Arbor Terrace of Asheville

The facility failed to provide a matching therapeutic diet menu for a resident's physician-ordered mechanical soft chopped diet. This lack of guidance for food service staff was identified during a kitchen observation and confirmed through interviews with the Dietary Director.

The regulation requires that water be served to each resident at each meal in addition to other beverages.

The facility failed to maintain a matching therapeutic diet menu for food service staff guidance. Specifically, one resident with a physician-ordered mechanical soft chopped diet did not have a corresponding menu available in the kitchen.

The facility failed to ensure water was served to residents at each meal. Observations showed significant numbers of residents in the Assisted Living and Special Care units were provided other beverages instead of water during breakfast and lunch services.

The facility failed to ensure that Resident #5 had physician orders to self-administer various prescription and over-the-counter medications. Specifically, there were no orders permitting the resident to self-administer medications, and several medications found in the resident's room were expired. Additionally, the resident's clinical assessment did not include orientation information or orders supporting self-administration.

The facility failed to ensure that one resident had physician orders for the self-administration of several prescription and over-the-counter medications, including topical gels, eye drops, and mouth pain medications. This lack of documentation violates the requirement that self-administration must be ordered by a licensed professional and documented in the resident's record.

The facility failed to administer medications as ordered for one resident. Specifically, there was no entry in the March 2023 eMAR for Miralax, and the April 2023 eMAR failed to reflect the medication order that began on 03/07/23.

The facility failed to administer medications as ordered for one resident regarding two medications used to treat constipation. Specifically, orders for Miralax and Dulcolax suppository from March 2023 were not entered into the electronic medication administration record (eMAR), resulting in missed doses.

The facility failed to ensure appropriate follow-up for a resident's medical referral. Specifically, after an x-ray was ordered to rule out a cervical spine fracture, there was no evidence that the follow-up for the requested CT scan was completed.

The facility failed to ensure necessary follow-up for a resident's medical referral. Specifically, the facility did not follow up on an order for a CT scan of the cervical spine to rule out a fracture following reports of neck and shoulder pain.