Inspection Reports for
New Haven Care Center
9503 HIGHWAY 100, NEW HAVEN, MO, 63068-1300
Back to Facility ProfileDeficiencies (last 3 years)
Deficiencies (over 3 years)
5 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
9% better than Missouri average
Missouri average: 5.5 deficiencies/yearDeficiencies per year
8
6
4
2
0
Census
Latest occupancy rate
69 residents
Based on a March 2025 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
Occupancy over time
Inspection Report
Routine
Census: 69
Deficiencies: 3
Date: Mar 21, 2025
Visit Reason
The inspection was conducted to assess compliance with professional standards of care related to medication administration, including insulin administration, extended release medication handling, and oxygen orders for residents.
Findings
The facility failed to properly utilize the electronic medication administration record (eMAR) for insulin administration and documentation for multiple residents, crushed extended release potassium chloride against pharmacy recommendations, and administered oxygen to a resident without a physician's order.
Deficiencies (3)
Failure to utilize the eMAR and document insulin dosages for multiple residents.
Failure to administer extended release potassium chloride per pharmacy recommendations; crushed medication for a resident unable to swallow pills.
Failure to obtain a physician's order for oxygen for one resident using oxygen.
Report Facts
Residents sampled: 30
Facility census: 69
Insulin doses not documented: 69
Extended release potassium chloride dose: 20
Oxygen flow rate: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| LPN A | Licensed Practical Nurse | Administered insulin without using eMAR and referenced handwritten sliding scale |
| RN B | Registered Nurse | Administered insulin using eMAR but did not document doses |
| LPN C | Licensed Practical Nurse | Crushed extended release potassium chloride against recommendations and unaware of physician/pharmacy consultation |
| Assistant Director of Nursing | ADON | Interviewed regarding medication administration policies and deficiencies |
| Director of Nursing | DON | Interviewed regarding medication administration and oxygen order deficiencies |
| Administrator | Facility Administrator | Interviewed regarding expectations for medication administration and documentation |
Inspection Report
Annual Inspection
Census: 66
Deficiencies: 5
Date: Dec 15, 2023
Visit Reason
The inspection was conducted to assess compliance with regulatory requirements related to resident care, safety, nutrition, and infection control at New Haven Care Center.
Findings
The facility was found deficient in providing adequate personal hygiene care to residents unable to perform their own activities of daily living, ensuring safe mechanical lift transfers, preventing choking hazards during meal service, maintaining nutritional status to prevent significant weight loss, and implementing proper infection prevention and control procedures including hand hygiene.
Deficiencies (5)
Failure to provide necessary care and assistance for activities of daily living including grooming, nail care, and shaving for residents unable to care for themselves.
Failure to provide safe mechanical lift transfers, including improper use of mechanical lift base and inadequate staff assistance.
Failure to provide appropriate diet and supervision during meal service to prevent choking hazard for a resident with swallowing difficulties.
Failure to ensure resident received necessary services and assistance to maintain nutritional status, resulting in significant weight loss without documented interventions or notifications.
Failure to use appropriate infection control procedures including hand hygiene between glove changes and use of disposable wipes, risking spread of infection.
Report Facts
Facility census: 66
Resident weight loss percentage: 6.33
Number of packages of denture cleaner: 93
Number of disposable razors: 8
Employees mentioned
| Name | Title | Context |
|---|---|---|
| RN C | Registered Nurse | Named in findings related to mechanical lift transfer and infection control deficiencies |
| CNA F | Certified Nurse Aide | Named in findings related to personal hygiene care and infection control deficiencies |
| CNA B | Certified Nurse Aide | Interviewed regarding supervision of resident during meals |
| LPN I | Licensed Practical Nurse | Interviewed regarding chemical storage and weight monitoring |
| Director of Nursing | Director of Nursing | Interviewed regarding facility policies and deficiencies |
| Registered Dietician | Registered Dietician | Interviewed regarding nutritional care and supervision |
| Medical Director | Medical Director | Interviewed regarding resident weight monitoring and notification |
| Social Services Director | Social Services Director | Interviewed regarding monitoring of resident meal intake |
| CNA L | Certified Nurse Aide | Interviewed regarding resident eating behaviors and meal assistance |
Inspection Report
Complaint Investigation
Census: 60
Deficiencies: 7
Date: Nov 4, 2022
Visit Reason
The inspection was conducted based on complaints and observations regarding failure to maintain resident dignity, safe and homelike environment, proper notification of transfers and discharges, comprehensive care planning, assistance with activities of daily living, wheelchair safety, and food safety practices.
Complaint Details
The visit was complaint-related, triggered by allegations of failure to maintain resident dignity, safe environment, proper notification of transfers, comprehensive care planning, assistance with ADLs, wheelchair safety, and food safety.
Findings
The facility was found deficient in multiple areas including failure to maintain dignity by not changing soiled catheter privacy bags, failure to maintain a safe and homelike environment with chipped paint and odors, failure to provide written discharge/transfer notices and bed hold policy information, incomplete and missing care plans for residents' medical and nursing needs, inadequate assistance with personal hygiene and grooming, improper wheelchair propulsion risking resident safety, and poor food safety practices including inadequate hand hygiene and improper cleaning of food preparation equipment.
Deficiencies (7)
Failure to maintain dignity by not changing wet and stained urinary catheter privacy bags for residents.
Failure to provide a safe, clean, comfortable and homelike environment due to chipped paint, gouged walls, black marks, dirty privacy curtains, and lingering odors in resident rooms.
Failure to provide written notice of discharge/transfer and bed hold policy to residents and/or representatives for hospital transfers.
Failure to develop and implement complete care plans addressing splint use, code status, oxygen use, facial hair and nail care preferences, blood sugar monitoring, and surgical wound care.
Failure to provide necessary care and assistance with activities of daily living including hair care and nail care for residents.
Failure to properly propel residents in wheelchairs with feet on foot pedals, risking injury.
Failure of dietary staff to perform hand hygiene consistently and failure to wash, rinse, and sanitize food processor and food preparation sink between uses, risking cross-contamination.
Report Facts
Facility census: 60
Residents affected: 2
Residents affected: 3
Residents affected: 6
Residents affected: 5
Residents affected: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| CNA H | Certified Nursing Assistant | Named in wheelchair propulsion deficiency |
| RN E | Registered Nurse | Named in catheter care and dignity deficiency |
| CNA F | Certified Nursing Assistant | Named in catheter care and dignity deficiency |
| DON | Director of Nursing | Interviewed regarding multiple deficiencies including catheter care, environment, care plans, and wheelchair safety |
| Administrator | Interviewed regarding multiple deficiencies including environment, transfer notices, care plans, and wheelchair safety | |
| SSD | Social Services Designee | Interviewed regarding transfer notices and baseline care plans |
| DM | Dietary Manager | Named in food safety and hand hygiene deficiencies |
| CNA/CMT A | Certified Nurse Aide/Certified Medical Technician | Named in hair and nail care and wheelchair propulsion deficiencies |
| LPN B | Licensed Practical Nurse | Interviewed regarding care plans and hair/nail care |
| Shower Aide D | Interviewed regarding hair and nail care | |
| RN I | Registered Nurse | Interviewed regarding nail care |
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