NHC Healthcare, Oak Ridge

In the surveyor’s words

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

• Actual harm, isolatedF600Jul 29, 2021

  Based on facility policy review, medical record review, facility investigation review, and interview, the facility failed to ensure 1 resident (Resident #2) was free from abuse of 7 residents reviewed for abuse. Resident #2 was punched in the face by Resident #1 and received a bruised eye (black eye), resulting in actual harm. The findings include: Review of the facility's policy titled, Patient Protection and Response Policy for Allegations/Incidents of Abuse, Neglect, Misappropriation of Property and Exploitation, dated 12/11/2017, showed .Abuse .will not be tolerated by anyone, including .patients .The patient has the right to be free from abuse .The center administrator is responsible for assuring that patient safety, including freedom from risk of abuse .holds the highest priority… […]

• No harm, potential for more than minimal, widespreadF812Nov 29, 2023

  Based on facility policy review, observations, and interviews, the facility failed to ensure food items were sealed properly, failed to ensure kitchen cooking/ serving equipment was maintained in a sanitary manner, and failed to ensure expired foods were discarded, which had the potential to affect 96 of 96 residents. The findings include: Review of the facility's policy titled, Safe Food Storage, dated ,d+[DATE], showed .properly store food items in a safe manner .Discard food items that have passed the expiration date .Securely wrap or cover all food items . Review of the facility's policy titled, Machine Warewashing, dated ,d+[DATE], showed .Check each rack for soiled items as it comes out of the machine. […]

• No harm, potential for more than minimal, isolatedF692Feb 19, 2026

  Based on facility policy review, facility document review, medical record review, observation, and interview, the facility failed to follow the facility's policy related to fluid restrictions for 3 residents (Resident#2, Resident#7, and Resident#23) of 5 residents reviewed for fluid restrictions.The findings include: Review of the facility's policy titled, FNS [Food Nutrition Services] Fluid Restriction Distribution Best Practice, undated, revealed .distribute fluid when a resident has an order for the fluid to be restricted .fluid restrictions order is entered .nursing should go to the Diet Order and to see if there is a Special Instruction note related to the fluid restriction . […]

• No harm, potential for more than minimal, isolatedF880Feb 19, 2026

  Based on facility policy review, observation and interview, the facility failed to ensure proper infection control practices during the medication administration for 2 residents (Resident #33 and Resident #34) of 4 residents reviewed for medication administration. The findings include: Review of the facility policy titled, Medication Administration, dated 2/25/2025, revealed .medications are administered as prescribed in accordance with good nursing principles and practices .the person administering medications adheres to good hand hygiene .gloves must be worn to prevent touching tablets . […]

• No harm, potential for more than minimal, isolatedF550Nov 29, 2023

  Based on facility policy review, medical record review, observation, and interview the facility failed to protect the resident's rights for 1 resident (Resident #20) of 53 residents reviewed. The findings include: Review of the facility policy titled, Resident Rights, revised 11/2017, showed .We strive to cultivate and sustain an excellent quality of life for each individual .by honoring and supporting each patient/resident's preferences, choices, values, and beliefs. Resident #20 was admitted to the facility on [DATE] with diagnoses including Chronic Respiratory Failure, Chronic Obstructive Pulmonary Disease, Congestive Heart Failure, and Diabetes Mellitus. […]