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Complaint Investigation

Magnolia Ridge Health And Rehabilitation Center

Inspection Date: November 20, 2025
Total Violations 1
Facility ID 106149
Location GAINESVILLE, FL
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Inspection Findings

F-Tag F0880

Infection Control Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0880

Provide and implement an infection prevention and control program.

Level of Harm - Minimal harm or potential for actual harm

Based on observation, record review, and interview, the facility failed to ensure staff used appropriate personal protective equipment (PPE) while performing midline care for the residents who were on enhanced barrier precautions (EBP) to prevent the possible spread of infection and communicable diseases for 1 of 2 residents reviewed for intravenous (IV) therapy (Resident #4). Findings include:During

an observation on 11/20/2025 at 10:05 AM, Staff A, Licensed Practical Nurse (LPN), entered Resident #4's room, performed hand hygiene with hand sanitizer, and donned gloves. Staff A proceeded to turn off the IV pump and then disconnected the IV tubing from Resident #4's midline. Staff A wiped the midline port with

an alcohol wipe and flushed 10 milliliters of normal saline into the midline. Staff A wiped the midline port with another alcohol wipe and applied a green cap to the midline. Staff A doffed the gloves and performed hand hygiene using hand sanitizer on her way out of the room. Staff A did not wear a gown.During an

interview on 11/20/2025 at 10:07 AM, Staff A, LPN, stated, Enhanced barrier precautions are for residents with certain types of infection, wounds, and catheters. I've also seen enhanced barrier precautions used for feeding tubes. I don't normally wear a gown for midlines or IVs. I just wear gloves.During an interview on 11/20/2025 at 12:00 PM, the Director of Nursing stated, I expect nurses to use enhanced barrier precautions every time they take care of a resident who has a break in their skin, G-tubes [gastric tubes], wounds, IVs, PICC [peripherally inserted central catheter] lines, and foley catheters.Review of Resident #4's physician order dated 11/18/2025 read, Enhanced Barrier Precautions for wounds, IV every shift. Wear gloves and a gown for the following High-Contact Resident Care Activities: Dressing, Bathing, Transferring, Changing Linens, Providing Hygiene, Changing Briefs or Assisting with Toileting. (EBP is required for residents with indwelling medical devices, wounds, or colonization with an MDRO [multi-drug-resistant organism]). every shift for Prophylaxis.Review of the facility policy and procedure titled Clinical Guidelines, PPE in Use to Prevent Spread of MDROs dated 10/2024 read, Purpose: Implementation of Personal Protective Equipment (PPE) Use in Nursing Homes to Prevent Spread of Multidrug-resistant Organisms (MRDOs). Procedure: 1. Multidrug-resistant organism (MDRO) transmission is common in skilled nursing facilities, contributing to substantial resident morbidity and mortality and increased healthcare costs. 2.

Enhanced Barrier Precautions (EBP) are an infection control intervention designed to reduce transmission of organisms that employs targeted gown and glove use during high contact resident care activities. 3. EBP may be indicated (when Contact Precautions do not otherwise apply) for residents with any of the following: Chronic wounds or indwelling medical devices, regardless of MDRO colonization status.

Residents Affected - Few

Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date

these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.

LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE

TITLE

(X6) DATE

FORM CMS-2567 (02/99) Previous Versions Obsolete

Facility ID:

If continuation sheet

Event ID:

📋 Inspection Summary

MAGNOLIA RIDGE HEALTH AND REHABILITATION CENTER in GAINESVILLE, FL inspection on recent inspection.

Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.

What this means: Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. All deficiencies must be corrected within required timeframes and are subject to follow-up verification.

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in GAINESVILLE, FL, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from MAGNOLIA RIDGE HEALTH AND REHABILITATION CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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