Inspection Reports for Grand Villa Assisted Living at Winston

Routine Construction Section Biennial Survey conducted to assess compliance with physical plant, fire safety, and other regulatory requirements for the assisted living facility.

Multiple deficiencies were cited including failure to meet building code requirements for exits, lack of privacy in bathrooms, missing hand grips, unsecured hazardous materials storage, poor housekeeping and maintenance issues, fire safety equipment failures, electrical hazards, plumbing and mechanical equipment deficiencies, and inadequate exhaust ventilation.

The Adult Care Licensure Section conducted a follow-up survey and complaint investigation initiated by the Forsyth County Department of Social Services from 11/13/24 through 11/15/24.

The facility failed to provide personal care related to nail trimming for two residents, failed to serve therapeutic diets as ordered for two residents, failed to administer medications as ordered for one resident, failed to accurately document medication administration for two residents, and failed to ensure residents' personal funds were available during established business hours for four residents.

Complaint investigation was initiated by the Forsyth County Department of Social Services on 11/02/24.

The Adult Care Licensure Section completed an annual survey and complaint investigation from August 20, 2024 to August 23, 2024, including complaint investigations initiated by the Forsyth County Department of Social Services.

The facility was found deficient in multiple areas including failure to respond immediately to a choking resident resulting in death, failure to ensure referral and follow-up for healthcare needs, failure to implement physician orders for therapeutic diets and medications, medication administration errors, and failure to properly account for residents' personal funds.

Complaint investigations were initiated by the Forsyth County Department of Social Services on August 1, 2024 and August 13, 2024 related to the death of a resident and other care concerns.

The Adult Care Licensure Section conducted an annual and follow-up survey from 05/02/23 through 05/03/23.

The facility failed to ensure sanitation and safety guidelines during feeding assistance, failed to serve required milk and water at meals, and failed to provide ordered nutritional supplements and medications as prescribed, including narcotic pain medication and antipsychotic medication, resulting in resident agitation and unmet nutritional needs.

The Adult Care Licensure Section conducted a follow-up survey and complaint investigation on November 8 and 9, 2022.

The facility failed to ensure medications were administered as ordered for 2 of 6 sampled residents. Resident #3 was administered olanzapine and probenecid despite hospital discharge orders to hold these medications until seen by the primary care provider. Resident #5 did not consistently receive prescribed brimonidine eye drops, with evidence of excess medication remaining and inconsistent administration documentation.

The visit included a complaint investigation related to medication administration errors for Residents #3 and #5. The complaint was substantiated based on findings of medication administration not in accordance with physician orders.

The Adult Care Licensure Section conducted a follow-up survey to verify correction of previous deficiencies and compliance with regulations.

The facility was found deficient in multiple areas including failure to ensure tuberculosis testing, health care personnel registry checks, criminal background checks, competency validation for Licensed Health Professional Support tasks, training on care of diabetic residents, adequate supervision of residents, health care referral and follow-up, medication administration, special care unit staff orientation and training, and controlled substance screening for staff.

The Adult Care Licensure Section conducted a follow-up survey to verify correction of previous deficiencies related to personal care and supervision, health care, medication administration, infection control, and resident rights.

The facility failed to provide adequate supervision for a resident with dementia and behavioral issues, failed to ensure referral and follow-up for healthcare needs including leg wraps and toenail care, and failed to administer medications as ordered for multiple residents. Infection control practices were not consistently followed, including improper glove use and hand hygiene during medication administration. Staff did not consistently wear facemasks as required. Additionally, a staff member was verbally disrespectful and yelled at residents, violating residents' rights.

The Adult Care Licensure Section conducted a follow-up survey and complaint investigation onsite related to a complaint initiated by the Forsyth County Department of Social Services.

The facility failed to provide adequate supervision for residents with multiple falls and wandering behaviors, failed to ensure proper health care referral and follow-up for wound care and blister management, failed to administer medications as ordered including crushing extended release medications and medication availability issues, failed to implement COVID-19 infection prevention guidance including proper mask use and staff screening, and failed to ensure residents' rights related to privacy and dignity in wandering and dining practices.

