The Enclave at Silkgrass

The facility failed to ensure medication orders were clarified with a physician for 2 of 3 sampled residents. Specifically, for one resident, a handwritten note regarding a topical medication was not verified, and there was no documentation that the physician was contacted to clarify whether the medication should be discontinued or continued.

The facility failed to ensure medication orders were clarified for two residents, specifically regarding a topical medication for rosacea and medications for Alzheimer's and depression. For Resident #2, conflicting documentation existed between a handwritten note stating a medication was 'never prescribed' and an order that listed the same medication under the 'discontinue' section. There was no documentation showing the physician was contacted to clarify these discrepancies.

The facility failed to ensure that one of three sampled residents had signed medication orders from a provider upon admission. This lack of verification or clarification of orders violates the requirement to maintain complete and signed physician orders for medications and treatments.

The facility failed to keep cleaning agents and personal care products in locked storage areas to prevent access by residents with dementia. Unlocked bathrooms in resident rooms, staff areas, and common hallways contained various bottles of shampoo, body wash, lotion, and disinfecting wipes accessible to residents.

The facility failed to keep cleaning agents and personal care products in locked storage areas to prevent access by residents with dementia. Observations revealed various bottles of shampoo, body wash, and cleaning supplies left on shelves and grab bars in resident bathrooms and common areas.

The facility failed to ensure that one of three sampled residents was tested for tuberculosis (TB) disease upon admission. A review of the resident's record showed no documentation of any tuberculosis skin testing available for review.

The facility failed to ensure that one of three sampled staff members was tested for Tuberculosis (TB) disease upon hire. While a chest X-ray was on file, there was no documentation of the required TB skin test.

The facility failed to ensure that one of three sampled staff members had no substantiated findings on the Health Care Personnel Registry (HCPR) upon hire. There was no documentation of an HCPR check in the staff member's personnel record.

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) upon hire.

The facility failed to ensure that one of three sampled staff members was tested for Tuberculosis (TB) disease upon hire. Specifically, the House Manager's personnel record lacked documentation of a TB skin test, containing only an outdated chest X-ray.