Chowan River Nursing and Rehabilitation Center

In the surveyor’s words

From the most serious findings on record at Chowan River Nursing and Rehabilitation Center, in the surveyor’s own words.

• Actual harm, isolatedF686Apr 30, 2021

  Based on record review, staff, registered dietician and physician interview the facility failed to implement a comprehensive approach to pressure ulcer care and services for a resident who was at risk for pressure ulcers for 2 (Resident #229 and Resident #34) of 6 residents reviewed for pressure ulcers. The findings included: 1. Resident #229 was admitted to the facility on [DATE] and had a diagnosis [MEDICAL RECORD OR PHYSICIAN ORDER] . Dysarthria is a weakness in the muscles used for speech which often causes slowed or slurred speech. On [DATE] the resident was diagnosed with COVID-19 and transferred to a COVID only facility. The resident was readmitted to the facility on [DATE]. An admission progress note revealed the following: Was admitted from a sister facility COVID only. […]

• Actual harm, isolatedF689Apr 30, 2021

  Based on record review and staff and resident interviews, the facility failed to provide adequate supervision when repositioning a resident in the bed during care, resulting in the resident falling off the bed and sustaining an injury to her right arm for 1 of 4 residents (Resident #67) reviewed. The findings included: Resident #67 was admitted to the facility on [DATE] with diagnoses that included hypertension and arthritis. The admission Minimum Data Set (MDS) assessment dated [DATE] noted Resident #67 was cognitively intact and required extensive assistance with 1 person physical assistance for bed mobility. A review of Resident #67's Care Plan dated 1/4/21, with a focus are of Activities of Daily Living care, revealed interventions to include bed mobility, one person assist. […]

• No harm, potential for more than minimal, widespreadF812Apr 30, 2021

  Based on observations and staff interviews the facility failed to maintain kitchen equipment clean and in a sanitary condition by failing to clean 2 of 2 ice machines and failed to clean the reach-in freezer filter grill. The findings included: A review of the Dietary Policy Manual (Revised on 2/9/16) Under Cleaning Procedures; Ice Making Machines. Exterior: reads as: Clean heavily soiled surfaces with a mild cleaning solution, then rinse with clear water and air dry. Observation on 4/26/21 at 2:53 PM the 300-hall ice machine was observed to have lime build up under the lid frame and rust was visible on the hinge screws. No debris or rust was observed in the ice. A second observation on 4/29/21 at 10:03 AM revealed the 300-hall ice machine to be in the same condition. […]

• No harm, potential for more than minimal, patternF761Jul 30, 2026

  Based on observations, record review, staff and Pharmacist interviews, the facility failed to remove expired medication and refrigerate medications according to the manufacturer's recommendations for 1 of 3 medication refrigerators observed for medication storage (Refrigerator #3).The findings included:a. An observation was conducted of the medication room on 7/29/26 at 3:42 PM with the Director of Nursing (DON). Refrigerator #3 contained 31 doses of the influenza high dose vaccine with an expiration date of 6/2026. The DON confirmed the vaccines were expired and removed the expired vaccines. An immediate interview was conducted with the DON on 7/29/26 at 3:44 PM. The DON stated the night shift nurses were responsible for checking the medication refrigerators during the night shift. […]

• No harm, potential for more than minimal, patternF698Apr 2, 2025

  Based on observations, record reviews and staff interviews, the facility failed to restrict the fluid intake for a resident with End Stage Renal Disease (a condition in which the kidneys lose the ability to remove waste and balance fluids) as ordered by the physician for 1 of 1 sampled resident reviewed for dialysis (Resident #114). The findings included: Resident #114 was admitted to the facility on [DATE] with diagnoses that included chronic congestive heart failure, chronic pulmonary edema, and dependence on renal dialysis. Review of Resident #114's care plan initiated on 2/28/25 identified the resident was at risk for complications due to hemodialysis, End Stage Renal Disease (ESDR). Resident is on 1500 ml (milliliters)/day restriction. […]