St. Margaret's Daughters Home

F 0554

Allow residents to self-administer drugs if determined clinically appropriate.

Level of Harm - Minimal harm or potential for actual harm

Based on observations, interviews, and record reviews, the facility failed to ensure a resident was assessed to ensure the resident could safely self-administer a medication prior to the resident self-administering medications for 1 (Resident #47) of 4 (Resident #5, Resident #47, Resident #72, Resident #105) sampled residents investigated for accidents. Findings: Review of Resident #47's Minimum Data Set with an Assessment Reference Date of 07/02/2025 revealed, in part, a Brief Interview for Mental status score of 11, which indicated Resident #47 had moderate cognitive impairment. Review of Resident #47's Physician Orders as of 08/20/2025 revealed, in part, no orders for Resident #47 to self-administer his medications, and no order for Voltaren gel (a gel medication used for arthritis pain). Review of Resident #47's Care Plan with a target date of 10/09/2025 revealed, in part, Resident #47 was not care planned to self-administer medications or have medications at his bedside. Review of Resident #47's Electronic Medication Administration Record from 08/01/20225 to 08/31/2025 revealed, in part, documentation that Resident #47's medications were administered by facility staff.Observation on 08/18/2025 at 11:10AM revealed a tube of gel labeled as Voltaren gel was present on Resident #47's bedside table. Observation on 08/19/2025 at 12:19PM revealed a tube of gel labeled as Voltaren gel was present on Resident #47's bedside table. In an interview on 08/19/2025 at 12:22PM, S8Licensed Practical Nurse indicated Resident #47 should not have access to the medication Voltaren. In an interview on 08/19/2025 at 12:31PM, S8LPN indicated Resident #47 was not assessed and/or care planned to self-administer medications. In an

interview on 08/20/2025 at 8:47AM, S2Director of Nursing indicated Resident #47 should not have had the medication Voltaren at his bedside because he wasn't assessed and care planned to self-administer medications .

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:

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

08/20/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

St. Margaret's Daughters Home

3525 Bienville St New Orleans, LA 70119

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

Federal health inspectors cited St. Margaret's Daughters Home in NEW ORLEANS, LA for a deficiency under regulatory tag F-F0628 during a standard health inspection conducted on 2025-08-20.

Category: Resident Rights Deficiencies

The facility was found deficient in the following area: Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 9 deficiencies cited during this inspection of St. Margaret's Daughters Home.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-09-29.

Federal health inspectors cited St. Margaret's Daughters Home in NEW ORLEANS, LA for a deficiency under regulatory tag F-F0645 during a standard health inspection conducted on 2025-08-20.

Category: Resident Assessment and Care Planning Deficiencies

The facility was found deficient in the following area: PASARR screening for Mental disorders or Intellectual Disabilities

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 9 deficiencies cited during this inspection of St. Margaret's Daughters Home.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-09-29.

F 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on

observations, interviews, and record reviews, the facility failed to:1. Ensure a resident's care plan was revised after a witnessed fall (Resident #72); and,2. Ensure a residents fall care plan interventions were implemented after a witnessed fall (Resident #72). This deficient practice was identified for 1 (Resident #72) of 4 (Resident #5, Resident #47, Resident #72, Resident #105) sampled residents investigated for accidents. Findings:1.Review of the facility's Accidents/Incidents Policy, last revised on 06/17/2002, revealed, in part the charge nurse and/or the nursing supervisor will initiate a plan of care change that was professionally warranted to ensure a resident's welfare and safety prior to the end of the shift. Review of Resident #72's Electronic Medical Record revealed, in part, Resident #72 was admitted to the facility on [DATE REDACTED] with a history of falling. Review of Resident #72's Incident and Accident Log, revealed, in part, Resident #72 had a witnessed fall with no injury on 08/17/2025. Review of Resident #72's care plan with a next review date of 11/10/2025 and last revision date of 05/19/2025 revealed, in part, Resident #72's care plan was not updated with new goals and/or interventions following Resident #72's fall on 08/17/2025. In an

interview on 08/19/2025 at 1:30PM, S2Director of Nursing (DON) indicated Resident #72's care plan was not updated with fall interventions after a witnessed fall on 08/17/2025, and should have been. In an

interview on 08/19/2025 at 2:30PM, S13Minimum Data Set (MDS) Nurse indicated the nurse supervisor/charge nurse on duty did not update Resident #72's care plan after Resident #72's fall prior to

the end of the shift on 08/17/2025, and should have. 2. Review of Resident #72's Activities of Daily Living (ADL) care plan initiated and revised on 08/19/2025 revealed, in part, Resident #72 required maximal assistance and required the assistance of two person to transfer. Review of Resident #72's Incident and Accident Log dated 08/20/2025 revealed, in part, S14Certified Nursing Assistant (CNA) attempted to transfer Resident #72 from the bed to the wheelchair without assistance which resulted in a witnessed fall.

In an interview on 08/20/2025 at 12:45PM, S2DON indicated Resident #72 was care planned to have two staff assist for transfers. S2DON further indicated Resident #72's fall care plan was not implemented when S14CNA attempted to transfer Resident #72 without assistance.

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

08/20/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

St. Margaret's Daughters Home

3525 Bienville St New Orleans, LA 70119

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0689

insecticide in the room.

