Alpha Concord Plantation

The facility failed to ensure the kitchen was clean and free of contamination, specifically regarding the reach-in ice machine. Observations revealed dirt residue lines on the deflector edges inside the ice machine storage bin and no posted cleaning schedule for the equipment. This was noted as a repeat citation following a previous health department inspection.

The facility failed to ensure one of eight sampled residents had completed required tuberculosis (TB) testing. Specifically, Resident #2 had a chest x-ray used to rule out TB instead of the required negative TB skin or blood test upon admission.

The facility failed to ensure physician follow-up was completed for two of three sampled residents who had medication refusals. For Resident #2, there was significant documentation of eye drop refusals without evidence that the primary care provider was notified.

The facility failed to ensure that one of three sampled residents had completed required tuberculosis (TB) testing upon admission. Specifically, Resident #2 had a negative chest x-ray on file, but lacked documentation of a negative TB skin test or blood test. Management and the Resident Care Director were unaware that a chest x-ray is only an acceptable alternative if a resident has a documented previous positive TB skin test result.

The facility failed to ensure the accuracy of the electronic Medication Administration Record (eMAR) for 2 of 3 sampled residents. Specifically, the facility failed to accurately document the administration, purpose, and effectiveness of as-needed (PRN) doses for a narcotic pain reliever and an anxiety medication. For Resident #3, discrepancies were found between the controlled substance count sheets and the eMAR, including doses signed out but not documented as administered.

The facility failed to ensure that one of three sampled staff members had been tested for tuberculosis disease upon hire. Personnel records for Staff B showed no documentation of a completed TB skin test at the time of employment.

The facility failed to ensure that the preparation and administration of medications and treatments by staff were in accordance with prescribed orders and facility policies.

The facility failed to ensure that 1 of 3 sampled staff members had been tested for tuberculosis disease prior to hire. Personnel records for Staff B showed no documentation of a TB skin test after July 2015.

The facility failed to ensure medications were administered as ordered for 2 of 6 residents during an 8:00 am medication pass. Specifically, a medication aide administered an incorrect dose of donepezil and failed to identify that aspirin had changed from enteric coated to chewable.