Average — CMS composite of the measures below.
The next survey window likely opens around May 2027
Estimate from public CMS data, current as of October 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Merry Heart Nursing Home during CMS and state inspections, most recent first.
Steam table pans were not sanitized and air dried before being stacked and stored. In the food prep area, two full-sized pans and two 1/4-sized pans were observed stacked with water between them, and the FNS stated they should have been air dried first. The porter said he washed the pans and placed them on a rack near the dishwasher, while the facility policy stated dishes are to be left in racks to dry and then stored.
CNA annual in-service training was not completed for 4 of 5 CNAs reviewed. Records showed each of the four CNAs had less than the required 12 hours of annual education, and the DON acknowledged the requirement was based on each CNA’s hire anniversary date. The facility policy required 12 hours of in-service education annually, including at least 6 hours on OBRA requirements.
Failure to provide adequate supervision for a cognitively impaired resident with a high fall risk. The resident had severe cognitive impairment, hydrocephalus, restlessness, agitation, and difficulty walking, and required assistance with toileting and other ADLs. The resident had multiple unwitnessed falls and floor incidents, including being found on the floor in the room, in bathrooms, and in a hallway, with one event causing a head laceration and eyebrow hematoma. Staff notes and fall investigations showed the resident was impulsive, moved quickly, and at times was left unattended during toileting or was found away from the assigned room.
Incomplete Comprehensive Care Plans: The facility failed to develop comprehensive, person-centered care plans for two residents. One resident with dementia, mood disorder, and major depressive disorder had a care plan that did not include prior aggressive behaviors, resistance with care, or related interventions, despite staff noting those behaviors and a recent GDR of Depakote. Another resident with anxiety and moderately impaired cognition had a PRN alprazolam order, but the care plan did not reflect anti-anxiety medication use or monitoring of effectiveness. Staff and the DON acknowledged the care plans were incomplete.
Failure to provide ordered oxygen therapy and required oxygen signage: Two residents receiving O2 had care issues identified by surveyors. One resident with pneumonia and COPD had a continuous O2 order at 2 LPM, but staff and the resident reported it was used only at night, with no documentation of refusal or physician notification to change the order. Another resident with acute and chronic respiratory failure with hypoxia had a continuous O2 order at 3 LPM, but surveyors found no O2-in-use sign posted outside the room, and staff confirmed the signage should have been present.
An LPN prepared a BP medication with hold parameters for a resident with HTN and CHF, using BP and HR readings taken earlier in the morning rather than immediately before administration. The LPN acknowledged the vitals could have changed before giving the metoprolol ER, and the DON stated the BP and HR should have been checked right before administration.
Improper Handling of Soiled Linens: A dietary aide placed a bag of soiled linen on the laundry room floor, and the FNS stated soiled laundry was usually left on the floor or on top of the washing machine for the laundry aide to take. The IP stated soiled linen should not be on the floor and that there should be a system for handling soiled linens, while the DON noted there should be a bin for soiled laundry linens. A facility policy required bagged soiled dietary linens to be placed into a designated laundry hamper/bin for washing.
A resident with severe cognitive impairment and fall risk was injured when a CNA failed to follow the facility's policy requiring two staff members for Hoyer lift transfers, resulting in the resident sustaining lacerations. The facility's policy and care plan specified the need for two-person assistance, which was not adhered to during the incident.
The facility failed to maintain the dignity of two unsampled residents during dining observations. A CNA and a HA were observed standing while feeding residents, which is a dignity concern. The HA acknowledged the issue, and the DON confirmed that staff should be seated when feeding residents.
Two residents reported receiving their mail opened and taped closed, causing distress. The Accounts Payable Manager admitted to mistakenly opening the mail and delaying its delivery for over four weeks. Both residents had intact cognition, and the administration confirmed that the mail should not have been opened.
The facility failed to identify and dispose of expired medications in two medication carts and improperly stored an unopened medication in one cart. An RN confirmed an expired Latanoprost was administered to a resident, and an LPN confirmed an expired Lantus was administered to another resident. Additionally, an unopened Lantus was found unrefrigerated. The facility's policies did not ensure proper medication expiration checks and storage.
The facility failed to ensure proper hand hygiene by a CNA and HA during meal service. Observations revealed that the HA did not lather soap for the recommended 20 seconds and turned off the faucet with bare hands. The HA was unsure of the correct handwashing procedure, and the DON confirmed the expectation for staff to perform hand hygiene before assisting residents.
