Based on record review and staff, Pharmacist, Nurse Practitioner, and Physician interviews the facility failed to provide effective monitoring of medication blood levels and manage dose changes for a seizure medication (valproic acid). On 5/10/23 Resident #10's valproic acid level was 108 (therapeutic level is 50-100 mcg/mL). The laboratory results were reported to the on-call provider who ordered a decrease in the daily dosage of Resident #10's valproic acid. No orders were entered into the resident's record that day for any repeat valproic acid level to be drawn. On 5/12/23 Resident #10's Physician electronically signed an order to repeat the valproic acid level on 5/15/23. …
F757 citations in North Carolina
Unnecessary drugs · Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
North Carolina cites F757 less often than its own record predicts
0.91 times the national share — cited less often here than elsewhere.
Of every deficiency written in North Carolina in 2025, this is the portion that was F757.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What North Carolina surveyors wrote
F757 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 review, hospital record review, family interview, staff interviews, consultant pharmacist, nurse practitioner, and physician interviews, the facility administered multiple unnecessary doses of a steroid medication to Resident #1 over the course of six days which had an outcome of elevated blood sugars requiring insulin administration to correct. The facility also failed to monitor blood sugars after the physician ordered monitoring. Resident #1 was admitted to the hospital and diagnosed with urinary tract infection with [CONDITION(S)]. This problem affected 1 of 3 Residents (Resident #1) reviewed for medication errors. …
Based on observations, record review, review of an online reference service for medical professionals, and interviews with the Medical Director, Consultant Pharmacist, and staff, the facility failed to monitor for therapeutic levels of divalproex (a medication which may be used to treat seizures or mood disorders, Resident #3) and levothyroxine (a medication used to treat hypothyroidism, Resident #12) for 2 of 5 residents reviewed for unnecessary medications.Findings included:1. …
The short window
Recent years
| Year | Share of North Carolina citations | vs expected |
|---|---|---|
| 2023 | 1.06% | 1.32× |
| 2024 | 0.72% | 1.02× |
| 2025 | 0.72% | 0.91× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else North Carolina surveyors cite →
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