Meridian Center

Inspectors wroteBased on observation and staff interviews, the facility failed to label and date food items stored for use in the reach-in refrigerator for 1 of 1 reach-in refrigerator and failed to use gloves when handling an unpeeled cucumber for 1 of 5 kitchen staff observed. These practices had the potential to affect food served to residents.

Inspectors wroteBased on record review, staff and resident interviews, the facility failed to protect a resident's right to be free from misappropriation of property when a staff member (Nurse Aide #8) accepted a meal purchased by Resident #144 through an online food delivery service and failed to reimburse Resident #144 for the cost of the meal. The deficient practice was for 1 of 2 residents reviewed for misappropriate of resident property (Resident #144). Findings Included:Resident #144 was admitted to the facility on [DATE]. Review of Resident #144's quarterly Minimum Data Set (MDS) Assessment indicated Resident #144 was cognitively intact. [...]

Inspectors wroteBased on observations, record review, and resident and staff interviews, the facility failed to provide nail care for 1 of 3 dependent residents reviewed for activities of daily living (ADL) (Resident #68).

Inspectors wroteBased on observations, record review, and resident, resident representative, staff, Neurosurgery Staff Nurse, Wound Care Physician, and Medical Director interviews, the facility failed to follow up with the neurosurgeon's office regarding a follow up appointment to address resident's staples. The deficient practice affected 1 of 1 resident reviewed for quality of care (Resident #1).

Inspectors wroteBased on observation, record review, resident and staff interviews, the facility failed to provide personal care in a safe manner when Resident # 44 was left unattended in shower room with the side rails on shower stretcher left in down position. Resident #44 rolled off the right side of shower stretcher and required transfer to the hospital for medical evaluation. This was for 1 of 4 residents reviewed for accidents (Resident #44).

Inspectors wroteBased on observations and staff interviews, the facility failed to secure a bottle of prescription eye drops that was left unattended on top of the second-floor medication cart for 1 of 5 medication carts reviewed for medication storage (second floor medication cart).

Inspectors wroteBased on observation and resident and staff interviews, the facility failed to provide food that was palatable in taste and temperature. The deficient practice affected 3 of 3 residents reviewed for food (Resident #14, #83, and #139).

Inspectors wroteBased on observation, record reviews, and interviews with staff, resident, and the Medical Director, the facility failed to ensure safe securement per manufacturer recommendations of a resident during a van transport. On 2/21/25, Resident #8 was being transferred to dialysis in the facility's transportation van. When Transportation Driver #1 made a left turn, Resident #8 and the wheelchair she was seated in tipped over onto the floor of the van. The Transportation Driver called 911. Resident #8 complained of pain to the right side of her neck and face and was transported to the hospital via Emergency Medical Services (EMS). Resident #8 was receiving a blood thinner which increased her risk of bleeding. While at the hospital, Resident #8 was found to not have sustained any injuries but was admitted for one day to receive her missed dialysis treatment before returning to the facility. [...]

Inspectors wroteBased on observations, record reviews, and staff and Medical Director interviews, the facility staff failed to disinfect a shared blood glucose meter (glucometer) between residents in accordance with the instructions provided by the manufacturer of the disinfectant wipes used for 1 of 2 residents whose blood glucose levels were checked (Residents #135). This occurred while there was at least one resident with a known bloodborne pathogen in the facility. Shared glucometers can be contaminated with blood and must be cleaned and disinfected after each use with an approved product and procedure. Failure to use an Environmental Protection Agency (EPA)-approved disinfectant in accordance with the manufacturer potentially exposes residents to the spread of blood borne infections. [...]

Inspectors wroteBased on record review and interviews with staff, residents, and the dialysis center Nurse Manager, the facility failed to provide transportation back to the facility after hemodialysis was completed which caused the residents to wait up to 2 hours to return. The residents requested they be transported back to the facility and not wait, which made one resident late for dinner. This deficient practice affected 2 of 3 residents reviewed for dialysis (Residents #22 and #8).

Inspectors wroteBased on staff interviews and record review, the facility failed to notify the North Carolina Medicaid Uniform Screening Tool (NC MUST), that is the State Mental Health or Intellectual Disability Authority, when a significant change in condition was identified for a resident with a mental disorder or intellectual disability (Resident #39) and failed to request a Preadmission Screening and Resident Review (PASRR) re-evaluation for PASRR Level II residents identified to have a significant change in his or her physical or mental status (Resident #11 and Resident # 179). This deficient practice affected 3 of 3 residents reviewed who had a significant change in condition.

