Miller's Health & Rehab by Miller's Merry Manor

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure a resident was assessed to self-administer medications and had physician's orders for the medications for 2 of 2 residents reviewed for self-administration of medication. (Residents 23 and F)1. During random observations on 7/21/25 at 11:00 a.m. and 3:24 p.m., on 7/22/25 at 10:18 a.m. and 3:33 p.m., on 7/23/25 at 9:37 a.m. and 2:38 p.m., and on 7/24/25 at 11:13 a.m., Resident 23 was observed sitting in a recliner chair. At those times, there was a tube of Neosporin cream on the over bed table. During an interview on 7/21/25 at 11:00 a.m., the resident indicated he used the cream for his dry skin on his arms. On 7/24/25 at 11:26 a.m., RN 1 entered the resident's room and observed the Neosporin cream on the over bed table. [...]

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure personal privacy was maintained related to the computer screen being left open with resident information visible on 1 of 2 units throughout the facility. (The 100 unit)

Inspectors wroteBased on record review and interview, the facility failed to ensure a stat (immediate) chest X-ray was reported timely, eye drops were administered as ordered by the physician, a skin tear was treated and monitored, and a resident was treated for constipation for 1 of 1 resident reviewed for hospitalization and 1 of 1 resident reviewed for constipation. (Residents B and G)

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure wound vac (vacuum) tubing was kept off the floor and treatments were followed as ordered by the physician for 2 of 4 residents reviewed for pressure ulcers. (Residents F and 44)

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure indwelling Foley (urinary) catheter tubing was kept off the floor, urinary outputs were documented, and urinalysis was collected in a timely manner for 2 of 3 residents reviewed for catheters. (Residents H and E)

Inspectors wroteBased on record review and interview, the facility failed to ensure food consumption logs and health supplements were completed for a resident with a history of weight loss for 1 of 1 resident reviewed for nutrition. (Resident 3)

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure clinical records were complete and accurately documented related to a resident's temperature on the Infection Control Assessment for 1 of 1 residents reviewed for urinary tract and respiratory infections, completed meal consumption and monitoring intake of nutritional supplements for 1 of 1 residents reviewed for nutrition, discontinuing pressure injury treatments for 1 of 2 residents reviewed for pressure ulcers, and the documentation of oxygen when not in use for 1 of 3 residents reviewed for oxygen therapy. (Residents 25, 40, 48 and 11)

Inspectors wroteBased on record review and interview, the facility failed to ensure a resident's preferences were honored related to the type of diet they received for 1 of 1 resident reviewed for choices. (Resident 50)

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure individualized Care Plans were developed and implemented related to behaviors for 1 of 15 residents reviewed for care plan development and implementation. (Resident 22)

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure bruised areas were assessed and monitored, and non-pressure skin treatments were completed as ordered, for 2 of 4 residents reviewed for non-pressure skin conditions. (Residents 40 and 6)

Inspectors wroteBased on observation, record review, and interview, the facility failed ensure adequate supervision was provided for a resident related to fall interventions for 1 of 1 resident reviewed for falls. (Resident 48)

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure oxygen was set at the correct flow rate, for 2 of 3 residents reviewed for respiratory care (Residents 49 and 44)

Inspectors wroteBased on record review and interview, the facility failed to ensure blood pressure and diuretic medications were not administered outside of their physician ordered parameters for 3 of 6 residents reviewed for unnecessary medications. (Residents 40, 49, and 6)

Inspectors wroteBased on record review and interview, the facility failed to ensure a resident was not given a medication listed as an allergy, making them at risk for potential adverse consequences, related to antibiotics for an urinary tract infection (UTI), for 1 of 3 residents reviewed for infections. (Resident B)

Inspectors wroteBased on record review and interview, the facility failed to ensure a resident was assessed and monitored after a fall, and failed to ensure the responsible party and Physician were notified after a fall for 1 of 3 residents reviewed for falls. (Resident C) The deficient practice was corrected on 10/31/23, prior to the start of the survey, and was therefore past noncompliance. The facility completed an investigation and inserviced staff regarding post fall procedures.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure residents had Physician's Orders for medications and an assessment to self-administer their own medications for 1 of 1 residents reviewed for self-administration of medication. (Residents 36)

Inspectors wroteBased on observation, record review and interview, the facility failed to ensure the Physician was notified of treatment refusals for 1 of 1 residents reviewed for notification of change. (Resident 8)

Inspectors wroteBased on record review and interview, the facility failed to protect the residents' right to be free from misappropriation of property related to stolen jewelry by CNA 1 for 2 of 2 residents reviewed for misappropriation of property. (Residents 50 and 23) The deficient practice was corrected by 2/17/23, prior to the start of the survey, and was therefore past noncompliance. The facility thoroughly investigated the missing jewelry as well as notified the police. A report was initiated by the police department and a detective was assigned to the case. CNA 1 was terminated as she failed to return phone calls or come back to the facility for a statement. The case was still open as some of the jewelry was still missing.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure dependent residents received the necessary care to maintain Activities of Daily Living (ADLs) related to turning and repositioning in bed and dirty fingernails for 2 of 4 residents reviewed for ADLs. (Residents 164 and 36)

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure areas of bruising were assessed and monitored, and geri-sleeves (protective skin sleeves) were applied as ordered for 1 of 1 residents reviewed for anticoagulant (blood thinning) medication side effects and 2 of 3 residents reviewed for skin conditions non-pressure related. (Residents 30, 22, and 33)

Inspectors wroteBased on interview and record review, the facility failed to ensure residents received proper treatment and assistive devices to maintain hearing abilities related to not monitoring and assisting with a resident's hearing aid for 1 of 1 resident reviewed for hearing. (Resident 23)

Inspectors wroteBased on record review and interview, the facility failed to ensure residents maintained acceptable parameters of nutritional status related to meal consumption records not completed for residents with a history of weight loss and supplements not provided as ordered for 1 of 1 residents reviewed for nutrition. (Resident 19)

Inspectors wroteBased on record review and interview, the facility failed to manage medications appropriately related to administering medications as ordered for 1 of 5 residents reviewed for unnecessary medications. (Resident 16)

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure medications were labeled correctly related to eye drops and insulin for 2 of 4 residents observed during medication pass (Residents 46 and 167)

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure infection control guidelines were in place and implemented related to an indwelling foley catheter on the floor and improper cleaning of a glucometer for 1 of 1 residents reviewed for catheters and 1 of 1 observations of a glucometer. (Residents 164 and 46)