Mennonite Home
MENNONITE HOME in ALBANY, OR — inspection on March 27, 2026.
Found 5 citations. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
During that time Resident 32 did not independently feed herself/himself and no other staff approached her/him to help with eating. On 3/25/26 at 8:08 AM Resident 32 was observed in a wheelchair in the dining room at a table alone.
There were three other residents in the dining room sitting together and staff served their breakfasts. At 8:52 AM, 44 minutes later, Resident 32 was served breakfast and a CNA assisted her/him with eating. On 3/25/26 at 12:19 PM Resident 32 was observed in the dining room with a full beverage in front of her/him, but the resident did not independently pick up the cup to take sips. Resident 32 was observed continuously until 1:17 PM, 58 minutes later, and was not approached by any staff to assist her/him with the beverage or offer a meal. On 3/25/26 at 2:46 PM Staff 5 (CNA) reported dependent residents waited until all other residents were served their meals before staff were available to assist them with eating. On 3/26/26 at 9:07 AM Staff 6 (CNA) stated Resident 32 required full assistance from staff for eating and drinking. On 3/26/26 at 10:17 AM Staff 7 (RNCM) stated residents who were able to independently eat were served first, and residents dependent for eating had to wait to be served until a CNA was free to assist them. On 3/26/26 at 10:51 AM Staff 2 (DNS) acknowledged dependent residents having extended wait times in the dining room while other residents ate did not meet facility standards.
385206 03/27/2026
Mennonite Home 5353 Columbus Street SE Albany, OR 97321
of psychotropic medications for 1 of 5 sampled residents (#4) reviewed for unnecessary medications.
include:Resident 4 admitted to the facility in 2025 with diagnoses including mild episode of depressive disorder.A 12/13/25 physician order indicated the following medications to be administered to Resident 4:- Duloxetine (antidepressant) for depression and pain.A review of the clinical record revealed no indication the risks and benefits of the antidepressant medication were reviewed, or consent was obtained for the use of Duloxetine for Resident 4.On 3/25/26 at 1:54 PM Staff 1 (Administrator) stated he was unable to locate any information to indicate the risks and benefits were reviewed, or a consent was obtained for Resident 4's use of the antidepressant.
385206 03/27/2026
Mennonite Home 5353 Columbus Street SE Albany, OR 97321
at risk for unmet hygiene and grooming needs.
Findings include: Resident 32 was admitted to the
Plan revealed Resident 32 needed one-person assistance for hygiene and bathing.
The 2/3/26 admission MDS for Resident 32 revealed she/he needed substantial to maximum assistance with hygiene tasks, was dependent for mobility, and received a BIMS score of 1 indicating severe cognitive impairment.The daily care documentation for 3/2026 revealed Resident received no bathing or nail care from 3/1/26 to 3/19/26. On 3/26/26 at 12:45 PM Witness 2 (Family Member) expressed concern for Resident 32's cleanliness and hygiene, as well as the length and cleanliness of her/his fingernails and toenails.
Witness 2 removed the resident's blanket and socks and prompted her/him to open her/his mouth.
There was white build-up around and between the resident's teeth. Resident 32 had a brown substance under all fingernails and her/his toenails extended past the toe tips.
Witness 2 started to clean and clip the resident's toenails and was observed to remove a large amount of white build-up from around the left big toenail.
Witness 2 indicated Resident 32's feet had a foul odor, which was also observed by the surveyor. On 3/26/26 at 1:29 PM Staff 6 (CNA) reported Resident 32 started receiving bathing through her/his hospice agency the previous week, but facility staff continued to be responsible for hygiene and grooming care. On 3/26/26 at 1:45 PM Staff 8 (CNA) stated she assisted Resident 32 that morning and acknowledged she did not wash the resident's hands or brush her/his teeth.
Staff 8 stated she did not have time to complete all of Resident 32's hygiene care that morning.On 3/26/26 at 2:33 PM Witness 5 (Hospice Nurse) stated Resident 32 received bathing services through hospice but did not have nail care on her/his hospice care plan.On 3/27/26 at 8:54 AM Staff 9 (CNA) stated hygiene tasks were to be completed daily and as needed, and nail care typically occurred after showers and as needed. On 3/27/26 at 9:09 AM Witness 3 (Hospice Aide) reported Resident 32 received her/his first shower from hospice on Thursday 3/19/26 but she did not recall the condition of the resident's toenails at that visit. On 3/27/26 at 9:16 AM Staff 7 (RNCM) acknowledged all hygiene care was to be completed twice per day, and nail care was to be done weekly and as needed.
Staff 7 was unable to identify a reason the facility did not provide bathing or nail care services from 3/1/26 to 3/19/26.
385206 03/27/2026
Mennonite Home 5353 Columbus Street SE Albany, OR 97321
residents at risk for seizures.
Findings include:Resident 25 was admitted to the facility in 10/2025
Physician Order revealed prescriptions for two anti-seizure medications: Briviact 50 mg given twice daily, and Clobazam 10 mg given at bedtime.
The 2/2026 MAR revealed Resident 25 missed her/his dose of Clobazam on 2/3/26, 2/4/26, and 2/5/26, as well as a dose of Briviact on 2/5/26.
Each missed dose was documented as med not available by Staff 10 (Certified Medication Assistant). On 3/26/26 at 3:10 PM Staff 10 (Certified Medication Assistant) acknowledged he was able to order medications but did not order Resident 25's anti-seizure medication when he saw it was out.
Staff 10 stated nursing staff, not him, was responsible for contacting a physician regarding missed medications but was unable to recall if he informed nursing staff of the missed medications. On 3/26/26 at 3:26 PM Staff 11 (LPN) stated on 2/5/26 she was notified Resident 25 was out of Briviact and would not receive her/his second dose that day.
Staff 11 further stated she was unaware of the three missed doses of Clobazam until 2/5/26. On 3/27/26 at 8:27 AM Witness 4 (Physician) stated Briviact and Clobazam were important medications for preventing Resident 25 from having seizures.
Witness 4 reported missed doses of those medications could result in a grand mal seizure On 3/27/26 at 10:23 AM Staff 7 (RNCM) acknowledged Resident 25 missed anti-seizure medications on 2/3/26, 2/4/26, and 2/5/26.
Staff 7 further acknowledged the missed medications increased Resident 25's risk for seizures.
Based on observation, interview, and record review it was determined the facility failed to ensure
reviewed for medication storage.
This placed residents at risk for reduced efficacy of medication.
Findings include:1. On 3/25/26 at 8:24 AM the third floor medication refrigerator temperature logs were observed to be blank on the following dates: 3/1/26; 3/4/26; 3/7/26; 3/8/26; 3/13/26; 3/14/26; 3/15/26; 3/16/26; 3/17/26; 3/18/26; 3/19/26; 3/21/26; 3/22/26; 3/23/26 and 3/24/26.
The medication refrigerator contained insulin and other medications. On 3/25/26 at 8:24 AM Staff 3 (LPN) acknowledged the temperature logs were blank on the identified dates and acknowledged the refrigerator contained insulin and other medications. On 3/25/26 at 9:04 AM Staff 2 (DNS) acknowledged the identified dates with blank temperature logs and provided no additional information.2. On 3/25/26 at 8:55 AM the second floor medication refrigerator temperature logs were observed to be blank on the following dates: 3/11/26; 3/12/26; 3/13/26; 3/18/26 and 3/19/26.
The medication refrigerator contained insulin and flu vaccines.On 3/25/25 at 8:55 AM Staff 4 (LPN) acknowledged the temperature logs were blank on the identified dates and acknowledged the refrigerator contained insulin and flu vaccines.On 3/25/26 at 9:04 AM Staff 2 (DNS) acknowledged the identified dates with blank temperature logs and provided no additional information.
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 TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE
385206 03/27/2026
Mennonite Home 5353 Columbus Street SE Albany, OR 97321
Frequently Asked Questions
More Reports
Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.
Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.
Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.