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Source: NC Division of Health Service Regulation
The facility failed to ensure that 8 of 9 exit doors accessible to residents identified as intermittently disoriented had audible alarms that activated when opened. Specifically, observations at the front entrance and in hallways A and C revealed doors that opened without sounding an alarm.
The facility failed to ensure contact with a resident's prescribing physician to verify or clarify medication orders. Specifically, for one resident, medications for high blood pressure, seizures, and mental health were administered based on verbal orders from a physician at a different facility rather than the resident's actual primary care provider.
The facility failed to ensure contact with a resident's prescribing practitioner to clarify medication orders. Specifically, for one resident, medications for various conditions were administered based on orders from a provider who was not the resident's primary care physician without proper verification.
The facility failed to serve therapeutic diets and nutritional supplements as ordered by the physician. Specifically, for two residents, the facility did not provide the required finger food diet and nutritional supplements, as evidenced by a resident being served standard breakfast items instead of the prescribed finger food alternatives.
The facility failed to complete the required corrective actions for tag 358 by the initial inspection date, with a revised completion date set for 09/02/23.
The facility failed to complete the required corrective actions for tag 310 by the initial inspection date, with a revised completion date set for 09/02/23.
The facility failed to complete the required corrective actions for tag 375 by the initial inspection date, with a revised completion date set for 09/02/23.
The facility failed to complete the required corrective actions for tag 377 by the initial inspection date, with a revised completion date set for 09/02/23.
The facility failed to ensure physician orders were implemented for a resident regarding fingerstick blood sugar (FSBS) checks. Specifically, despite orders to transition from daily to weekly checks, the resident continued to receive daily checks and had multiple instances of undocumented or refused blood sugar monitoring.
The facility failed to ensure physician orders were properly implemented for a resident's fingerstick blood sugar (FSBS) checks. Specifically, after a physician ordered a change from daily to weekly FSBS checks, the resident continued to receive daily checks through December 2021.
The facility failed to notify the primary care provider (PCP) regarding a resident's thromboembolic deterrent (TED) hose and daily blood pressure readings. Specifically, the facility did not communicate that a resident was not wearing prescribed compression stockings and did not notify the physician of significant blood pressure readings for two sampled residents.
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