Auburn Home In Waconia

During an interview on 9/24/25 at 12:06 p.m., licensed practical nurse (LPN)-A stated constipation interventions should be on a resident's care plan to direct staff on how to manage it.

During an interview on 9/24/25 at 3:05 p.m., the director of nursing (DON) stated if a resident had a diagnosis and history of constipation, and was prescribed medications for constipation, there was an expectation to have a care plan to manage constipation.

The DON acknowledged R1's care plan did not have a focus area for constipation.

The Bowel and Bladder Management policy dated 7/29/25, indicated staff will assess residents for past and present bowel patterns which may include medication review, medical diagnosis, and/or diet.

Staff will adopt a person-centered interdisciplinary care plan and implement interventions/approaches to bowel management to meet the goals of the individual and review the care plan at least quarterly.

Staff will review individuals that do not have a recorded BM within the past 3 days and provide appropriate intervention.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

11/25/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Auburn Home IN Waconia

594 Cherry Drive Waconia, MN 55387

SUMMARY STATEMENT OF DEFICIENCIES

During an interview on 9/24/25 at 2:03 p.m., RN-D stated RN-A called her when R1 was not feeling well, and RN-D advised RN-A to send R1 to the hospital and was not aware RN-A waited three hours to send R1. RN-D stated she was not aware no further assessments were done in the three hours while RN-A waited to send R1 to the hospital but would have expected continuous assessments until R1 went to the hospital. If she did not send him in right away, it was a delay in care. He should have gone right away. It was an emergency.

During an interview on 9/24/25 at 3:05 p.m., the director of nursing (DON) stated she was not aware RN-A did not send R1 to the hospital immediately and would question why RN-A didn't send R1 immediately, and why R1 was sent to the hospital by non-emergency transport.

The expectation would have been to assess every 30 minutes or more often with vital signs, until R1 was sent to the hospital.

The DON acknowledged no further assessments were documented on 7/21/25 between 12:47 a.m., and 3:31 a.m., but stated further assessment should have occurred.

The DON further acknowledged R1 was in pain and should have been sent to the hospital sooner to alleviate the pain.

During an interview on 9/24/25 at 3:46 p.m., the nurse practitioner (NP)-A stated if RN-A was told to send R1 to the hospital, R1 should have been sent immediately.

The NP-A stated she reviewed the hospital records, and R1 would not have been saved if he had been sent to the hospital right away but could have had comfort cares much sooner; R1 was in pain and did not need to be.

During an interview on 9/24/25 at 4:21 p.m., the medical director (MD)-A stated it was certainly possible sending R1 to the hospital could have made a difference for him, and staff should have called an ambulance to send R1 to the hospital right away.

The (MD)-A stated she would have expected assessment in between the two documented assessments by the nurse to know how the resident's condition was progressing, and the incident should be reviewed by the facility.

The Change of Condition and Provider Notification policy dated 7/29/25, indicated a change in condition is a deviation from an individual's baseline in physical, cognitive, behavioral, or functional status. A change in condition shall be reviewed by a registered nurse.

The primary care provider or on-call provider will be contacted. As applicable, the individual representative will be notified.

The individual with a change in condition will be monitored as appropriate.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

11/25/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Auburn Home IN Waconia

594 Cherry Drive Waconia, MN 55387

SUMMARY STATEMENT OF DEFICIENCIES

Ensure that the resident and his/her doctor meet face-to-face at all required visits.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and document review the facility failed to ensure a physician performed an initial comprehensive assessment within 30 days after admission for 1 of 3 residents (R3), failed to ensure physician visits every 30 days after admission for 90 days for 1 of 3 residents (R3) and failed to ensure physician visits every 60 days after the initial 90 days for 3 of 3 residents (R1, R2, R3).

Findings include: R1's quarterly Minimum Data Set (MDS) dated [DATE], indicated R1 was admitted [DATE]. R1 was cognitively intact with diagnoses that included Parkinson's Disease (a movement disorder of the nervous system that often causes constipation related to slow movement of food through the gut and reduced physical activity), required a wheelchair for mobility, and substantial/ maximum assistance [helper does more than half the effort] from staff for mobility.R1's progress notes dated 7/21/25 at 3:31 a.m., indicated discharge on [DATE].R1's provider visits for 2025 included nurse practitioner (NP) visits monthly from January to July, except March.

The medical record lacked evidence of any physician visits to date in 2025.R2's quarterly MDS dated [DATE], indicated R2 admitted [DATE]. R2 had intact cognition with diagnoses that included heart failure, chronic lung disease, diabetes, impaired kidney function, and asthma. R2 required a walk or wheelchair for mobility, substantial/maximum assistance from the staff for mobility, and was unable to walk independently.R2's progress notes dated 9/20/25 at 1:34 a.m., indicated discharge on [DATE]. R2's provider visits records indicated visits by a NP every month in 2025, except February and August, and lacked indication of a physician visits in 2025.R3's admission MDS dated [DATE], indicated admission to the facility on 6/13/25, severe cognitive impairment with diagnoses that included impaired kidney function, malnutrition, asthma for which R3 required oxygen therapy. R3 required a walker or wheelchair for mobility, partial/moderate assistance (helper does less than half the effort), and was able to walk with supervision.R3's provider visits included an initial admission visit on 6/26/25, performed by the NP, and a provider visit on 8/26/25, also performed by the NP.

The electronic medical record lacked indication R3 was seen by a physician for the initial assessment, every 30 days after admission, or for an assessment in July by any provider.

During an interview on 9/24/25 at 3:05 p.m., the director of nursing (DON) stated the expectation was for residents to see a physician every 60 day after admission, and an NP could alternate visits with the physician.

The DON acknowledged, I know we have been having problems with that.During an interview on 9/25/25 at 10:44 a.m., the NP-A stated she emailed the scheduler and DON and informed them physician visits did not occur on schedule, and R1 needed another provider as his provider did not round in the facility.

The NP acknowledged R1, R2, and R3 had no physician visits in 2025, and she had performed the admission visit for R3 instead of a physician.

During an interview on 9/25/25 at 11:43 a.m., the administrator stated a physician should perform an admission visit and then visit every 30 days for 90 days. A physician then performs visits every 60 days but could alternate those visits with a NP.

The administrator stated she was not aware the physician visits were not occurring per regulation.The Physician Visit Schedule policy dated 7/29/25, indicated all individuals will be seen by their physician or physician extender in accordance with the standards set in their regulatory service line.

Facility ID: