Avina Of Mayville
Avina of Mayville in Mayville, WI — inspection on February 21, 2025.
Found 1 citation. 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
The facility failed to create a care plan related to R2's alcohol consumption and failed to implement interventions for behaviors associated with R2's alcohol consumption.
This is evidenced by:
The facility policy titled Safety for Resident with Substance Use Disorder, dated 1/25, states in part: It is the policy of this facility to create an environment that is as free of accident hazards as possible, for residents with a history of substance use disorder.
Definitions: substance use disorder (SUD) is defined as recurrent use of alcohol and/or drugs that causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home . 1.
Residents with a history of SUD will be assessed for risks .
Care plan interventions will be implemented to include increased monitoring and supervision of the resident and their visitors. 2.
When substance use is suspected .facility staff should implement the care plan interventions, which includes notification of the resident's physician or non-physician practitioner. 3.
Care planning interventions will address risks by providing appropriate diversions for resident and encouraging resident to seek out facility staff to discuss their plan of care .7.
The facility will make an effort to prevent substance use which may include providing substance use treatment services, such as behavioral health services, medication-assisted treatment (MAT), alcoholic/narcotics anonymous meetings, working with their resident and the family, if appropriate, to address goals related to their stay in the nursing home, and increased monitoring and supervision.
R2 admitted to the facility on [DATE] with diagnoses including alcohol abuse, repeated falls, unsteadiness on feet.
R2's Brief Interview for Mental Status (BIMS) on 11/26/24 has a score of 15, indicating R2 is cognitively intact.
R2's Medication administration and Treatment administration records for January 2025 and February 2025 do not include monitoring of behaviors and/or substance use.
R2's physician orders dated 2/21/25 does not include an order stating R2 can consume alcoholic beverages.
R2's comprehensive care plan dated 2/21/25, states in part:
Focus: The resident is functioning at an independent level in his leisure pursuits.
Goal: The resident will make one positive statement about his leisure pursuits to staff weekly.
525616
Form Approved OMB
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.
Building 525616 B.
Wing 02/21/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Crossroads Care Center of Mayville 305 S Clark St Mayville, WI 53050