Steam Table Pans Not Air Dried Before Storage
Penalty
Summary
The facility failed to sanitize and air dry steam table pans in a manner to prevent microbial growth. During observation in the food preparation area, two shallow full-sized steam table pans were found stacked on a shelf with water between them, and the FNS stated they should have been air dried before being stacked. The FNS also stated that the porter was responsible for washing the steam table pans. When interviewed, the porter stated he washed the pans and placed them on a rack near the dishwasher, and the surveyor then observed two deep 1/4-sized steam table pans that had also been stacked with water between them. Review of the Dishwashing Procedures policy showed that dishes are to be left in the racks to dry and then stored.
CNA Annual In-Service Training Not Completed
Penalty
Summary
The facility failed to ensure that 4 of 5 randomly selected CNAs received the required 12 hours of annual in-service education. Review of the facility’s records on 6/25/26 showed that CNA #1 had 11.5 hours, CNA #2 had 8 hours, CNA #3 had 9.5 hours, and CNA #4 had 8.75 hours of in-service training for the 2025 to 2026 anniversary period. The surveyor reviewed the in-service education records for five CNAs and identified that these four CNAs did not meet the facility’s annual training requirement. The surveyor informed the DON, LNHA, and AA of the concern that the 12-hour CNA in-service education requirement had not been completed for 4 of 5 CNAs reviewed. The DON later stated the identified CNAs were called in to complete their education and acknowledged that the 12-hour education was expected to be completed from each hired anniversary date annually. The DON also stated HR was responsible for ensuring the education was completed and did not know why HR had not called in the CNAs earlier. The facility policy stated that each CNA must receive 12 hours of in-service education annually, with at least 6 hours covering OBRA requirements.
Failure to Provide Adequate Supervision for a High Fall-Risk Resident
Penalty
Summary
The facility failed to ensure adequate supervision for a resident with severe cognitive impairment and a high fall risk. The resident had diagnoses including hydrocephalus, mild cognitive impairment, restlessness and agitation, a history of TIA, and difficulty walking. The MDS assessment showed a BIMS score of 6 out of 15, indicating severe cognitive impairment, and the resident required substantial to maximal assistance with toileting hygiene and assistance with multiple other ADLs and transfers. The resident experienced multiple unwitnessed falls or floor incidents while in the facility. One incident occurred when the resident was found lying on the floor in the room and did not know what happened, resulting in a laceration to the left side of the head and a hematoma on the left eyebrow. Other incidents included being found sitting on the bathroom floor while trying to clean themself up, being found sitting on the floor in another room's bathroom, being found on the floor in the resident's own room, being found lying on the floor in a bathroom, and being found sitting on the floor in a hallway while grabbing handrails. The fall investigations and staff statements showed that the resident was impulsive, moved quickly, and required close monitoring, especially during toileting and bathroom use. One incident involved an aide leaving the resident unattended in the bathroom to retrieve clothing, and another involved the resident entering a room away from their own room and being found on the bathroom floor. The facility's own fall prevention policy stated that residents should be observed closely, kept occupied, and have needs anticipated to prevent falls, including placement in front of the nursing station and toileting supervision.
Incomplete Comprehensive Care Plans
Penalty
Summary
The facility failed to develop comprehensive, person-centered care plans for 2 residents reviewed for comprehensive care plans. For one resident with diagnoses including dementia, mood disorder, and major depressive disorder, the record showed a care plan for antidepressant medication, but it did not include any exhibited behaviors or interventions related to behaviors. The resident’s EMR showed prior mood and aggressive behaviors, a recent discontinuation of Depakote after a gradual dose reduction, and occasional episodes of resistance with care, yet these behaviors were not reflected in the care plan. For the second resident, the admission record showed diagnoses including anxiety and adjustment insomnia, and the MDS indicated moderately impaired cognition. The resident had a physician order for alprazolam 0.25 mg every 8 hours as needed for anxiety for 14 days, but the care plan report did not reflect the use of anti-anxiety medication. Staff interviews indicated the care plan should have been initiated to monitor the effectiveness of the medication and related nursing interventions, but it had not been added. Interviews with nursing staff and administration confirmed that care planning was expected to be a team responsibility and that behaviors, resistance to care, and anti-anxiety medication use should be included when present. The facility policy titled Interdisciplinary Plan of Care stated that care planning shall be implemented through assessment findings, the prescribed treatment plan, and development of reasonable and measurable goals. The updated care plan provided for one resident was acknowledged by the AA and DON to have been incomplete and to have lacked behavioral information needed for a comprehensive and individualized care plan.
