placed the residents at risk of consuming contaminated food.

Inspectors wroteThe facility had a census of 92 residents. Based on observation, record review, and interview, the facility failed to maintain an effective quality assessment and assurance (QAA) program to develop corrective actions plans and monitor them to correct identified quality deficiencies prior to survey. This deficient practice placed the residents at risk for ineffective care.

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents. Based on observation, record review, and interview the facility failed to adhere to infection control practices for COVID-19 (a virus which is characterized mainly by fever and cough, and is capable of progressing to severe symptoms and in some cases causes death especially in older people, and those with underlying health conditions) droplet isolation precautions which placed the residents who resided in the facility at increased risk for contracting COVID-19 infection and failed to implement a water management program for the Legionella disease (Legionella is a bacterium spread through mist, such as from air-conditioning units for large buildings. [...]

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents. Based on observation, record review, and interview, the facility failed to act promptly upon the concerns of the resident council group concerning issues of care and life in the facility. This placed the residents at risk of decreased quality of care and services.

Inspectors wroteThe facility had a census of 92 residents. Thirteen residents resided on the secured female memory care unit. Based on observation, record review, and interview the facility failed to provide housekeeping services to maintain a sanitary and homelike environment for the 13 residents who reside on the memory care unit. This placed the residents at risk for reduced quality of life.

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents. Based on observation, record review, and interview, the facility failed to monitor medication room refrigerator temperatures of one of two medication rooms, and lock one of five medication carts which placed residents at risk receiving ineffective medication stored in the medication room refrigerator and leave an unattended, unlocked medication cart which placed residents at risk of unintended ingestion/loss of medications.

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents. Based on record review and interviews the facility failed to obtain immunization status, provide immunization, or obtain an informed declination for five residents, Resident (R) 13, R34, R33, R81, and R82, with the current Center of Disease Control and Prevention (CDC) influenza (flu) and/or pneumococcal (pneumonia-respiratory illness) immunization which placed the residents at risk for contracting influenza or pneumonia.

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents, with five reviewed for abuse. Based on observation, record review, and interview, the facility failed to prevent an incident of neglect for Resident (R)36, when staff willfully refused to provide R36 the required level of toileting assistance. The facility furtehr failed to prevent resident to resident abuse by Resident (R)194, who had multiple resident to resident altercations. This deficient practice placed the residents at risk for injury and impaired physical and psychosocial well-being. Findings Included: - R36's Electronic Medical Record (EMR) documented diagnoses including a fractured femur (thigh bone) and dementia (progressive mental disorder characterized by failing memory, confusion). [...]

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents. Based on record review and interview, the facility failed to report incidents of resident-to-resident abuse involving Resident (R) 194 to the state agency as required. The placed the residents at risk for ongoing injury and unidentified abuse or mistreatment. Findings Included: - The Electronic Medical Record (EMR) for R194 documented diagnoses of Alzheimer's disease (a progressive disease that destroys memory and other important mental functions), dementia (progressive mental disorder characterized by failing memory, confusion), and anxiety (a feeling of worry, nervousness, or unease). [...]

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents. Based on record review and interview, the facility failed to investigate incidents of resident-to-resident abuse involving Resident (R) 194. This placed the residents at risk for unidentified and ongoing abuse or mistreatment.

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents with two reviewed for hospitalization. Based on observation, interview, and record review the facility failed to provide a bed hold notice to Resident (R)51, upon admission to the hospital twice. This deficient practice placed R51 at risk impaired rights to return to her original facility room upon return from the hospital.

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents. Based on interview and record review the facility failed to develop a baseline care plan for Resident (R)293's immediate health and safety needs, including dietary, activities of daily living (ADL) assistance, communication barriers, and respiratory. This deficient practice placed R293 at risk for inadequate care and services related to her health and safety.

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents. Based on observation, interview and record review the facility failed to develop a comprehensive care plan for Resident (R) 72's diabetic and wound care needs. The facility further failed to develop a care plan for R293's health and safety needs, including dietary, activities of daily living (ADL) assistance, respiratory and communication. This deficient practice placed the residents at risk for inadequate care and services. Findings Included: [...]

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents. Based on observation, interview, and record review the facility failed to review and revise the care plan for Resident (R)51 regarding her use of supplemental oxygen and R34 for dialysis (a process of purifying the blood of a person whose kidneys are not working normally) related care. This deficient practice placed R51 at risk for inadequate care related to her use of oxygen and R34 at risk for inadequate care related to dialysis.

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents, with seven reviewed for activities of daily living (ADLs). Based on observation, record review, and interview, the facility failed to provide consistent bathing services for Resident (R) 16 and R35. This placed the residents at risk for impaired dignity and skin issues.

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents with four reviewed for pressure ulcers (wound to skin and underlying tissue resulting from prolonged pressure on the area). Based on observation, record review and interview, the facility failed to involve the Registered Dietician (RD) for nutritional interventions for one of four sampled residents, Resident (R) 72, who developed a facility acquired pressure ulcer. This placed the resident at risk to worsen his current pressure ulcer or develop more skin issues.

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents with two reviewed for respiratory treatment. Based on observation, interview, and record review the facility failed to provide adequate respiratory care and services regarding Resident (R)51's use of supplemental oxygen. This deficient practice placed R51 at risk for less than optimal oxygen therapy.

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents with one reviewed for dialysis (the process of removing excess water, solutes, and toxins from the blood in people whose kidneys can no longer perform these functions naturally). Based on observation, interview and record review the facility failed to provide care and services for Resident (R) 34 with regard to his dialysis access when staff did not routinely assess the access site and lacked ongoing communication between the dialysis center and facility. This deficient practice placed R34 at risk for avoidable complications related to dialysis.

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents with six reviewed for accident hazards. Based on observation, record review and interview, the facility failed to complete an assessment for the safe use of side rails for one sampled resident, Residents (R) 33. This placed the resident at risk for entrapment and injuries related to side rail use.

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents, with three reviewed for dementia (progressive mental disorder characterized by failing memory, confusion) care. Based on observation, record review, and interview, the facility failed to provide the necessary person-centered dementia care to attain the highest practicable physical, mental, and psychosocial well-being for one sampled resident, Resident (R) 194, who had multiple incidents of behaviors and resident-to-resident altercations. This placed the resident at risk for injury and unmet physical and psychosocial needs. Findings Included: [...]

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents with five reviewed for unnecessary drugs. Based on observation, interview and record review the facility failed to obtain a copy and act upon the Consultant Pharmacist (CP) recommendations for Resident (R) 36's medication regimen review. This deficient practice placed R36 at risk for medication related issues.

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents with five residents reviewed for unnecessary medications. Based on observation, record review, and interview the facility failed to notify the physician of elevated blood sugars out of the physician ordered parameters for Resident (R) 72 and failed to complete a physician ordered laboratory test for R36. This placed the residents at risk for adverse side effects and health problems.

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents. Based on observation, interview and record review the facility failed to ensure the resident received drinks consistent with her preferences for Resident (R)86 who requested milk with every meal. This deficient practice placed R86 at risk to not have her rights and choices respected.

Inspectors wroteThe facility had a census of 92 residents. The sample included 22 residents. Based on record review and interviews the facility failed to obtain immunization status, provide immunization, or obtain an informed declination for three of five sampled residents, Resident (R) 13, R34, and R82, for COVID-19 ( highly contagious, potentially fatal respiratory virus) immunization which placed the residents at increased risk for contracting COVID-19.