Winston County Nursing Home

Inspectors wroteBased on observations, interviews, record reviews, facility document review, and facility policy review, the facility failed to develop and implement care plans to address a physician-ordered fluid restriction for two (2) of five (5) dialysis residents, Resident #43 and Resident #58.

Inspectors wroteBased on observations, interviews, record review, facility document review, and facility policy review, the facility failed to ensure a physician-ordered fluid restriction was implemented and monitored for three (3) of five (5) dialysis residents. Resident #12, #43, and #58. Findings Include: Record review revealed that the facility does not have a policy and presented a statement on facility letterhead dated 06/17/26, that stated, (Proper name) nursing home does not have a policy specific to fluid restrictions on dialysis residents, signed by the Administrator. Resident #12An observation and interview with Resident #12 on 6/16/26 at 8:30 AM revealed she was lying in bed. A 32-ounce water pitcher full of ice water was located on the bedside table. The resident stated she attended dialysis three times weekly and was not aware of a fluid restriction. [...]

Inspectors wroteBased on observation, staff interview, and facility policy review, the facility failed to store foods in kitchen refrigeration that was maintained in a clean, sanitary condition and good repair for one (1) of two (2) kitchen tours. Findings Include:Review of the facility policy titled Food Handling Guidelines: Cooling Process and Cold Holding, revised 4/26, revealed under, Policy: . An effective preventative maintenance plan is in place for each piece of food service equipment. All refrigeration is maintained in good working order and is calibrated, serviced, or tested per the manufacturer's instructions .During the initial kitchen tour on 6/15/26 at 11:00 AM, observation of the tray line cooler revealed the interior lower metal surface contained an excessive amount of moisture and was covered with a greenish-black substance in spotty patches. [...]

Inspectors wroteBased on observations, resident interviews, staff interviews, record review, and facility policy review, the facility failed to promote dignity and maintain independence during meal service by failing to provide a table knife to residents who were capable of independently cutting their own food for six (6) of eight (8) residents reviewed during a dining observation in the Cypress Cottage. Residents #6, Resident #16, Resident #34, Resident #49, Resident #70, and Resident #90Findings Include:Review of the facility policy titled Resident Rights revised 2/1/23 revealed under, Policy: [...]

Inspectors wroteBased on record review, observations, resident interviews, staff interviews, and facility policy review, the facility failed to make prompt efforts to resolve resident grievances related to food quality, food preferences, alternative menu selections, meal variety, food temperature, and food palatability as evidenced by unresolved concerns identified during six (6) of 12 months of Resident Council meetings reviewed. Resident #6, #13, #25, #28, #34, #38, #42, #49, #69, #81, and #99 Findings Include:Review of the facility policy titled Grievances-Family and Resident Grievances revealed under, Policy: It is the policy of this facility to support each resident's and family member's right to voice grievances without discrimination, reprisal, or fear of discrimination. Additionally revealed under, Policy Explanation and Compliance Guidelines: . 12. [...]

Inspectors wroteBased on observations, resident interviews, staff interviews, test tray review, and facility policy review, the facility failed to ensure food was palatable and consistent with resident food preferences and dislikes for nine (9) of 23 residents reviewed for food services in the Elm and Cypress cottages (Residents #6, #8, #16, #34, #49, #58, #70, #81, and #90).

Inspectors wroteBased on observation, staff interviews, and facility policy review, the facility failed to ensure medications were stored in a properly secured refrigerator for one (1) of four (4) medication storage rooms.

Inspectors wroteBased on observation, staff interview, record review and facility policy review, the facility failed to ensure staff implemented Enhanced Barrier Precautions (EBP) during medication administration for one (1) of four (4) care areas observed. Resident #9Findings Include:Review of the facility policy titled Infection Control-EBP with an effective date of 4/01/2024 revealed, It is the policy of this facility to implement enhanced barrier precautions for the prevention of transmission of multidrug-resistant organisms .2. Initiation of Enhanced Barrier Precautions: i .indwelling medical devices (e.g . [...]

Inspectors wroteBased on observations, resident and staff interviews, facility document review, and facility policy review, the facility failed to provide an effective system for residents to summon staff assistance when the call light system was nonfunctional for two (2) of 24 residents residing on one (1) nursing unit, Unit C. (Resident #52 and #95)

Inspectors wroteBased on observation, staff interview, facility policy review, the facility failed to ensure items in the kitchen refrigerator, freezer and dry good spices were labeled and dated on one (1) of two (2) kitchen tours during survey.

Inspectors wroteBased on staff interviews, record review, and facility policy review, the facility failed to submit criminal background checks on four (4) of five (5) new employee personnel records reviewed during survey. Employee #1, #2, #3, and #5.

Inspectors wroteBased on staff interview, record review, and facility policy review, the facility failed to ensure a resident's choice for end of life care was indicated accurately on medical records for one (1) of 24 residents reviewed for advance directives.

Inspectors wroteBased on observations, resident and staff interviews, record reviews, and facility policy review, the facility failed to ensure a resident received the necessary care and treatment of a nephrostomy for one (1) of three (3) residents with urinary catheter systems.

Inspectors wroteBased on observation, staff interviews, and facility policy review the facility failed to ensure items in the kitchen refrigerator and refrigerated cooler were labeled and dated, expired food items were removed and that food bins were covered for one (1) of two (2) kitchen tours.

Inspectors wroteBased on observation, resident and staff interviews, record review and facility policy review the facility failed to change, date, and label and store oxygen tubing and to post oxygen signage at the entrance to residents' rooms for three (3) of four (4) residents reviewed with oxygen. Residents #2, Resident #42 and Resident #184. Findings Include: Review of facility policy Oxygen Therapy with revision date of 02/09/18 revealed under Policy Explanation and Compliance Guidelines: .4. NO SMOKING and/or OXYGEN IN USE signs will be posted at the entrance of the resident's room. Facility Policy also revealed under Oxygen Concentrator the following: .3. Change humidified bottle and tubing weekly. [...]

Inspectors wroteBased on staff interviews, record review and facility policy review the facility failed to submit criminal background checks on three (3) of five (5) new employee personnel records reviewed.

Inspectors wroteBased on observations, staff interview, record review and facility policy review the facility failed to implement a comprehensive care plan for three (3) of 18 care plans reviewed. Resident #2, Resident #42 and Resident #184. Findings Include: Record review of the facility policy titled Care Plan with a revision date of 09/04/2014 revealed under Purpose .To direct resident care from admission to discharge. Resident #184 An observation on 10/11/22 at 11:03 AM, revealed Resident #184 lying in bed receiving Oxygen (O2)via biprong nasal cannula at five (5) Liters Per Minute (LPM). O2 tubing was not dated or labeled and there was no O2 signage on the resident's room door. Record review of Resident #184's care plans revealed the following care plan: [...]