Failure to Provide Ordered Oxygen Therapy and Required Oxygen Signage
Penalty
Summary
The facility failed to ensure necessary respiratory care and services for residents receiving oxygen therapy. For one resident admitted with pneumonia and COPD, the electronic health record showed a physician order for oxygen continuously via nasal cannula at 2 LPM every shift, but the resident stated the oxygen was only used at night. Survey observations on two separate days found the oxygen concentrator not operating or the tubing not connected to the resident, and the resident again stated oxygen was used mostly at night. The RN confirmed the continuous oxygen order but acknowledged the resident used oxygen only overnight. The record contained no documentation that the resident refused oxygen as prescribed and no communication with the physician to update the resident’s status or change the oxygen order. For another resident admitted with acute and chronic respiratory failure with hypoxia, the record showed a physician order for oxygen continuously at 3 LPM via nasal cannula, and the care plan included administering oxygen as ordered. Survey observations found the resident awake with a nasal cannula attached to a concentrator running at 1.5 to 2 LPM, but there was no oxygen-in-use sign posted outside the room. The RN stated the resident should have been receiving oxygen at 3 LPM continuously and that signage should be present outside the room. The DON acknowledged that signage for oxygen use should have been in place and that the nurse should check the resident’s oxygen order. Facility policy also stated that staff, visitors, and residents should be alerted with an oxygen sign by the resident’s room door.
Failure to Recheck Vital Signs Before Administering BP Medication
Penalty
Summary
The facility failed to ensure that a high blood pressure medication with ordered parameters was administered in accordance with the physician’s instructions and medication administration standards for Resident #130. The resident had an order for Metoprolol Succinate ER 25 mg by mouth once daily for hypertension, to be held if systolic blood pressure was less than 110 and heart rate was less than 60. During medication preparation, an LPN obtained the resident’s blood pressure and heart rate at 7:33 AM and referenced those vital signs while preparing the medication. At 8:20 AM, the LPN was ready to administer the medication, but the blood pressure and heart rate had not been rechecked immediately before administration. When the surveyor reviewed the record with the LPN, she stated she knew the medication had parameters and that the resident also had congestive heart failure, and acknowledged that the vital signs could have changed in the 47 minutes since they were first taken. The DON later stated that the blood pressure and heart rate should have been taken immediately before administration of the high blood pressure medication. The facility policy stated that medications are administered as prescribed and in accordance with good nursing principles and practices.
Improper Handling of Soiled Linens
Penalty
Summary
Staff failed to ensure infection control practices were followed when handling soiled linens in the laundry room. On 6/23/26 at 10:40 AM, the surveyor observed a dietary aide drop a plastic bag of soiled linen inside the laundry room on the floor. The dietary aide stated that soiled laundry is usually placed on the floor for the laundry aide to take. The surveyor also observed a bin of soiled mops in the room, but no bin for soiled linen. During the same observation, the Food Nutrition Supervisor stated that soiled laundry is placed on top of the washing machine or on the floor and that the laundry aide takes care of it, adding that there was no provided bin for soiled linen in the laundry room. The Infection Preventionist stated that soiled linen should not be on the floor and that there should be a system for handling soiled linens. The DON later stated that there should be a bin for soiled laundry linens. A facility policy reviewed on 6/25/26 titled, Infection Prevention and Control - Handling and Laundry of Soiled Dietary Linens, stated that bagged soiled napkins and aprons are to be placed into the designated laundry hamper/bin for washing.
Failure to Follow Fall Prevention Protocols
Penalty
Summary
The facility failed to adhere to fall prevention interventions as outlined in the Individual Comprehensive Care Plan (ICCP) for a resident who was at risk for falls due to deconditioning, gait, and balance problems. The resident, who was severely cognitively impaired and dependent on staff for activities of daily living and transfers, was involved in an incident where a Certified Nursing Assistant (CNA) did not follow the facility's policy requiring two staff members for Hoyer lift transfers. Instead, the CNA attempted to transfer the resident independently, resulting in the resident sustaining three linear lacerations. The incident occurred despite the facility's policy and procedures clearly stating that a Hoyer lift requires two caregivers to operate. The resident's medical record and care plan specified the need for two-person assistance during transfers, which was not followed. The facility's fall investigation confirmed the CNA's failure to adhere to the policy, leading to the resident's injuries. The facility's Director of Nursing and other staff confirmed the requirement for two staff members during Hoyer lift transfers, and the CNA involved did not respond to attempts for an interview.
