Wilkesboro Health and Rehabilitation

In the surveyor’s words

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

• Actual harm, isolatedF686Dec 2, 2021

  Based on record review, staff, Nurse Practitioner, and Medical Doctor interview the facility failed to identify and assess a change in a resident skin condition for 1 of 3 residents reviewed for pressure ulcers (Resident #143) resulting in the development of an unstageable deep tissue injury to the residents sacral area. The findings included: Resident #143 was admitted to the facility on [DATE] with diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . Review of the 5-day admission Minimum Data Set (MDS) dated [DATE] indicated that Resident #143 was severely cognitively impaired for daily decision making and required extensive assistance with bed mobility and transfers. The MDS further indicated Resident #143 was at risk for developing pressure ulcers but had none on admission. […]

• No harm, potential for more than minimal, patternF582Sep 11, 2024

  Based on record review and staff interviews, the facility failed to provide a complete Skilled Nursing Facility Advanced Beneficiary Notice of Non-coverage (SNF ABN) by omitting the estimated out of pocket cost for care for 4 of 4 residents reviewed for beneficiary notices (Residents #4, #151, #45, #11). The findings included: a. Resident #4 was admitted to the facility on [DATE]. The medical record revealed a CMS-10123 Notice of Medicare Non-Coverage letter (NOMNC) was relayed by phone on 8/21/24 to Resident #4's representative. The notice indicated that Medicare coverage for skilled services was to end on 8/23/24. […]

• No harm, potential for more than minimal, patternF812Sep 11, 2024

  Based on observations and staff interviews, the facility failed to discard expired food and food items with signs of spoilage stored for use in 1 of 1 walk-in cooler. The facility also failed to label and date food items in 1 of 1 walk in cooler and in 1 of 2 nourishment room freezers (Hall 100). Additionally, the facility failed to store a dry ingredient scoop in a manner to prevent cross-contamination of food. These practices had the potential to affect food served to residents. The findings included: a. An initial tour of the kitchen was made on [DATE] at 11:13 AM. […]

• No harm, potential for more than minimal, patternF690Jun 15, 2023

  Based on observations, record reviews and staff interviews, the facility failed to anchor a Resident's indwelling urinary catheter tubing (Resident #53) to prevent pulling and trauma and failed to change the drainage sponge as ordered around a Resident's suprapubic stoma (an artificial opening in the skin) where the suprapubic urinary catheter was inserted (Resident #19). This was for 2 of 3 residents (Resident #53 and #19) who were reviewed for urinary catheters. The findings include: 1. Resident #53 was admitted to the facility on [DATE] with diagnoses that included obstructive uropathy requiring a urinary catheter. Review of Resident #53's care plan dated 04/16/23 indicated the resident required an indwelling urinary catheter related to obstructive uropathy. […]

• No harm, potential for more than minimal, patternF761Dec 2, 2021

  Based on observations and staff interviews the facility failed to remove loose unsecure medications from the medication cart drawers for 3 of 3 medication carts reviewed for medication storage (300 Hall Cart, 200 Hall Cart #3 and #2). The findings include: An observation was made on 12/02/21 at 12:18 PM of the 300 Hall medication cart. The observation revealed 8 unidentified medications of various shapes, sizes and colors and a half of a white tablet lying loose and unsecure in the drawers of the medication cart. An interview was conducted with Medication Aide (MA) #2 on 12/02/21 at 12:18 PM. The MA who had been employed for 2 years observed the loose medications and stated she could not identify the various medications and that the medications should not be loose in the drawers. […]