Carolina Village Inc

In the surveyor’s words

From the most serious findings on record at Carolina Village Inc, in the surveyor’s own words.

• No harm, potential for more than minimal, patternF812Jan 24, 2025

  Based on observations and staff interviews, the facility failed to remove food items past the date indicated for use in the walk-in refrigerator. This practice occurred in 1 of 1 walk-in refrigerator and had the potential to affect food served to residents. Findings included: An observation of the walk-in refrigerator on 01/21/25 at 9:22 AM with the Certified Dietary Manager (CDM) revealed the following: 1 a. A five pound container of sour cream dated 1/13 that had been opened and was available for use. During an interview on 01/21/25 at 9:22 AM the CDM revealed the date on the container was the date the sour cream was opened and she expected it to be discarded on 1/20/25, seven days after being in use. The CDM removed the container of sour cream from the walk-in refrigerator. c. […]

• No harm, potential for more than minimal, patternF812Aug 4, 2022

  Based on observations and staff interviews, the facility failed to label and date food items in 1 of 1 walk-in cooler and 1of 1 walk-in freezer. This practice had the potential to affect the food served to residents. The findings included: An initial tour of the kitchen was made on 8/1/2022 at 11:13 AM with the Dietary Manager (DM). The following problems were observed in the walk-in cooler: 1 opened and used pack of honey smoked turkey breast with no label and no date 1/2 pack of opened and used corn beef with no label and no date 1/2 container of opened and used thousand island dressing with no date 1/4 carton of opened and used milk with no date An observation of the walk-in freezer was made on 8/1/2022 at 11:18 AM with the DM. […]

• No harm, potential for more than minimal, patternF867Aug 4, 2022

  Based on observations and staff interviews, the facility's Quality Assessment and Assurance (QAA) Committee failed to maintain implemented procedures and monitor interventions previously put in place following the recertification survey of 8/04/22. This was for one deficiency cited during the 8/04/22 survey and subsequently recited on the 9/21/22 survey. The repeated deficiency was in the area of Food Safety Requirements. The facility's continued failure during two federal surveys shows a pattern of the facility's inability to sustain an effective QAA program. […]

• No harm, potential for more than minimal, patternF867Aug 4, 2022

  Based on observations and staff interviews, the facility's Quality Assessment and Assurance (QAA) Committee failed to maintain implemented procedures and monitor interventions previously put in place following the recertification survey of 8/04/22. This was for one deficiency cited during the 8/04/22 survey and subsequently recited on the 9/21/22 survey. The repeated deficiency was in the area of Food Safety Requirements. The facility's continued failure during two federal surveys shows a pattern of the facility's inability to sustain an effective QAA program. […]

• No harm, potential for more than minimal, isolatedF554Jan 24, 2025

  Based on observations, record review, and staff and resident interviews, the facility failed to assess the ability of a resident to self-administer medications and supplements for 1 of 1 resident with medication observed in the room (Resident #3). Findings included: Resident #3 was admitted to the facility 12/12/24 with diagnoses including hypertension (high blood pressure) and hypercholesterolemia (high cholesterol). Review of Resident #3's medical record revealed no documentation that Resident #3 was assessed for self-administration of medications or supplements. The admission Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #3 was cognitively intact. […]