MOORSVILLE, NC- ACCORDIUS HEALTH AT MOORSVILLE

The Department of Health & Human Services conducted an inspection of the facility. The following  highlighted decencies listed below were found in a public survey.

Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.

Based on staff interviews and record reviews, the facility failed to have effective systems in place to ensure there were dietary staff to prepare meals when dietary staff did not arrive to work on the 1/22/23. The Central Supply Clerk and three Nurse Aides (NAs) prepared breakfast, lunch, and dinner resident meals without checking the internal temperature of cooked foods before serving and did not serve resident mechanically altered diets as ordered. This led to the high likelihood for residents to be at risk of choking or aspiration. This situation affected 9 of 9 residents (Resident #1, Resident #22, Resident #53, Resident #69, Resident #31, Resident #57, Resident #8, Resident #17, and Resident #26) for 3 of 3 meals. The staff also prepared breakfast, lunch, and dinner resident meals without checking the internal temperature of cooked foods before serving for 91 of 91 residents.

Ensure each resident’s drug regimen must be free from unnecessary drugs.

Based on record review, staff, Psychiatric Nurse Practitioner, Nurse Practitioner, and Medical Director interviews the facility failed to implement Psychiatric Nurse Practitioner recommendations for medication changes and labs (blood draws) for 3 of 5 residents reviewed for unnecessary medications (Resident #42, Resident #43, and Resident #22).

Honor the resident’s right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

Based on observations, record review, and staff interviews the facility failed to repair exposed damaged dry wall on 1 of 7 units (100 hall) and affected 5 of 12 occupied rooms (room [ROOM NUMBER], room [ROOM NUMBER], room [ROOM NUMBER], room [ROOM NUMBER], and room [ROOM NUMBER]), the facility also failed to label personal care items located in shared bathrooms on 1 of 7 units (400 hall) and affected 3 of 6 shared bathrooms (Rooms #400/402, Rooms #401/403, and Rooms #405/407).

Ensure each resident receives an accurate assessment.

Based on record review and staff interview the facility failed to accurately code the Minimum Data Set (MDS) in the areas of antipsychotic medications and indwelling catheters (Resident #43, Resident #22 and Resident #51) for 3 of 6 sampled residents.

Develop and implement a complete care plan that meets all the resident’s needs, with timetables and actions that can be measured.

Based on observations, record review, resident, and staff interview’s the facility failed to implement a comprehensive care plan for a resident that wandered daily (Resident #43) and for a resident that verbalized a desire to lose weight (Resident #54) for 2 of 4 residents reviewed.

Provide care and assistance to perform activities of daily living for any resident who is unable.

Based on observations, record reviews, staff and resident interviews, the facility failed to provide dependent residents with showers (Resident #74, #183, #184 and #186) and failed to provide nail care (Resident #53) and failed to provide shaves (Resident#75) to 6 of 8 residents reviewed for activities of daily living.

Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.

Based on observations, record review, resident, and staff interview’s the facility failed to offer or apply a hand splint and palm guard as ordered for 1 of 3 residents reviewed for range of motion (Resident #48).

Provide enough food/fluids to maintain a resident’s health.

Based on observations, record review and Registered Dietician (RD), Medical Director (MD) and staff interviews the facility failed to provide a nutritional supplement as recommended by the Registered Dietician for a resident with significant weight loss for 1 of 2 residents reviewed for nutrition (Resident 22).

Provide safe and appropriate respiratory care for a resident when needed.

Based on observations, record review, and staff interview’s the facility failed to administer oxygen at the prescribed rate and failed to clean the oxygen concentrator filter for 1 of 3 residents reviewed for respiratory care (Resident #11).

Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.

Based on record reviews and staff, Psychiatric Nurse Practitioner, Nurse Practitioner and Medical Director interviews the facility failed to implement Psychiatry recommendations for psychotropic medication changes for 1 of 5 residents reviewed for unnecessary medications (Resident #22).

Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.

Based on observations, record review, test tray, resident, and staff interview’s the facility failed to provide palatable food that was appetizing in temperature and texture for 5 of 5 residents reviewed with food concerns (Resident #9, Resident #12, Resident #27, Resident #30, and Resident #35).

Administer the facility in a manner that enables it to use its resources effectively and efficiently.

Based on record review, resident, staff interviews, the facility Administration failed to provide effective leadership and oversight to ensure effective systems were in place to have trained dietary staff available to prepare meals for residents. On 1/22/23 dietary staff did not arrive to work and the Central Supply Clerk and three Nurse Aides (NAs) prepared breakfast, lunch, and dinner resident meals without serving 9 of 9 residents mechanically altered meals as ordered (Resident #1, Resident #22, Resident #53, Resident #69, Resident #31, Resident #57, Resident #8, Resident #17, and Resident #26). This led to the high likelihood of aspiration or choking.