Inspectors wroteBased on observations and staff interviews, the facility failed to ensure 1 of 2 kitchen icemakers was free from black and gray debris and wet mixing bowls were not stacked together before they were fully dry. This had the potential to affect all residents who received ice and/or food that came into contact with the mixing bowls. An observation completed on 08/11/25 at 9:38 AM revealed 1 of the facility's 2 icemakers in the kitchen had black and gray debris running down the ice divider inside of the ice maker and then along the top ridge of the icemaker where the door opened and closed. The black and gray debris was wet in nature and appeared to be running down the divider and potentially dripping onto the ice. Additional observations at this time revealed 3 large metal mixing bowls that had recently been washed, nested together on a storage shelf. [...]

Inspectors wroteBased on record review and staff interview, the facility failed to complete an admission Minimum Data Set (MDS) assessment in the 14-day timeframe for 1 of 33 residents (Resident #190) reviewed for MDS assessments.

Inspectors wroteBased on staff interviews and record review, the facility failed to develop a comprehensive care plan to address a resident's needs as identified in the admission assessment for 1 of 36 residents (Resident #4) whose care plans were reviewed.

Inspectors wroteBased on staff interviews and record review, the facility failed to submit a quarterly Minimum Data Set (MDS) assessment within the required time limit for 1 of 4 residents (Resident #75) reviewed for the Resident Assessment facility task.

Inspectors wroteBased on staff interviews and record reviews, the facility failed to accurately code the Minimum Data Set (MDS) assessment to reflect whether anticonvulsant and anticoagulant medications were administered for 1 of 36 residents (Resident #4) whose MDS assessment was reviewed.

Inspectors wroteBased on observations, record review, and staff, resident, and Nurse Practitioner (NP) interviews the facility failed to transfer a resident safely from a shower to the resident's room. On 06/12/24 Resident #1 was being pushed in a shower chair down the hall by Nursing Assistant (NA) #1 and the resident fell forward out of the chair hitting the floor. The fall resulted in the resident being sent out to the hospital for complaints of severe pain. Resident #1 indicated from a 1-10 (10 being the most pain) her pain level was an 11 in her lower extremities and wanted to be sent out to the hospital immediately. [...]

Inspectors wroteBased on record review, resident interview, staff interview and Nurse Practitioner interview, the facility failed to provide assistive devices to prevent accidents for 1 of 4 residents (Resident #110) reviewed for falls. Resident #110 fell out of bed, hit her head on the floor, yelled, and screamed of pain, sustaining a 36 centimeters [cm] full thickness curvilinear (crescent) wound to the lateral aspect of the right lower leg and the right first toenail was almost completely avulsed (torn off) with only attachments on the lateral proximal (from the side to the center) nail.

Inspectors wroteBased on observations, resident and staff interviews and record review, the facility failed to honor a resident's choice to receive showers as scheduled or requested. This was for 1 (Resident #88) of 3 residents reviewed for choices.

Inspectors wroteBased on observations, record and staff interviews the facility failed to protect a resident's right to be free from abuse when Resident #420 struck Resident #133 with a cane. This affected 1 of 9 residents reviewed for abuse.

Inspectors wroteBased on record review and staff interviews, the facility failed to report allegations of abuse to Adult Protective Services (APS). This deficient practice was for 3 of 3 residents reviewed for abuse. (Resident # 11, Resident #319, Resident #133).

Inspectors wroteBased on record review, observations, resident, and staff interviews the facility failed to provide nail care to 1 of 7 residents who were dependent on staff for assistance with activities of daily living (Resident #102).

Inspectors wroteBased on observation, staff, resident and the Medical Director interviews and record review, the facility failed to obtain Physician orders for continuous oxygen for a resident with a diagnoses of chronic obstructive pulmonary disease (COPD) and Emphysema. The facility also failed to adminster oxygen at the ordered rate for Resident #86. This was for 2 (Resident #16 and Resident #86) of 3 residents reviewed for respiratory care.

Inspectors wroteBased on staff interviews and record review, the facility's Quality Assurance and Performance Improvement committee (QAPI) failed to maintain implemented effective procedures and monitor the interventions the committee put into place following the recertification and complaint survey dated 07/19/21 and on complaint survey on 04/14/22 for F 677. An F 677 was subsequently recited during the recertification and complaint survey dated 05/17/24. The continued failure of the facility during three federal surveys of record showed a pattern of the facility's inability to sustain an effective QAPI program.

Inspectors wroteBased on staff interviews and record review, the facility failed to revise the comprehensive care plan in the area of staff assistance with dressing and bathing for 1 (Resident #88) of 15 residents reviewed for activities of daily living (ADLs).