Brookdale Asheville Walden Ridge

The facility failed to follow physician orders regarding medication administration for a resident. Specifically, staff administered metoprolol succinate ER despite documented heart rates below the 60 bpm threshold required to hold the dose.

The facility failed to follow physician orders regarding medication parameters for one resident. Specifically, staff administered metoprolol succinate ER despite the resident's pulse being below the required threshold of 60 beats per minute on two separate occasions in June and July 2023.

The facility failed to provide adequate supervision for a resident with Alzheimer's disease and wandering behaviors, which resulted in the resident eloping from the facility. Although the resident's care plan required redirection and monitoring, the resident was able to exit the building during a period of staff distraction.

The facility failed to provide adequate supervision for a resident with Alzheimer's disease and documented wandering behaviors. This lack of supervision resulted in the resident eloping from the facility on 03/26/22. Additionally, the resident's care plan was not updated with new interventions following the elopement event.

The facility failed to ensure medication containers had correct labels for one resident regarding allopurinol, mirtazapine, and fexofenadine. Specifically, medication bubble packs contained incorrect dosages that did not match current physician orders, and there were no stickers indicating changes in directions. This error occurred despite the facility's electronic records showing the correct doses were being administered.

The facility failed to ensure medication containers had correct labels for one resident. Specifically, a bubble pack for allopurinol was labeled for 300mg daily despite a physician's order for 150mg daily, and there was no indication of the direction change on the packaging.

The facility failed to employ sufficient personnel to perform housekeeping and food service duties, resulting in direct care staff performing laundry, cleaning, and dining room tasks across all shifts. Interviews and record reviews revealed that housekeeping staff were frequently reassigned to direct care, and food service staff lacked adequate assistance to manage meal preparation and dining room service for over 30 residents.

The facility failed to employ sufficient personnel to perform housekeeping and food service duties, resulting in direct care staff performing laundry, cleaning, and dining room duties across all shifts. Interviews and time card reviews confirmed that direct care staff were burdened with these tasks, and the sole housekeeper was frequently reassigned to direct resident care.