Brookdale Reynolda Road

The facility failed to ensure the electronic Medication Administration Record (eMAR) was accurate for a resident approved to self-administer medications. Specifically, the record lacked necessary accuracy regarding the administration of prescribed medications such as hydrocodone, insulin, and coumadin.

The facility failed to ensure the electronic Medication Administration Record (eMAR) was accurate for a resident who self-administers medications. Discrepancies were found between physician orders and the eMAR, including incorrect dosages, missing medications, and missing dosage information for vitamins. Additionally, there was no secondary review process in place to ensure physician orders were entered into the eMAR accurately.

The facility failed to ensure that medication administration was in accordance with physician orders for one resident. Specifically, staff failed to administer Humalog insulin as prescribed when the resident's blood sugar levels exceeded the threshold of 250 mg/dL on multiple occasions throughout March, April, and May 2017.

The facility failed to ensure that medication administration was in accordance with orders by a licensed prescribing practitioner. Specifically, staff failed to administer Humalog insulin as ordered for 1 of 3 sampled residents when blood sugar levels exceeded the prescribed threshold of 250. Review of the eMAR showed six separate instances in March 2017 where blood sugar readings were above 250, but no documentation of the required insulin administration was present.

The facility failed to ensure that one of six sampled staff members had a completed North Carolina Health Care Personnel Registry (HCPR) check prior to being hired. The Business Office Manager failed to run the required check for the cook until after the employee had already been working at the facility.

The facility failed to assure proper follow-up regarding residents' refusal of prescribed therapeutic diets. Specifically, the facility did not contact the primary care physician, speech therapist, or dialysis center for two of the five sampled residents regarding these dietary refusals.

The facility failed to ensure that one of six sampled staff members had no substantiated findings listed on the North Carolina Health Care Personnel Registry (HCPR) prior to being hired. The Business Office Manager failed to run the required HCPR check for the employee until after the survey began.

The facility failed to assure follow-up with primary care physicians, speech therapists, and dialysis centers regarding residents' refusal of ordered therapeutic diets. Specifically, for two sampled residents, the facility did not coordinate care after they were found to be non-compliant with renal and pureed diet orders.

The facility failed to ensure that one of three sampled staff members had a completed North Carolina Health Care Personnel Registry (HCPR) check performed prior to their hire date. Documentation showed the check was not performed until after the employee had already begun working.

The facility failed to ensure that all therapeutic diets, including nutritional supplements and thickened liquids, were served as ordered by the resident's physician. This was identified as a Type B violation.

The facility failed to ensure that one of three sampled staff members had no substantiated findings listed on the North Carolina Health Care Personnel Registry (HCPR) prior to their hire date. Records showed the staff member was hired in May 2015, but the most recent HCPR check on file was dated from 2014.

The facility failed to ensure that therapeutic diets, including Renal, Nectar Thickened liquids, and Carbohydrate Control diets, were served as ordered by the resident's physician. For Resident #2, the meal served included items like chicken with gravy and mashed potatoes, which did not comply with the specific substitutions required for their Liberalized Renal diet.