Merrimack County Nursing Home

In the surveyor’s words

From the most serious findings on record at Merrimack County Nursing Home, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Mar 21, 2024

  Based on interview and record review, it was determined that the facility failed to ensure that residents received adequate supervision, during and after a fire alarm, which resulted in a resident eloping and a delay in locating the resident in which the resident was held at the hospital for observation and treatment for hypothermia for 1 of 3 resident reviewed for elopement in a final sample of 39 residents (Resident Identifier #99). Findings include: Interview on 3/19/24 at approximately 11:00 a.m. with Staff D (Administrator) revealed that on 3/13/24, the fire alarm sounded at 12:50 a.m. due to smoke coming from a resident room. The fire alarm sounded and the locking mechanism of the locked doors disengaged which led to all exit doors being unlocked. […]

• No harm, potential for more than minimal, patternF761Feb 28, 2025

  Based on observation, interview, and record review, it was determined that the facility failed to ensure expired medications were removed from stock and multidose vials were labeled with an open/expiration date for 3 out of 4 medication rooms and 1 out of 7 medication carts observed (Resident identifiers are #31, #33, #36, #112, #126, and #152). Findings include: Observation on 2/26/25 at approximately 8:15 a.m. with Staff B (Registered Nurse) of Young Adult/Hospice medication room revealed a bottle of Omeprazole suspension for Resident #152 with an expiration date of 2/15/25 in the medication refrigerator. Interview on 2/26/25 at approximately 8:20 a.m. with Staff B confirmed the above findings. […]

• No harm, potential for more than minimal, patternF812Apr 8, 2022

  Based on observation and interview, it was determined that the facility failed to ensure that kitchen utensils were stored in a sanitary environement for food service safety in 6 out of 6 kitchenettes observed. Findings include: Standard: Review on 4/6/22 of the U.S. FDA (Food Drug and Administration) Food Code (2017), retrieved from: https://www.fda.gov/media/ 2/download, revealed [page 152-153] .Storing 4-903.11 Equipment, Utensils, Linens, and Single-Service and Single-Use Articles. (A) Except as specified in ¶ (D) of this section, cleaned EQUIPMENT and UTENSILS, laundered LINENS, and SINGLE-SERVICE and SINGLEUSE ARTICLES shall be stored: (1) In a clean, dry location; (2) Where they are not exposed to splash, dust, or other contamination . […]

• No harm, potential for more than minimal, patternF886Apr 8, 2022

  Based on interview, record review, policy review and CDC (Centers for Disease Control) Long term care guidance it was determined that the facility failed to test 2 symptomatic residents for COVID-19 out of 3 residents reviewed for symptoms in a survey sample of 36 residents reviewed. (Resident identifiers are #88, and #111.) Findings include: Resident #88 Review on 4/7/22 of Resident #88's medical record revealed the following Nurse Progress Note, dated 3/28/22: At 1930 LNA (Licensed Nursing Assistant) reported that resident was throwing up; upon entering the room found resident in [pronoun omitted] bed laying on [pronoun omitted] right side with a basin in front of [pronoun omitted] with a small amount of liquid emesis with small food particles; resident stated that it all happened all of… […]

• No harm, potential for more than minimal, patternF756Mar 25, 2021

  Based on medical record review and interview, it was determined that the facility failed to ensure that Drug Regimen Reviews by a licensed Pharmacist include GDR (Gradual Dose Reduction) for antipsychotics for 3 residents out of a final survey sample of 35 residents. (Resident identifiers are #34, #46 and #118.) Findings include: Resident #118 Review on 3/24/21 of Resident #118's physician orders [REDACTED]. Review on 3/25/21 of Resident #118's monthly Drug Regimen Reviews from January 2020 to February 2021 revealed that there were no pharmacy recommendations for GDR attempts for Resident #118's [MEDICATION NAME]. Interview on 3/25/21 at approximately 11:35 a.m. with Staff B (Unit Manager) confirmed above findings. […]