Failure to Maintain Resident Dignity During Feeding
Penalty
Summary
The facility failed to maintain the dignity of two unsampled residents during dining observations on the 1st floor. This deficiency involved two staff members, a Certified Nursing Assistant (CNA) and a Hospice Aide (HA), who were observed standing while feeding residents during lunch meals. On two separate occasions, the surveyor noted the HA and CNA standing while feeding unsampled residents, which is a dignity concern. The HA acknowledged the issue during an interview, confirming that staff should be seated when feeding residents. The Director of Nursing (DON) also confirmed that staff should be seated during feeding to maintain resident dignity.
Failure to Deliver Unopened Mail in a Timely Manner
Penalty
Summary
The facility failed to deliver unopened mail in a timely manner for two residents, resulting in a breach of privacy and confidentiality. During a resident council meeting, two residents reported receiving their mail opened and then taped closed, which caused them distress. The residents could not identify who delivered the opened mail. One resident's daughter, who is also the Power of Attorney, confirmed that the mail was opened and delivered more than a month after the postmarked date. The resident's medical records indicated that both residents had intact cognition, with BIMS scores of 15 and 13, respectively. Interviews with facility staff revealed that the Accounts Payable Manager (APM) sometimes mistakenly opened residents' mail and failed to apologize for the error. The APM admitted to keeping the mail for over four weeks due to being busy, which delayed its delivery to the residents. The Director of Activities and the Concierge confirmed the mail handling process, stating that personal mail should be distributed by the activities staff without being opened. The administration acknowledged that the APM should not have opened the residents' mail.
Medication Storage and Expiration Deficiencies
Penalty
Summary
The facility failed to identify and dispose of expired biologicals in two of three medication carts and improperly stored an unopened biological in one of the three medication carts inspected. During an inspection of a medication cart on the third floor, a surveyor found an opened bottle of Latanoprost Solution 0.005% for a resident that was expired. The Registered Nurse (RN) confirmed the expiration and noted that it was the only supply available for administration. The electronic Medication Administration Record (eMAR) showed that the expired medication had been administered multiple times in the previous days. The RN stated that the night shift nurse was responsible for checking expiration dates, and the nurses who administered the doses should have verified the dates before administration. On the first floor, a surveyor found an opened bottle of Lantus insulin for another resident that was not labeled with an expiration date, despite the manufacturer's instructions to discard it after 28 days at room temperature. The Licensed Practical Nurse (LPN) confirmed the expiration and noted it was the only opened bottle available. The eMAR indicated that the expired Lantus had been administered several times. Additionally, an unopened bottle of Lantus was found unrefrigerated, contrary to the manufacturer's storage recommendations. The LPN acknowledged that the nurse who received the medication should have refrigerated it. The facility's Medication Administration policy did not include a process to ensure medications were not expired, and the Medical Storage policy required clear labeling and appropriate storage temperatures, which were not adhered to in these instances.
Inadequate Hand Hygiene During Meal Service
Penalty
Summary
The facility failed to adhere to appropriate infection control practices during meal service, specifically concerning hand hygiene. During observations on two separate occasions, a Certified Nursing Assistant (CNA) and a Hospice Aide (HA) did not perform hand hygiene while assisting residents with meal setup. The surveyor noted that the HA applied soap to her hands but did not lather for the recommended 20 seconds before rinsing, and she turned off the faucet with her bare hands, which is against proper hand hygiene protocol. The HA admitted to being unsure of the correct handwashing duration, indicating a lack of awareness of the proper procedure. The Director of Nursing (DON) confirmed that staff are expected to perform hand hygiene before assisting residents and should wash their hands for a full 20 seconds outside the stream of running water. The CNA was unavailable for an interview, and the concerns were discussed with the DON, Licensed Nursing Home Administrator (LNHA), Assistant LNHA, and Administrator in Training (AIT).
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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| Dwelling Place At St Clares | 4.4 mi | ★★★★★ | 6 | 0 |
| Excel Care At Dover | 5.2 mi | ★★★★★ | 4 | 0 |
| Holly Manor Center | 5.2 mi | ★★★★★ | 0 | 0 |
| Morris View Healthcare Center | 6.9 mi | ★★★★★ | 20 | 1 |
| Heath Village | 9.2 mi | ★★★★★ | 8 | 0 |
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