Based on record review, and staff, Friend #1, Friend #2, Family Member, Home Health Nurse, Adult Protective Services Social Worker, hospital Social Worker, Nurse Practitioner, and Primary Care Physician interviews, the facility failed to ensure a safe and orderly discharge for a resident that had severe cognitive impairment, incontinent of bowel and bladder, required assistance with all activities of daily living, and was not capable of managing her medications prescribed for diabetes, hypertension, hypothyroidism, pain and depression. Resident #1 was discharged to her apartment where she lived alone with friends (Friend #1 and Friend #2) who indicated they were unable to provide the 24-hour level of care the resident required. …
F627 citations in North Carolina
Resident Rights Deficiencies
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
North Carolina cites F627 more often than its own record predicts
1.54 times the share F627 takes of citations nationally.
Of every deficiency written in North Carolina in 2025, this is the portion that was F627.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What North Carolina surveyors wrote
F627 findings written in North Carolina, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
Based on record reviews and staff, home health agency representatives, Resident and family member interviews, the facility failed to ensure Resident #1 received the required medical supplies, coordination of home health services, and adequate caregiver instruction for 1 of 3 residents reviewed for transfer/discharge (Resident #1). Findings included:Resident #1 was admitted to the facility on [DATE] with diagnoses of diabetes mellitus, gastroparesis (a long-term medical condition where the stomach empties food into the small intestine much too slowly), encounter for attention to the gastrostomy (a medical procedure that creates an opening from the outside of the abdomen directly into the stomach. …
What else North Carolina surveyors cite →
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