Complaint investigation initiated by Forsyth County Department of Social Services on January 11, 2022.

The Adult Care Licensure Section conducted an annual and follow-up survey with a complaint investigation from August 18, 2021 through August 20, 2021, exiting via telephone on August 23, 2021.

The facility was found deficient in multiple areas including failure to have matching therapeutic diet menus for residents with combination diets, failure to serve 8 ounces of milk twice daily to Special Care Unit residents, failure to serve water with each meal, failure to serve therapeutic diets as ordered, failure to administer medications as ordered for three sampled residents, failure to treat residents with respect and dignity related to meal service, and failure to ensure medication aides passed the required written exam within 60 days.

The survey included a complaint investigation as part of the annual and follow-up survey process.

The Adult Care Licensure Section conducted an annual and follow-up survey from 02/05/20 through 02/06/20 to assess compliance with adult care home regulations.

The facility failed to ensure tuberculosis (TB) testing upon hire for 2 of 6 sampled staff and failed to competency validate 2 of 6 sampled staff for Licensed Health Professional Support (LHPS) tasks including resident transfers. Additionally, the facility failed to clarify a physician's medication order for one resident, resulting in discontinuation of a medication without proper verification.

The visit was a Biennial Follow Up Construction Survey conducted to verify correction of previously cited deficiencies related to building code and physical plant requirements.

The facility still did not meet the North Carolina State Building Code requirements for exit doors in the Special Care Unit dining room. The exit doors were equipped with a double cylinder deadbolt requiring a key to open, and not all staff responsible for evacuation had keys, with the med tech being the only staff member with a key and not present between 3:00 pm and 4:00 pm.

The Adult Care Licensure Section and the Forsyth County Department of Social Services conducted a follow-up survey and complaint investigation from 10/16/19 through 10/18/19, initiated by the Adult Care Licensure Section on 10/16/19.

The facility failed to provide adequate supervision for Resident #1, a dementia patient with behavioral disturbances and a history of falls, resulting in multiple serious injuries including bruises, cuts, rib fractures, and a punctured lung. Additionally, the facility failed to accurately document administration of Humalog sliding scale insulin for Resident #2, and failed to ensure residents received care compliant with relevant laws and regulations.

The complaint investigation was initiated due to concerns about inadequate supervision and care for Resident #1, who had multiple falls and injuries, and issues with medication administration for Resident #2.

This is a Biennial Follow Up Construction Survey conducted to verify correction of previous deficiencies related to physical plant and safety code compliance.

The facility was found to have multiple deficiencies including failure to meet building code exit requirements, unsafe and unmaintained physical plant conditions such as damaged walls, ceilings, floors, and furnishings, fire safety equipment not maintained or inspected properly, plumbing and electrical equipment issues, and inadequate exhaust ventilation in several areas.

The Adult Care Licensure Section and Forsyth County Department of Social Services conducted a follow-up survey and complaint investigation related to medication administration, health care follow-up, and staffing in the Special Care Unit.

The facility failed to assure referral and follow-up to medical providers for medication orders, failed to administer medications as ordered including cardiac and diabetic medications, failed to maintain accurate medication administration records, and failed to provide sufficient staffing on the third shift in the Special Care Unit.

Complaint investigation initiated by Forsyth County Department of Social Services on July 13, 2019, related to medication administration and health care follow-up.

The Adult Care Licensure Section conducted an annual and follow-up survey from 03/05/19 through 03/08/19 to assess compliance with state regulations and resident care standards.

The facility failed to maintain hot water temperatures within required limits, failed to ensure tuberculosis testing upon admission for a sampled resident, failed to notify physicians regarding critical health indicators and missed medications for multiple residents, and had medication administration errors including missed doses and documentation deficiencies. Additionally, the facility failed to ensure proper podiatry referrals and toenail care, and did not complete required drug screening for a staff member.

This is a Biennial Follow Up Construction Survey conducted to verify correction of previously cited deficiencies related to physical plant and safety compliance.

