A Vision Come True

The facility failed to clarify medication orders with a physician regarding specific parameters for blood pressure medication. Specifically, for one resident, the order for clonidine did not clearly define the necessary systolic or diastolic blood pressure thresholds for administration.

The facility failed to clarify medication orders for a resident regarding blood pressure medication that included specific parameters. While the resident's blood pressure was being monitored twice daily, the facility did not ensure that the orders were clear or complete regarding the required frequency of monitoring or the administration of as-needed medication.

The facility failed to properly administer a prescribed anti-viral medication for one resident. Specifically, while a physician ordered Valacyclovir 1gm three times daily, medication administration records showed no documentation of the 2:00pm dose being given, and the resident confirmed he only received medications in the morning and evening.

The facility failed to ensure health care needs were met for a resident by failing to schedule follow-up Occupational Therapy (OT) and Physical Therapy (PT) appointments following a hospital admission. Additionally, the facility failed to notify a mental health provider regarding a medication that was being administered daily despite being ordered as needed.

The facility failed to ensure health care needs were met for a resident following a hospital discharge. Specifically, the facility did not schedule required follow-up appointments for Occupational Therapy (OT) and Physical Therapy (PT) despite physician orders. Additionally, the facility failed to notify a mental health provider regarding a medication order change.

The facility failed to ensure that all staff members had no substantiated findings listed on the North Carolina Health Care Personnel Registry (HCPR) upon hire. Specifically, the review of sampled staff records showed no documentation of HCPR checks for Staff A and Staff B, and a lack of required job descriptions and hire dates for Staff A.

The facility failed to ensure that all staff members had no substantiated findings listed on the North Carolina Health Care Personnel Registry (HCPR) upon hire. Specifically, the facility could not provide documentation of HCPR checks for 3 out of 4 sampled staff members, including Staff A and Staff B.

The facility failed to ensure that 3 of 4 sampled staff members had no substantiated findings listed on the North Carolina Health Care Personnel Registry (HCPR) upon hire. Specifically, documentation of HCPR checks was missing for Staff A, Staff B, and Staff D, which is necessary to ensure staff are qualified to work in an adult care home.