Inspection Reports for
Mirabel Lodge

Complaint investigation was substantiated for not providing timely medical attention to residents.

The facility failed to seek timely medical attention for residents in at least four known cases, did not ensure documentation of residents' condition and care, had communication issues with the Licensing Department, and lacked a Medication Technician on all shifts while leaving PRN medication pre-poured for the night shift.

Complaint investigation was substantiated for failure to provide timely medical attention to residents.

The facility failed to seek timely medical attention for residents in at least four known cases, did not ensure documentation of residents' condition and care, had communication issues with the Licensing Department, and lacked a Medication Technician on all shifts while leaving PRN medication pre-poured for the night shift.

The facility was found to have incomplete medication training documentation for a caregiver passing medications independently. Incident reports submitted for three residents lacked required details such as nature of events, findings, treatment, and disposition. A deficiency was cited for failure to meet medication training requirements.

The facility failed to provide complete medication training documentation for an employee passing medications independently. Incident reports for three residents sent to emergency rooms lacked required details such as nature of events, findings, treatment, and attending physician information.

The complaint alleged staff did not seek timely medical attention for resident R1 and failed to notify the resident's PCP of a change in condition. The investigation found these allegations substantiated based on record reviews and interviews.

The investigation substantiated that staff delayed seeking medical attention for resident R1 who exhibited symptoms of hypoxia and fever. The facility failed to maintain proper PRN medication administration records and did not effectively communicate with the resident's PCP, continuing to use fax despite being advised it was ineffective.

During the complaint investigation, staff interviews were obstructed by licensee instructions to not discuss resident information with external callers, limiting the investigation. The complaint was substantiated with a deficiency cited for failure to provide timely medical care.

The facility failed to provide timely medical care to resident R3, who had a swollen and purple leg for at least one month before being seen by a doctor. The licensee also instructed staff to not discuss resident information with external callers, hindering complaint investigation interviews. A Type A deficiency was cited for failure to meet personnel requirements related to timely medical care.

During the complaint investigation, staff interviews were obstructed by the licensee's instruction to not discuss resident information with external callers. Staff reported being told to refer all inquiries to the facility administration, limiting the licensing agency's ability to conduct confidential interviews.

The facility failed to provide timely medical care to resident R3, resulting in a Type A deficiency. There were issues with documentation and staff cooperation during the complaint investigation. The licensee instructed staff to not discuss resident information with external callers, which was addressed by the licensing agency.

The complaint investigation was substantiated. Allegations included personal rights violations and failure to follow physician care orders. The preponderance of evidence standard was met for both allegations. A civil penalty of $250 was assessed for repeated violations within 12 months.

The investigation substantiated that staff made inappropriate comments and failed to communicate intentions during resident transfers, violating personal rights. Staff also did not follow physician orders to use gait belts during transfers, posing immediate risk to residents. A civil penalty of $250 was assessed for repeated violations within 12 months.

The inspection identified multiple deficiencies including fire clearance violations due to bedridden residents occupying non-cleared rooms, expired fire extinguishers, call alert system failures, medication administration errors, staff working without proper clearance, and sanitation and maintenance issues such as cracked toilets, feces in bathrooms, lack of hygiene supplies, and unpacked dry goods without expiration dates. Civil penalties totaling $1000 were issued for fire clearance and staff clearance violations.

The complaint investigation was substantiated for the allegation that staff did not dispense medication to a resident as prescribed, confirmed by medication administration records and hospice documentation. The allegation that staff failed to inform the resident's authorized representative of a change in condition was unsubstantiated.

The investigation substantiated that staff did not dispense medication to a resident as prescribed, including missed doses of Seroquel and improper medication crushing practices, posing an immediate risk to resident health. Another allegation that staff failed to inform the resident's authorized representative of a change in condition was found unsubstantiated due to insufficient evidence.

The complaint was substantiated based on evidence that the facility gates were locked and impassable, preventing safe exit. The licensee repaired the gate promptly. An immediate civil penalty of $500 was assessed.

The investigation found that the facility had issues with the front and side gates being locked and impassable, posing an immediate health and safety risk. The gate maglock was faulty and was replaced promptly. The allegation was substantiated, and an immediate civil penalty of $500 was assessed. However, an amendment noted that the secured perimeter waiver was not approved, and the facility is operating under a previous fire clearance.

The facility was found to have multiple deficiencies including fire clearance violations, maintenance and safety issues, medication administration errors, lack of activities, expired food items, incomplete care plans, insufficient staff training, and non-functional emergency alarm systems. An immediate civil penalty of $500 was issued for the fire clearance violation.

The complaint was substantiated. The allegation was that staff did not ensure a resident received their medication as prescribed, leading to behavioral issues. The investigation confirmed the medication was not administered from June 2023 until November 2023 due to ordering errors and inadequate medication management.

The investigation substantiated that the facility failed to ensure resident R1 received their prescribed medication Sertraline for approximately six months due to errors in medication ordering and management. The designated medication technician was no longer employed, and the facility had not contacted a pharmacy for medication management review as required.

The facility was found to have several deficiencies including maintenance issues such as missing face cover plates and drawers, hot water temperatures outside the regulated range, and admission agreements not updated after change of ownership. Staff training and resident care plans were generally compliant, but there were noted failures in timely medical attention and adequate direct care staffing.

The facility was observed to have some deficiencies including non-operational auditory alarm systems in all resident rooms and obstructed exits in rooms 2, 4, and 6, which were immediately cleared. Other observations included compliance with fire safety, food storage, and emergency preparedness regulations.