The facility was found to have multiple deficiencies including failure to meet NC State Building Code requirements for occupant load and exits, unsafe and unmaintained physical plant conditions such as damaged walls, floors, ceilings, and furnishings, fire safety system failures including loose or missing sprinkler escutcheon plates, malfunctioning fire alarm and emergency lighting systems, electrical safety issues including non-GFCI outlets and exposed wiring, presence of prohibited portable electric heaters, and inadequate exhaust ventilation in required areas.

The Adult Care Licensure Section and the Forsyth County Department of Social Services conducted a follow-up survey and complaint investigation from October 23, 2018 through October 26, 2018, initiated by a complaint on September 5, 2018.

The facility failed to maintain walls, ceilings, and floors in good repair and clean condition in multiple resident rooms, bathrooms, and hallways, resulting in a Type B violation. Additionally, the facility failed to provide adequate supervision for a resident in the Special Care Unit (SCU) who attempted to climb onto the roof and eloped through an unsecured window, constituting a Type A2 violation. The facility also failed to complete timely Licensed Health Professional Support (LHPS) assessments for residents and had inaccuracies in medication administration records for a resident's pain medication.

The complaint investigation was initiated by the Forsyth County Department of Social Services on September 5, 2018, related to facility conditions and resident safety concerns.

Construction Section Biennial Survey conducted to assess compliance with physical plant, fire safety, and other regulatory requirements.

Multiple deficiencies were cited including failure to meet building code requirements, unsafe physical plant conditions, inadequate housekeeping and maintenance, fire safety system failures, electrical and plumbing issues, and malfunctioning resident call systems.

Complaint Follow Up Construction Survey conducted to verify correction of previously cited deficiencies.

The building fire safety was not maintained in a safe and operating condition, specifically the kitchen had two holes sealed with an unapproved orange foam material not listed as a firestopped system.

Complaint Follow Up survey conducted; deficiencies cited requiring a new Plan of Correction.

The Adult Care Licensure Section and the Forsyth County Department of Social Services conducted a follow-up survey and complaint investigation from 07/11/18 to 07/13/18, initiated by a complaint on June 26, 2018.

The facility failed to ensure referral and follow-up to meet the routine and acute health care needs of Resident #7 related to a left lower leg wound, resulting in hospitalization. Additionally, the facility failed to maintain accurate accounting and verification of residents' personal funds for Residents #1, #2, and #4, constituting a continuing unabatd Type B violation.

Complaint investigation initiated by Forsyth County Department of Social Services on June 26, 2018, related to Resident #7's wound care and personal funds management for Residents #1, #2, and #4.

The inspection was conducted in response to a complaint alleging that due to a ceiling leak, the kitchen was unsanitary for preparing and serving food.

The complaint was substantiated with findings of roof leaks causing holes in the kitchen ceiling above food preparation areas, exposing food and surfaces to dripping water and debris. Additional issues included a leaking HVAC condensation line and deteriorated roof decking. Fire safety deficiencies were also noted with unsealed penetrations in the fire-resistance-rated ceiling assembly. Repairs and protective measures were initiated during the inspection period.

The complaint was substantiated. The complaint alleged unsanitary kitchen conditions due to a ceiling leak. The Forsyth County Environmental Health Specialist confirmed the violation and indicated the health department would suspend the food service permit until repairs were made.

The Adult Care Licensure Section and the Forsyth County Department of Social Services conducted a follow-up survey and complaint investigation initiated by Forsyth County Department of Social Services on February 6, 2018.

The facility was found deficient in multiple areas including failure to maintain the physical environment, failure to notify residents or responsible parties of rate changes, failure to provide adequate personal care and supervision, failure to assure physician notification for aggressive behaviors, failure to maintain accurate controlled substance records, failure to properly account for residents' personal funds, and failure to protect residents' rights including freedom from abuse and retaliation.

Complaint investigation was initiated on February 6, 2018 by Forsyth County Department of Social Services related to multiple resident care and safety concerns including physical assault and financial mismanagement.

