Sunrise of Raleigh

The facility failed to maintain a safe environment by leaving unsecured oxygen cylinders on the floor in a resident's room. These cylinders were not stored in a proper rack or crate as required. Staff acknowledged that cylinders should never be stored on the floor and noted that oxygen providers sometimes leave them unsecured.

The facility failed to ensure the medication administration record was accurate, as evidenced by Resident #1 not having the removal of a lidocain patch performed according to the physician's order.

The facility failed to ensure medication administration was in accordance with orders, specifically regarding Resident #6 and #7 where medications were not available or properly ordered.

The facility failed to ensure the environment was free from hazards, as evidenced by unsecured oxygen cylinders being found during the survey.

The facility failed to ensure that medication staff met required training and qualification standards. Specifically, a staff member was identified as not meeting the necessary criteria, and the facility must ensure all medication aides and supervisors complete required training and skills validation.

The facility failed to maintain an accurate medication administration record (MAR). Discrepancies were noted regarding discontinued medications, such as Fluconazole and Vitamin C, and incorrect dosages of supplements remaining on the medication cart.

The facility failed to ensure the accurate preparation and administration of medications in accordance with physician orders. Multiple instances were identified where medication orders, such as Gabapentin, Vitamin D3, and Zinc Oxide, required clarification with the physician or correction in the EMAR.

The facility failed to assure that the preparation and administration of medications and treatments by staff are in accordance with orders by a licensed prescribing practitioner.

The facility failed to ensure that 2 of 5 sampled staff members had completed the required 5, 10, or 15-hour medication staff training. Specifically, documentation was missing for the 5-hour training for one staff member and no training documentation was found for another.

The facility failed to administer medications as ordered for one resident. Specifically, the facility continued to administer Lexapro at the original dose instead of following titration instructions and failed to initiate the newly ordered Zoloft 25mg once a day.

The facility failed to ensure coordination of care with a primary care provider and mental health provider for a resident experiencing acute behavioral changes. Despite the resident's hospitalization and emergency room visits for aggression and altered mental status, there was no documentation that the physician was notified of these changes, and discharge instructions lacked follow-up care instructions.

The facility failed to ensure proper documentation and completion of the two-step Tuberculosis skin test process for a resident. While the test was eventually read and documented, the process required oversight to ensure compliance with admission requirements.

The facility failed to maintain refrigerators in the Memory Care unit in a clean and orderly manner. Specifically, several refrigerators had missing handles, sharp metal projecting from screw holes, and thick frost build-up.

The facility failed to maintain resident rooms in the Memory Care unit in a clean, orderly, and hazard-free manner. Specifically, 10 of 14 sampled refrigerators had missing handles with sharp metal projections, thick frost build-up, and worn or dirty gaskets.