Walnut Cove Health and Rehabilitation

In the surveyor’s words

From the most serious findings on record at Walnut Cove Health and Rehabilitation, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Dec 18, 2024

  Based on observation, record review, and interviews with facility staff including Transport Aide/Driver #1, the facility failed to ensure the lift gate/platform was in the elevated position before unloading a resident from the back of the facility van for 1 of 3 residents sampled for accidents (Resident #1). On 10/24/24 Transport Aide Driver #1 pushed Resident #1 backwards out of the van and he fell approximately 17 and 1/2 inches out of the transport van to a lift platform that was located on the ground. Resident #1 fell out of his wheelchair and landed on his left side with half of his body on the lift platform and the other half of his body on the asphalt, and he struck his head on the asphalt. […]

• Immediate jeopardy, isolatedF689Jul 15, 2024

  Based on observation, record review, staff and resident interviews and a life safety surveyor interview the facility failed to ensure the safety of residents in the designated smoking area of the facility when a staff member supervising the residents who smoked lit Resident #78's cigarette and allowed the resident to smoke with a combustible tank of compressed oxygen attached to the back of her wheelchair while she sat in the wheelchair. Residents who were also smoking were seated near the oxygen tank. The oxygen tank was turned off while the residents smoked. Even if turned off, it is not safe to smoke around an oxygen tank, oxygen-enriched levels can remain on tubing, clothing, hair, and skin increasing the risk for fire and/or explosion. […]

• Immediate jeopardy, isolatedF600Dec 14, 2023

  Based on observations, record review, and resident, family, staff, Psychiatric Nurse Practitioner and Law Enforcement interviews the facility failed to protect a resident's right to be free from physical abuse when Nurse Aide (NA) #1 and NA #2 forcefully turned Resident #1 causing her forehead and left knee to hit the wall. The two NAs continued to provide incontinence care after the resident yelled and screamed for them to stop. Resident #1 reported she no longer felt safe when new staff came in to provide care to her. One of three sampled residents were affected by the deficient practice (Resident #1). The findings included: Resident #1 was admitted to the facility on [DATE]. The Resident was discharged to the hospital on 11/20/23 and readmitted to the facility on [DATE]. […]

• No harm, potential for more than minimal, widespreadF812Jul 15, 2024

  Based on record review, observations and interviews with the facility staff and Dietary District Manager, the facility failed to: 1) Wash hands / change gloves between handling soiled and clean dishes to prevent cross-contamination and failed to allow all clean service ware and dishware to air dry during 1 of 1 observation of the dish washing practices; 2) Label, date, and seal food items stored in the Dietary Department's walk-in freezer and dry food storage room; and 3) Maintain a sanitary environment in 1 of 2 nourishment rooms by having black dried substances behind the ice machine and beside and under the refrigerator (Long Hall nourishment room). The findings included: 1. […]

• No harm, potential for more than minimal, patternF584Dec 2, 2021

  Based on observations and staff interviews, the facility failed to maintain clean rooms and clean floors and bedside tables for 2 of 12 rooms (121 and 122), failed to maintain a bathroom floor in good repair for 1 of 12 rooms (Room 121), and failed to maintain walls in good repair for 3 of 12 rooms (121B, 122A and 109B). The findings were: 1. On 11/29/21 at 10:10 AM, an observation was made of the floor in Room 121. The floor was visibly soiled with dirt and dried debris, crumbs and other debris were observed on the side of the bed against the wall and there was non-skid tape under the bed that were that was loosening and torn up. The bedside table bases were also observed to have stained substances on them. Overbed lights in the room had dust build up. […]