Patriot Living of Yadkinville

The facility failed to administer medications as ordered for 3 out of 6 sampled residents. Specifically, for Resident #1, the facility held 100mg tablets of losartan potassium despite orders for a 50mg dose, and the available tablets were unscored and could not be safely split to meet the prescribed dosage.

The facility failed to administer medications as ordered for 3 of 6 sampled residents, specifically involving antihypertensive, acid reflux, and antihistamine medications. In one instance, staff were cutting unscored 100mg losartan tablets in half to attempt to meet a 50mg order, despite the medication being unavailable in the correct strength. This resulted in a discrepancy between the physician's orders and the actual administration of medication.

The facility failed to provide clean top and bottom sheets for one resident. Specifically, records indicated that linen changes were not consistently performed as needed, and there was no documentation confirming that linens were changed as required for the resident.

The facility failed to provide adequate supervision for a resident with a history of falls, resulting in an ankle fracture. There was no facility policy available regarding resident falls or supervision, and no documented fall prevention interventions were implemented following a fall on 09/28/23.

The facility failed to ensure that written notice of discharge was provided prior to discharging residents. This failure was identified in 3 out of 4 sampled residents.

The facility failed to implement documented fall prevention interventions following falls involving Resident #3 on 09/28/23 and 10/03/23. Additionally, there was a lack of incident reporting and documentation regarding a fall on 09/28/23.

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 prior to their hire. Documentation showed no proof of an HCPR check was completed for the staff member when they were hired on 06/14/22.

The facility failed to ensure adequate health care follow-up to meet the needs of residents. Specifically, two of five sampled residents were identified as having inadequate follow-up for episodes of choking on food and pills, as well as increased behaviors.

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 hire. Specifically, there was no documentation that an HCPR check was completed for the Resident Care Coordinator before her hire date on June 14, 2022.

The facility failed to ensure health care follow-up to meet the needs of two residents who experienced episodes of choking and increased behaviors. For one resident, multiple choking incidents involving food and pills were documented by staff, but there was no evidence that the primary care provider was notified or that the swallowing concerns were addressed.