Monroe City Manor Care Center

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure the range hood was free of an accumulation of grease and debris, failed to ensure the floors in the kitchen were free of a buildup of grease and debris, and failed to properly store food items. The facility census was 54.1. Review of the facility policy, Cleaning Instructions: Hoods and Filters, dated 2020, showed hoods and filters will be cleaned regularly, at least once a month. Review of the Dietary Sanitation Evaluation, dated 6/6/25 and completed by the facility's consultant dietitian, showed the hoods and filters were not clean and dust was noted. Review of the Dietary Sanitation Evaluation, dated 7/11/25 and completed by the facility's consultant dietitian, showed the hoods and filters were not clean and had dust. [...]

Inspectors wroteBased on interview and record review, the facility failed to offer and/or administer the pneumococcal vaccine as indicated by the current Centers for Disease Control and Prevention (CDC) guidelines for three residents (Residents #1, #38 and #47), in a review of 17 sampled residents. The facility census was 54. Review of the CDC's Pneumococcal Vaccine Timing for Adults, updated October 2024, showed the following:-For adults 50 years or older who have never received any pneumococcal vaccine or whose previous vaccination history is unknown, administer PCV15, PCV20, or PCV21; -If PCV15 is administered, administer a dose of PPSV23 at least one year after the dose of PCV15. [...]

Inspectors wroteBased on interview and record review, the facility failed to implement policies and procedures to ensure residents' trust accounts were not allowed to go into a negative balance which affected one resident (Resident #40), in a review of seven sampled residents for which the facility maintained accounts. The facility census was 54. Review of the undated facility policy, Management of Residents' Personal Funds, showed the following:-The resident may have the facility hold, safeguard, and manage his or her personal funds;-Should the facility manage the resident's funds, the facility acts as a fiduciary of the resident funds and holds, safeguards, manages and accounts for the personal funds of the resident;-Inquiries concerning the facility's management of resident funds are referred to the administrator or to the business office. 1. [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to follow physician orders for one resident (Resident #51), in a review of 17 sampled residents, when staff did not compare the pharmacy label of a medication card against the medication administration record and administered the wrong dose of medication to the resident. Staff also failed to follow manufacturer's recommendation and professional standards when administering eye drops for one resident (Resident #2), when pressure was not applied and held to the inside corner of the eye (inner canthus), after administration. The facility census was 54. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure dietary equipment was free of an accumulation of grease, oil, dust and debris, failed to remove damaged food containers from the dry storage room, failed to seal/date opened packages, and failed to ensure an ice machine drain contained a drainage air gap. The facility census was 54. Review of the facility's Cleaning Rotation Policy, 2011 Edition, showed the following: -Guideline - Equipment and utensils will be cleaned according to the following guidelines, or manufacturer's instructions; -Items cleaned after each use included can opener, small food preparation equipment, work tables and counters; -Items cleaned daily included stove top, grill, kitchen and dining room floors, toaster, and exterior of large appliances; -Items cleaned weekly included hoods, filters, shelves, ovens, and cupboards); [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure meals were served to meet the nutritional needs of the residents. Staff failed to prepare and serve food according to the diet spreadsheet menu. The facility census was 54. Review of the facility's Diet Orders Policy, 2011 Edition, showed the following: -Guideline: Each resident will have a diet order prescribed by the physician and documented in the health record. All physicians will prescribe diets using the terminology of the house diets and/or terminology in the diet manual. Diet orders received from an admission source that do not conform to the standard language of the facility will be converted to an available diet order offered at the facility; -Procedure: Diet orders are clearly communicated, using the designated diet order communication form, to dining services; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to conduct regular inspections of bed frames, mattresses and bed rails to identify areas of possible entrapment and to ensure the bed rails, mattresses and bed frames were compatible for five residents (Residents # 2, #3, #4, #36, #48) with bed rails, in a review of 14 sampled residents. The facility census was 54. Review of the facility's bed assist device policy, updated on 2/20/23, showed maintenance staff will install all bed assist devices using the manufacturer's instructions and regularly check the mattress and assist device for areas of possible entrapment and other safety concerns. Review of the Food and Drug Administration's Guide of Bed Safety, Bed Rails in Hospitals, Nursing Homes and Home Health Care: The Facts, revised April 2010, showed the following: [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to post the total hours nursing staff (registered nurse (RN), certified nurse assistant (CNA), certified medication technician (CMT), and licensed practical nurse (LPN)) worked for each shift. The facility census was 54. Review of the facility's undated policy, Posting Direct Care Daily Staffing Numbers, dated 2001 and last revised 2006, showed the following: -Our facility will post, on a daily basis for each shift, the number of nursing personnel responsible for providing direct care to residents; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure the walk-in freezer temperature was maintained at 0 degrees Fahrenheit (F) or below, failed to ensure food items were labeled and dated, failed to ensure a food item was not prepared on the steam table, failed to ensure two ice machines were free of an accumulation of debris, failed to ensure fresh produce was washed prior to preparation, and failed to ensure cookware was free of a buildup of black debris and were easily cleanable. The facility census was 48. Record review of the facility policy, Food Storage (Dry/Refrigerated/Frozen), dated 2011, and showed the following: -Food shall be stored at appropriate temperatures and using appropriate methods to ensure the highest level of food safety; -Frozen storage guidelines to be followed: [...]