The Adult Care Licensure Section and the Forsyth County Department of Social Services conducted an annual survey and a State Involved Complaint Investigation on November 14-16, 2017, based on complaints initiated by Forsyth County Department of Social Services on 9/28/17, 10/26/17 and 11/3/17.

The facility failed to provide required supervision checks every 2 hours during the night shift for one resident, resulting in an unnoticed death. Additionally, the facility failed to serve therapeutic diets as ordered for two residents and did not ensure accurate accounting and monthly verification of residents' personal funds for three residents.

The visit included a State Involved Complaint Investigation triggered by complaints initiated by Forsyth County Department of Social Services on 9/28/17, 10/26/17, and 11/3/17.

The visit was a Biennial Follow Up Construction Survey conducted to verify correction of previously cited deficiencies.

The facility has not satisfactorily corrected the previously cited deficiencies related to housekeeping and sanitation, specifically failing to maintain a sanitation score of 85 or above, with a recorded score of 81 on 12/20/2016.

This is a biennial follow-up construction survey to verify correction of previously cited deficiencies at Salem Terrace.

The survey found some deficiencies corrected, but others remain uncorrected, including lack of hand grips in the handicap bathroom, obstructed exit sidewalk, water damage causing ceiling stains, broken countertop at the nurse station, and a sanitation score below required standards.

The Adult Care Licensure Section and the Forsyth County Department of Social Services conducted a complaint investigation on 08/31/2016 and 09/01/2016 at Salem Terrace.

The facility failed to attend to personal care needs for 3 sampled residents in the Memory Care Unit who were unable to attend to themselves, including inadequate incontinence care and inconsistent toileting checks. Additionally, the facility failed to maintain accurate pharmaceutical records for medications received from outside pharmacies for 3 residents.

The investigation was triggered by a complaint regarding inadequate personal care and pharmaceutical services at the facility.

The Adult Care Licensure Section and the Forsyth County Department of Social Services conducted a follow-up survey on July 21 and July 22, 2016 to verify correction of previous deficiencies.

The facility failed to maintain walls, ceilings, and floors in good repair as evidenced by multiple water stains and damaged drywall in residents' rooms and common areas due to roof leaks. The facility also failed to maintain a sanitation score of 85 or higher, with the last score being 84. Additionally, air conditioning unit covers were broken or missing in some areas, exposing the interior of the units.

The Adult Care Licensure Section and the Forsyth County Department of Social Services conducted an annual survey and complaint investigation on 4/05/16-4/07/16. The complaint investigation was initiated by the Forsyth County Department of Social Services on 4/01/16.

The facility was found to have multiple deficiencies including failure to maintain the physical environment in a clean and safe condition, housekeeping and furnishings in good repair, sanitation scores below required levels, incomplete medication orders for wound care, and improper infection control practices related to diabetic finger stick lancing pens.

The complaint investigation was initiated by the Forsyth County Department of Social Services on 4/01/16 and was conducted concurrently with the annual survey from 4/05/16 to 4/07/16.

The Adult Care Licensure staff conducted an annual survey and follow-up visit to assess compliance with sanitation and housekeeping standards.

The facility failed to maintain a sanitation score of 85 or above, receiving a score of 84 on a local Environmental Health inspection. Damaged flooring and sticky residue on floors were noted, with repairs underway or planned. Several demerits related to walls, floors, lighting, vermin control, and other sanitation issues were identified but mostly corrected or under repair.

The Adult Care Licensure Section and the Forsyth County Department of Social Services conducted a complaint investigation initiated by Forsyth County Department of Social Services on 2015-02-11 regarding Resident #1's aggressive and violent behavior resulting in physical assaults and the death of another resident.

The facility failed to provide adequate supervision and failed to notify the physician or refer Resident #1 to mental health services despite documented violent and aggressive behaviors. Resident #1 assaulted multiple residents and staff, culminating in the death of a 93-year-old female resident. The facility admitted Resident #1 despite concerns about his violent history and failed to ensure appropriate safety and protection for other residents.

Complaint investigation initiated by Forsyth County Department of Social Services on 2015-02-11 due to Resident #1's aggressive and violent behavior leading to physical assaults and death of another resident.