Yancey House

The facility failed to ensure that mealtime table service included a complete non-disposable place setting consisting of a knife, fork, and spoon. During an observation of 21 residents, it was noted that knives were missing from the place settings. Interviews with residents and staff confirmed that the absence of knives prevented residents from cutting their food, such as chicken, and that the cook intentionally omitted them from the napkin rolls.

The facility failed to ensure medications were administered as ordered for 2 of 5 sampled residents. Specifically, for Resident #1, amlodipine was documented as administered on 02/21/24, yet the medication was not available for administration during an observation later that day.

The facility failed to ensure medications were administered as ordered for 2 of 5 sampled residents. Specifically, medications for high blood pressure, depression, stomach acid, constipation, and a vitamin supplement were not available for administration despite being documented as given on the eMAR. Additionally, a medication used to treat PTSD was not available for administration.

The facility failed to ensure the electronic medication administration record (eMAR) was accurate for one resident regarding a topical cream for a yeast infection. Specifically, a physician's order for nystatin/triamcinolone cream was not entered into the eMAR, resulting in a lack of documentation for the administration of the medication for 44 days.

The facility failed to ensure the electronic medication administration record (eMAR) was accurate for a resident receiving treatment for a yeast infection. Specifically, a physician's order for nystatin/triamcinolone cream dated 03-02-23 was not entered into the eMAR, despite the medication being dispensed and applied by staff.

The facility failed to administer medications as ordered for several residents, including failure to administer an antipsychotic, a medication for joint inflammation, and a medication to prevent constipation. Specifically, an audit of Resident #1's records showed incorrect dosing instructions and administration times for haloperidol. This resulted in a medication error rate of 6% during observed medication passes.

The facility failed to administer medications as ordered for several residents, including failures to administer an antipsychotic, a medication for joint inflammation, and a medication to prevent constipation. This resulted in a 6% medication error rate during observed medication passes. The facility also failed to abate a previous Type B violation regarding this issue.