Inspection Reports for Mercy Caregivers Of Minnesota
556 84Th Avenue Ne, Spring Lake Park, MN 55432, MN, 55432
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Inspection Report
Follow-Up
Census: 5
Capacity: 5
Deficiencies: 12
Sep 9, 2024
Visit Reason
Follow-up survey conducted to determine if orders from the June 20, 2024 survey were corrected.
Findings
The follow-up survey verified that the facility is in substantial compliance. The prior June 20, 2024 survey identified multiple deficiencies including staffing plan issues, food code violations, employee record deficiencies, emergency preparedness plan gaps, fire safety code violations, physical environment hazards, resident assessment delays, medication management plan deficiencies, and medication setup documentation issues.
Severity Breakdown
Level 1: 1
Level 2: 10
Level 3: 1
Deficiencies (12)
| Description | Severity |
|---|---|
| Failed to develop and post a required staffing plan ensuring sufficient staffing and emergency response capability. | Level 2 |
| Food was not prepared and served according to Minnesota Food Code, including discarded shell eggs and unlabeled ready-to-eat foods. | Level 2 |
| Employee records lacked required documentation including job description, health screenings, and background study for one employee. | Level 2 |
| Emergency preparedness plan lacked required content, testing, and quarterly review of missing resident policy. | Level 2 |
| Smoke alarms were not interconnected as required by fire code. | Level 2 |
| Physical environment hazards included use of non-combustible ashtray and failure to maintain good repair. | Level 2 |
| Fire safety and evacuation plans were not developed or provided, and required training and drills were not conducted. | Level 2 |
| Physical facility elements did not meet egress window requirements, constituting a distinct hazard to life. | Level 3 |
| Failed to provide required notice of right to designate a representative on a document separate from the contract for one resident. | Level 1 |
| Resident assessments were not completed within required timeframes; 14-day and 90-day reassessments were late for one resident. | Level 2 |
| Failed to develop an individualized medication management plan with required content for one resident. | Level 2 |
| Documentation of medication setup lacked required details including medication name, dose, times, route, and person completing setup for one resident. | Level 2 |
Report Facts
Residents present: 5
Licensed capacity: 5
Fine amount: 3000
Assessment days late: 1
Assessment days late: 1
Egress window minimum openable area: 648
Egress window measured openable area: 195
Egress window measured openable area: 497
Egress window measured openable area: 550
Egress window measured openable area: 452
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jess Schoenecker | Supervisor, State Evaluation Team | Signed follow-up survey letter dated October 11, 2024 |
| Jodi Johnson | Supervisor, State Evaluation Team | Signed June 20, 2024 survey letter |
| ULP-C | Unlicensed Personnel | Named in medication administration and employee record deficiency |
| LALD-A | Licensed Assisted Living Director | Named in multiple findings including staffing, fire safety, and medication management |
| CNS-B | Clinical Nurse Supervisor | Named in resident assessment and medication management deficiencies |
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