Inspection Reports for
The Milton Home

This citation relates to Intake 2654973 and 2658962. The complaint investigation found that Resident B's wheelchair tipped over during transport due to improper securing by Employee 3, causing minor injuries treated at an emergency room. The facility's investigation could not identify other contributing factors.

The facility failed to ensure that Resident B's wheelchair was properly secured in the facility van, resulting in the wheelchair tipping over during transport and causing minor injuries requiring emergency room treatment. The investigation found that the wheelchair was improperly secured by the bus driver, Employee 3, which allowed the emergency release lever to be activated and loosened a safety strap.

The facility was found not in compliance with emergency preparedness requirements including failure to annually review and update the Emergency Preparedness Plan, risk assessment, policies and procedures, communication plan, and training/testing program. Life safety deficiencies included improper exit discharge elevation, non-illuminated exit signage, incomplete maintenance of battery-operated smoke alarms, improper kitchen hood extinguishing system setup, fire alarm system lacking semi-annual visual inspections, and corridor doors that did not close and latch properly.

Complaint IN00440061 - No deficiencies related to the allegations are cited. Complaint IN00437310 - No deficiencies related to the allegations are cited. Complaint IN00434826 - No deficiencies related to the allegations are cited.

The facility was found deficient in multiple areas including care plan development, care plan conferences, activity provision, medication storage and labeling, food sanitation, infection prevention, medication administration, employee health records, medication security, and health statements. No deficiencies were cited related to the investigated complaints.

The facility was found deficient in developing complete and person-centered care plans, conducting timely care plan conferences, providing 1:1 activities as per care plans, properly labeling and storing medications, maintaining sanitary kitchen conditions, and implementing infection prevention during medication administration.

The complaint investigation related to complaint IN00422710 involved allegations that CNA 3 was rough with Resident C during care and was verbally abusive. The investigation confirmed these allegations and found a pattern of negative behavior by CNA 3. The facility delayed reporting the incident to the state until 11/27/23, despite the grievance being filed on 11/24/23.

The facility failed to ensure Resident C was free from abuse by CNA 3, who was found to have a pattern of negative behavior including rough treatment and verbal abuse. Additionally, the facility failed to timely report the suspected abuse to the state authorities.

Complaint IN00422710 was substantiated with federal/state deficiencies cited at F600 and F609 related to abuse and neglect. Complaints IN00422849 and IN00421811 were not substantiated with deficiencies.

The facility was found to have deficiencies related to abuse and neglect involving Resident C, specifically regarding rough treatment by a CNA. The facility failed to ensure the resident was free from abuse and failed to report the incident timely. Other complaints were found to have no deficiencies.

The facility was found not in compliance with emergency preparedness testing requirements, generator maintenance, life safety code corridor obstructions, electrical panel security, elevator inspection and testing, sprinkler system maintenance, smoke detector battery testing, fire alarm system maintenance, and electrical receptacle testing. Corrective actions and plans of correction were provided for each deficiency.

Complaint IN00416523 was investigated and no deficiencies related to the allegations were cited.

The facility was found deficient in several areas including failure to provide quarterly statements for resident trust funds, failure to provide SNF-ABN forms after Medicare discharge, food served at improper temperatures, improper food storage including expired items, incomplete or missing service plans for residents, lack of mental health screenings and care plans for residents with major mental illness, missing health statements for communicable diseases, and incomplete tuberculosis testing documentation.

The facility was found deficient in providing quarterly statements for resident trust funds, issuing required Medicare notices, serving food at proper temperatures, and properly storing and disposing of expired foods and spices. These deficiencies affected multiple residents and had potential for minimal harm.

Complaint IN00400057 was substantiated but no deficiencies related to the allegations were cited. The complaint was ultimately unsubstantiated due to lack of evidence.

The facility failed to ensure hot water temperatures were maintained at a safe level in 2 of 2 nursing units, with several locations exceeding the maximum allowable temperature of 120 degrees Fahrenheit. No residents were found to be affected by the deficient practice and no residents were burned. The building mixing valve was adjusted to 120 degrees and water temperatures were brought into compliance.

The facility was found not in compliance with Life Safety Code requirements due to failure to ensure that hazardous area doors, such as storage rooms, were provided with properly working self-closing devices. Specifically, the housekeeping basement storage closet door near Therapy was not self-closing and contained combustible items.

Complaint IN00389408 was substantiated with federal/state deficiencies cited at F686 related to pressure ulcer treatment and care.

The facility failed to provide adequate services such as assessments and wound dressing changes to promote healing of an unstageable/full thickness pressure ulcer and Moisture Associated Dermatitis for 1 of 3 residents reviewed (Resident B). Documentation and treatment orders were not consistently followed or completed, including wound care treatments and nutritional supplements.

The facility was found not in compliance with Life Safety Code requirements, including issues with egress door locking mechanisms, stairway enclosure door latches, hazardous area door self-closures, and corridor doors with holes compromising smoke resistance.

The facility was found deficient in multiple areas including transfer and discharge documentation, baseline and comprehensive care plans, ADL care, quality of care, pressure ulcer prevention, medication management, infection control, resident rights documentation, evaluations, and clinical records.

The facility was found deficient in multiple areas including failure to develop baseline care plans within 48 hours of admission, incomplete individualized care plans, inadequate assistance with activities of daily living, failure to obtain physician orders for treatments, lack of pressure ulcer care, improper use of splints, inadequate fall investigations and interventions, failure to provide appropriate catheter care, lack of physician orders for oxygen use, unnecessary medications, and failure to implement infection control guidelines for unvaccinated new admissions.