Inspection Reports for
Grafton County Nursing Home
3855 DARTMOUTH COLLEGE HIGHWAY, NORTH HAVERHILL, NH, 03774
Back to Facility ProfileDeficiencies (last 3 years)
Deficiencies (over 3 years)
5 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
22% worse than New Hampshire average
New Hampshire average: 4.1 deficiencies/yearDeficiencies per year
8
6
4
2
0
Occupancy
Latest occupancy rate
87% occupied
Based on a January 2025 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
Occupancy rate over time
Inspection Report
Annual Inspection
Census: 118
Deficiencies: 8
Date: Jan 31, 2025
Visit Reason
The inspection was conducted as an annual survey to assess compliance with regulatory requirements for nursing home care, including resident care, safety, and facility policies.
Findings
The facility was found deficient in multiple areas including failure to properly assess and document use of physical restraints, inaccurate Minimum Data Set (MDS) assessments, failure to provide appropriate adaptive equipment for activities of daily living, failure to identify resident trauma preferences, inadequate dental care, failure to provide nourishing bedtime snacks, incomplete and inaccurate medical record documentation, and failure to conduct annual reviews of infection prevention and control policies.
Deficiencies (8)
Failure to determine if a device was a restraint for 1 of 1 resident reviewed for restraints.
Failure to ensure that the Minimum Data Set (MDS) assessment accurately reflected residents' dental status for 2 of 2 residents reviewed.
Failure to provide appropriate adaptive equipment to maintain ability to perform activities of daily living for 2 of 2 residents reviewed.
Failure to identify resident preferences to eliminate or mitigate triggers causing re-traumatization for 1 of 3 residents reviewed.
Failure to ensure residents obtained routine dental care for 2 of 2 residents reviewed.
Failure to offer nourishing bedtime snacks for residents on 4 of 4 units reviewed without Resident Council consent.
Failure to follow standards of practice for complete medical records related to death pronouncement and incorrect weight documentation for 2 residents.
Failure to conduct annual reviews of infection prevention and control program policies and procedures.
Report Facts
Residents reviewed: 24
Facility census: 118
Deficiencies cited: 8
Weight records: 156.3
Weight records: 194.7
Weight records: 193.7
Weight records: 156.6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff U | Registered Nurse | Confirmed Resident #25 wore dentures and that Resident #25's dentures hurt |
| Staff T | MDS Coordinator | Confirmed MDS coding errors for Residents #25 and #63 |
| Staff Q | Licensed Nursing Assistant | Confirmed Resident #5 was eating from a styrofoam container without a lip plate and Resident #58 was eating from a styrofoam container |
| Staff H | Social Services | Documented trauma history and reactions of Resident #38 |
| Staff F | Administrator | Interviewed regarding trauma assessments and infection prevention policy reviews |
| Staff G | Social Service Director | Interviewed regarding trauma assessments and resident interactions |
| Staff E | Director of Nursing | Confirmed lack of dental follow-up for Resident #63 and death pronouncement documentation |
| Staff C | Licensed Nursing Assistant | Interviewed about snack offerings on Maple Unit |
| Staff D | Licensed Nursing Assistant | Interviewed about snack offerings on Maple Unit |
| Staff KK | Licensed Nursing Assistant | Interviewed about snack offerings on Profile Unit |
| Staff LL | Licensed Nursing Assistant | Interviewed about snack offerings on Profile Unit |
| Staff I | Licensed Nursing Assistant | Interviewed about snack offerings on Granite Unit |
| Staff J | Licensed Nursing Assistant | Interviewed about snack offerings on Granite Unit |
| Staff K | Licensed Nursing Assistant | Interviewed about snack offerings on Granite Unit |
| Staff L | Licensed Nursing Assistant | Interviewed about snack offerings on Granite Unit |
| Staff R | Licensed Nursing Assistant | Interviewed about snack offerings on Meadow Unit |
| Staff S | Licensed Nursing Assistant | Interviewed about snack offerings on Meadow Unit |
| Staff N | Licensed Practical Nurse | Documented death pronouncement for Resident #120 |
| Staff V | Licensed Practical Nurse | Interviewed regarding weight discrepancies for Resident #42 |
| Staff HH | Infection Preventionist | Interviewed regarding infection prevention policy reviews |
Inspection Report
Routine
Census: 99
Deficiencies: 6
Date: Feb 8, 2024
Visit Reason
The inspection was conducted as a routine regulatory oversight visit to assess compliance with Medicare and Medicaid requirements, including beneficiary notification, PASARR screening, activities programming, foot care, nurse staffing postings, and laboratory services.
Findings
The facility was found deficient in multiple areas including failure to provide Notice of Medicare Non-Coverage to residents, incomplete PASARR screenings, inadequate activities programming especially on weekends, failure to provide timely podiatry care, inaccurate and incomplete nurse staffing postings, and failure to obtain ordered laboratory tests for a resident.
Deficiencies (6)
Failed to provide the Notice of Medicare Non-Coverage (NOMNC) prior to the last covered day of Medicare services for 2 of 3 residents reviewed.
Failed to complete PASARR screening and follow-up Level II PASARR for residents requiring long-term care.
Failed to provide an ongoing program of activities to meet residents' interests and needs, especially on weekends.
Failed to provide appropriate foot care and timely podiatry services for a resident with diabetes.
Failed to post nurse staffing information in a prominent, accessible place and failed to post accurate actual hours worked for licensed and unlicensed staff for 31 days.
Failed to obtain laboratory tests as ordered by physician for one resident.
Report Facts
Residents reviewed for advanced beneficiary protection notification: 3
Residents reviewed for PASARR: 25
Resident census: 99
Nurse staffing postings reviewed: 31
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Director of Nursing | Confirmed failure to provide NOMNC and PASARR findings; confirmed nurse staffing posting deficiencies; confirmed podiatry care issues |
| Staff L | Social Services Assistant | Confirmed NOMNC forms were not provided |
| Staff M | Social Worker | Confirmed PASARR screening deficiencies |
| Staff D | Assistant Activities Director | Confirmed lack of structured weekend activities |
| Staff C | Licensed Nursing Assistant | Reported no structured weekend activities and resident boredom |
| Staff F | Registered Nurse | Reported no structured weekend activities and resident boredom |
| Staff H | Registered Nurse | Observed resident foot issues and confirmed podiatry list addition |
| Staff K | Advanced Practice Registered Nurse | Not aware resident had not been seen by podiatrist since last June |
| Staff B | Scheduler | Responsible for posting nurse staffing information; confirmed postings were incomplete |
| Staff G | Licensed Practical Nurse | Confirmed failure to obtain ordered laboratory tests |
Inspection Report
Annual Inspection
Deficiencies: 1
Date: Dec 9, 2022
Visit Reason
The inspection was conducted as an annual survey to assess compliance with regulatory requirements, specifically reviewing the Quality Assessment and Assurance group's membership and meeting frequency.
Findings
The facility failed to ensure that the minimum required committee members attended the Quality Assurance Performance Improvement (QAPI) meetings at least quarterly for all four meetings reviewed in 2022.
Deficiencies (1)
Facility failed to ensure minimum required committee members attended QAPI meetings at least quarterly for 4 of 4 meetings reviewed.
Report Facts
Quarterly meetings reviewed: 4
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Administrator | Confirmed findings regarding committee attendance during interview |
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