Tube feeding · Quality of Life and Care Deficiencies
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
F693 in North Carolina. Pick another state for the same tag.
Against expectation — 2025
North Carolina cites F693 more often than its own record predicts
Versus expected share1.79×
1.79 times the share F693 takes of citations nationally.
Share of North Carolina citations1.25%
Of every deficiency written in North Carolina in 2025, this is the portion that was F693.
North Carolina1.25%
National0.70%
Share of all citations that were F693.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What North Carolina surveyors wrote
F693 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.
J · Immediate jeopardy, isolatedJuly 24, 2026
Based on record review and interviews with staff, Physicians and Nurse Practitioners (NP), the facility failed to identify the seriousness of new onset and continued vomiting, complete and document ongoing comprehensive nursing assessments of the residents condition or identify the urgent need for medical attention for a severely cognitively impaired resident with a diagnosis of traumatic brain injury who received all fluid and caloric intake through bolus tube feedings six times a day. Resident #145 had an acute vomiting episode on [DATE] and the 6:00 AM bolus feeding was held. Nursing staff provided three scheduled bolus tube feedings on [DATE] before the 10:00 PM bolus tube feeding was held due to vomiting. …
Based on observations, staff interviews and record review the facility failed to provide the residents tube feeding according to the physician's orders for 1 of 1 resident (Resident #5) reviewed for tube feeding. Resident #5 expericenced significant weight loss of 13.9 percent.
The findings included:
Resident #5 was admitted to the facility on [DATE]. His diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] .
Resident #5's Care Plan last reviewed on 12/22/21 indicated he required tube feeding related to dysphagia. The interventions included, See MAR (medication administration record) for current feeding orders. The Care Plan also indicated Resident #5 had the potential for nutritional risk related to receiving 100% of nutrition via PEG (percutaneous endoscopic gastrostomy) tube. …
D · No harm, potential for more than minimal, isolatedAugust 21, 2026
Based on observation, record review, staff interviews and Medical Director interview, the facility failed to provide a way for nursing staff to measure the head of bed elevation for residents receiving tube feedings. In addition staff was unable to ensure the head of residents beds were elevated at least 30 degrees according to physician orders for 1 of 2 residents reviewed for tube feeding (Resident's #78's). The findings included:Resident #78 was admitted to the facility on [DATE] with diagnosis that included cerebral infarction (stroke), dysphagia (difficulty swallowing), and gastro-esophageal reflux.Review of Resident #78's physician orders revealed an order for Glucerna 1.5 (an enteral feeding) with a flow rate of 70 milliliters for 21 hours with start date of 6/25/26 written by the… …
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