NHC Healthcare, Bristol

In the surveyor’s words

From the most serious findings on record at NHC Healthcare, Bristol, in the surveyor’s own words.

• Actual harm, isolatedF689Aug 20, 2025

  Based on resident interview, staff interview, clinical record review, and facility document review, the facility staff failed to ensure the resident environment remains as free of accident hazards as is possible as evidenced by failure to lock the shower chair breaks prior to transfer resulting in a fall with a subsequent fracture for 1 of 16 sampled residents (Resident #7).The findings included:For Resident #7, the facility staff failed to lock the shower chair breaks prior to transfer causing the resident to fall and suffer a fracture at the base of the left thumb and skin tears to the forearms. Resident #7's diagnosis list indicated diagnoses, which included, but not limited to Chronic Obstructive Pulmonary Disease, Chronic Congestive Heart Failure, Osteoporosis, and History of Falling. […]

• No harm, potential for more than minimal, patternF684Aug 20, 2025

  Based on staff interview, clinical record review, and facility document review, the facility staff failed to follow medical provider orders for medication administration for 6 of 16 sampled residents (Resident #10, #11, #12, #13, #14, and #15). The findings included:1. For Resident #10, the facility staff administered Levothyroxine at 9:00 PM instead of 6:00 AM as ordered by the medical provider. Levothyroxine is a medication used to treat hypothyroidism. Resident #10's diagnosis list indicated diagnoses, which included, but not limited to Dementia and Hypothyroidism. […]

• No harm, potential for more than minimal, patternF658Jul 15, 2021

  Based on observation and staff interviews, the facility staff failed to follow professional standards of practice as evidenced by the presence of physician pre-signed blank Virginia Department of Health DDNR (Durable Do Not Resuscitate) Order forms on 2 of 2 nursing care units. The findings included: The facility staff failed to obtain the physician's signature on VDH (Virginia Department of Health) DDNR Order forms at the time of completion. The facility staff maintained the process of a physician pre-signing blank resident DDNR Order forms for availability as needed by the nursing staff. The surveyor observed 43 physician pre-signed blank VDH DDNR Order forms available on the nursing care units. […]

• No harm, potential for more than minimal, patternF689Jul 15, 2021

  Based on observation, staff interview, and facility document review, the facility staff failed to ensure the resident environment remained free of accident hazards on 2 of 2 nursing care units, second and third floors. The findings included: The facility staff failed to ensure water temperatures were maintained in acceptable parameters to decrease the risk of resident injury. All temperatures referenced reflect the Fahrenheit temperature scale. 07/14/2021 11:34 a.m., the MD (maintenance director) checked the water temperature in the bathroom sink of room 307 using a digital thermometer. This temperature read 128. 07/14/2021 11:39 a.m., the surveyor and the MD went to the roof and the MD adjusted the mixing valve. […]

• No harm, potential for more than minimal, isolatedF609Aug 20, 2025

  Based on staff interview, record review and facility document review, the facility staff failed to report an allegation of verbal abuse for one of 16 residents in the survey sample, resident # 1. For resident # 1 (R1), the facility staff failed to report an allegation of staff to resident verbal abuse.R1's diagnoses included but were not limited to dementia with behavior disturbance, psychotic disturbance, mood disturbance, anxiety, and adult failure to thrive. The minimum data set assessment (MDS) with an assessment reference date of 7/7/25 assigned the resident a brief interview for mental status score of 3 out of 15 indicating severe cognitive impairment. […]