Level of Harm - Minimal harm or potential for actual harm

Observation on 08/18/2025 at 4:00PM revealed two cans of aerosolized insecticide the lower shelf of Resident #75’s room.

Residents Affected - Some

Observation on 08/19/2025 at 2:44PM revealed S8Licensed Practical Nurse (LPN) picked up the two cans of aerosolized insecticide and placed them in the closet of Resident #75’s room. S8LPN further indicated she was unaware Resident #75 had two cans of aerosolized insecticide in Resident #75’s room.

In an interview on 08/20/2025 at 12:30PM, S1Administrator indicated Resident #75 should not have had aerosolized insecticide in her room.

1. 2. Review of the facility’s Accidents/Incidents Policy, last revised on 06/17/2002, revealed, in part the

charge nurse and/or the nursing supervisor will initiate a plan of care change that was professionally warranted to ensure a resident’s welfare and safety prior to the end of the shift.

Review of Resident #72’s Electronic Medical Record revealed, in part, Resident #72 was admitted to the facility on [DATE REDACTED] with a history of falling.

Review of Resident #72’s Incident and Accident Log, revealed, in part, Resident #72 had a witnessed fall with no injury on 08/17/2025.

Review of Resident #72’s Activities of Daily Living (ADL) care plan initiated and revised on 08/19/2025 revealed, in part, Resident #72 required maximal assistance and required the assistance of two person to transfer.

Review of Resident #72’s Incident and Accident Log dated 08/20/2025 revealed, in part, S14Certified Nursing Assistant (CNA) attempted to transfer Resident #72 from the bed to the wheelchair without assistance which resulted in a witnessed fall.

In an interview on 08/20/2025 at 12:45PM, S2DON indicated Resident #72 was care planned to have two staff assist for transfers. S2DON further indicated Resident #72’s fall care plan was not implemented when S14CNA attempted to transfer Resident #72 without assistance.

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

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

08/20/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

St. Margaret's Daughters Home

3525 Bienville St New Orleans, LA 70119

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

Federal health inspectors cited St. Margaret's Daughters Home in NEW ORLEANS, LA for a deficiency under regulatory tag F-F0761 during a standard health inspection conducted on 2025-08-20.

Category: Pharmacy Service Deficiencies

The facility was found deficient in the following area: Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.

Scope/Severity Level E: pattern, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 9 deficiencies cited during this inspection of St. Margaret's Daughters Home.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-09-29.

Federal health inspectors cited St. Margaret's Daughters Home in NEW ORLEANS, LA for a deficiency under regulatory tag F-F0812 during a standard health inspection conducted on 2025-08-20.

Category: Nutrition and Dietary Deficiencies

The facility was found deficient in the following area: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Scope/Severity Level E: pattern, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 9 deficiencies cited during this inspection of St. Margaret's Daughters Home.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-09-29.

Federal health inspectors cited St. Margaret's Daughters Home in NEW ORLEANS, LA for a deficiency under regulatory tag F-F0842 during a standard health inspection conducted on 2025-08-20.

Category: Resident Assessment and Care Planning Deficiencies

The facility was found deficient in the following area: Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Scope/Severity Level E: pattern, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 9 deficiencies cited during this inspection of St. Margaret's Daughters Home.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-09-29.

F 0925

Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

Level of Harm - Minimal harm or potential for actual harm

Based on observations, interviews, and record reviews, the facility failed to ensure the facility was free of pests. Findings:Observation on 08/18/2025 at 8:56AM revealed 4 black flying insects were present in the kitchen's dry storage room. In an interview on 08/18/2025 at 8:56AM, S11Dietary Manager (DM) confirmed

the presence of the black flying insects in the facility's dry storage room and in the facility's kitchen. In an

interview on 08/19/2025 at 11:13AM, S11DM confirmed that the facility's kitchen had an increased amount of black flying insects. Observation on 08/19/2025 at 11:20AM revealed 3 black flying insects were present

in the kitchen's dry storage room. Observation on 08/19/2025 at 11:23AM revealed 3 black flying insects flying around the kitchen's shelving unit. Observation on 08/19/2025 at 11:24AM revealed a gallon bottle of distilled vinegar with the bottle's cap ajar. Further observation revealed at 4 black insects were floating in

the liquid contained in the gallon bottle of distilled vinegar. In an interview on 08/19/2025 at 11:25AM, S11DM confirmed that there were insects floating in the gallon bottle of distilled vinegar. In an interview on 08/19/2025 at 12:12 PM, S2Director of Nursing (DON) was informed of findings in kitchen, including multiple black flying and dead insects. S2DON acknowledged insects should not have been present in the facility's kitchen. In an interview on 08/19/2025 at 12:15PM, S2DON confirmed she was aware that the black flying insects were in the facility, but that she was not aware the insects were in the facility's kitchen.

In an interview on 08/20/2025 at 10:33AM, S1Administrator indicated that the black flying insects were periodically present in the facility. S1Administrator further indicated S11DM had not notified S1Administrator that the black flying insects had returned to the facility's kitchen. S1Administrator further indicated that it was part of S11DM's job to be aware of the state of the facility's kitchen. S1Administrator further indicated that S11DM should have notified pest control and facility administration as soon as the black flying insects had returned to the facility's kitchen. S1Administrator confirmed that the black insects should not have been present in the facility.

Residents Affected - Some

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

Event ID:

Facility ID:

If continuation sheet