Inspection Reports for Hayesville House
480 Old 64 West Hayesville, NC 28904, Hayesville, NC, 28904
Back to Facility ProfileDeficiencies (last 5 years)
Deficiencies (over 5 years)
9.2 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
77% worse than North Carolina average
North Carolina average: 5.2 deficiencies/yearDeficiencies per year
16
12
8
4
0
Census
Latest occupancy rate
60% occupied
Based on a October 2023 inspection.
This facility has shown a decline in demand based on occupancy rates.
Census over time
Inspection Report
Annual Inspection
Census: 36
Capacity: 60
Deficiencies: 1
Date: Oct 10, 2023
Visit Reason
The Adult Care Licensure Section and the Clay County Department of Social Services conducted an annual survey and complaint investigation on 10/10/23-10/11/23.
Complaint Details
The visit included a complaint investigation. Interviews with residents' family members and staff revealed frequent staffing shortages on weekends, making it difficult to provide timely personal care to residents.
Findings
The facility failed to ensure required staffing hours were met on all three shifts based on census data from multiple sampled shifts in late September and early October 2023. Staffing shortages were documented on first, second, and third shifts, particularly on weekends, impacting resident care.
Deficiencies (1)
Facility failed to ensure required staffing hours were met on all three shifts based on census of 35-36 residents during sampled shifts from 09/23/23 through 10/08/23.
Report Facts
Staffing shortage hours: 8
Staffing shortage hours: 7.5
Staffing shortage hours: 8
Staffing shortage hours: 13
Staffing shortage hours: 11
Staffing shortage hours: 11
Staffing shortage hours: 3.5
Staffing shortage hours: 6.5
Staffing shortage hours: 3.5
Staffing shortage hours: 9.25
Staffing shortage hours: 2
Staffing shortage hours: 11
Staffing shortage hours: 7.5
Inspection Report
Capacity: 60
Deficiencies: 13
Date: Aug 28, 2019
Visit Reason
The facility was surveyed for conformance with 2005 Rules for Licensing of Adult Care Homes of Seven or More Beds and applicable portions of the 2009 Edition of the North Carolina State Building Code(s), Institutional Occupancy, as part of a Construction Section Biennial Survey.
Findings
Multiple deficiencies were cited related to physical plant conditions including unsafe outside premises, poor housekeeping and furnishings, unsecured compressed gas cylinders, malfunctioning emergency and fire safety equipment, electrical hazards, blocked or malfunctioning corridor doors, use of prohibited portable electric heaters, and failure to maintain required exhaust ventilation systems.
Deficiencies (13)
Outside grounds are not maintained in a safe condition; sidewalks and porches create tripping hazards.
Building walls not kept in good repair; handrail end return missing exposing rough edges.
Building mechanical systems not kept clean; ventilation system in beauty shop has excessive dust/lint.
Compressed gas cylinders (oxygen and helium) not physically secured, creating projectile hazards.
Building emergency equipment not maintained in safe and operating condition; exit sign directional indicator removed.
Smoke barrier doors do not latch properly, failing to restrict fire and smoke.
Building components such as panic hardware missing parts, commercial kitchen hood fire suppression system lacks required inspections and documentation.
Fire safety compromised by unsealed penetrations in fire-resistance-rated assemblies.
Electrical system unsafe; broken grounding prong, multiple plug adaptors without overcurrent protection, power taps improperly connected, GFCI receptacles missing covers or non-functional.
Smoke tight corridor doors and corridor doors not maintained; doors do not latch or are blocked open by unapproved devices.
Fire extinguishers not properly maintained; last documented monthly inspections were over a year prior.
Use of prohibited portable electric heaters found in Resident Care Manager's Office.
Ventilation system failed to maintain required mechanical exhaust in specified wings.
Report Facts
Licensed capacity: 60
Inspection Report
Capacity: 60
Deficiencies: 8
Date: Jun 13, 2017
Visit Reason
The facility was surveyed for conformance with the 2005 Rules for the Licensing of Adult Care Homes and the 2002 North Carolina Building Code for Institutional Unrestrained Occupancies as part of a Construction Section Biennial Survey.
Findings
The survey identified multiple deficiencies including lack of current annual fire safety inspection reports, presence of chronic unpleasant odors, housekeeping hazards such as improperly maintained ice machine drain lines and missing vacuum breakers, irregular fire safety rehearsals on each shift, and building equipment issues such as smoke barrier doors not latching and malfunctioning exit signs.
Deficiencies (8)
Facility did not have current annual Fire Marshal building safety inspection report; last dated 3-19-2015.
Facility not maintained free of chronic unpleasant odors; strong sewer gas odor noted beyond smoke barrier doors.
Ice machine drain line extended into floor drain, risking contamination.
Hose on shower wand in Beauty Salon long enough to reach sink basin without vacuum breaker, risking water contamination.
Fire drill rehearsals not conducted regularly on each shift quarterly; missing rehearsals in 2nd quarter (3rd shift) and 4th quarter last year (2nd shift).
Fire drill rehearsal records lacked sufficient description of activities involved.
Corridor smoke barrier doors near rooms 107 and 303 did not latch properly, risking fire and smoke spread.
Exit sign near room 306 did not work on battery, risking evacuation delay.
Report Facts
Licensed capacity: 60
Inspection Report
Annual Inspection
Deficiencies: 1
Date: Nov 9, 2016
Visit Reason
The Adult Care Licensure Section conducted annual and follow-up surveys, and a complaint investigation on November 9-10, 2016.
Findings
The facility failed to maintain 10 of 28 resident rooms free from mold on the air output vents of through the wall heat pumps, with mold observed in multiple rooms across different halls. Housekeeping staff reported daily cleaning but no set schedule for cleaning heat pump units, and residents reported inconsistent cleaning of these units.
Deficiencies (1)
Facility failed to assure 10 of 28 resident rooms were free from mold on the air output vents of through the wall heat pumps.
Report Facts
Resident rooms observed: 28
Rooms with mold: 10
Rooms observed on 400 hall: 9
Rooms with mold on 400 hall: 5
Rooms observed on 300 hall: 7
Rooms with mold on 300 hall: 3
Rooms observed on 100 hall: 6
Rooms with mold on 100 hall: 2
Rooms observed on 200 hall: 0
Inspection Report
Complaint Investigation
Deficiencies: 2
Date: Jul 13, 2016
Visit Reason
The Adult Care Licensure Section and the Clay County Department of Social Services conducted a follow-up survey and complaint investigations on July 12 and 13, 2016, initiated by the Clay County Department of Social Services on May 24 and June 7, 2016.
Complaint Details
Complaint investigations were initiated by the Clay County Department of Social Services on May 24, 2016 and June 7, 2016, regarding allegations of inappropriate touching by Staff J during incontinence care of Resident #7. Multiple staff interviews confirmed inappropriate behavior. The facility failed to report this to the Health Care Personnel Registry as required.
Findings
The facility failed to report allegations of sexual abuse against one staff member to the Health Care Personnel Registry (HCPR). Multiple staff interviews and record reviews revealed inappropriate touching by Staff J during incontinence care of Resident #7, and the facility did not notify the HCPR as required.
Deficiencies (2)
Failed to report allegations of sexual abuse against one staff member to the Health Care Personnel Registry (HCPR).
Failed to protect residents from mental and physical abuse due to failure to report an allegation of sexual abuse to the Health Care Personnel Registry (HCPR).
Report Facts
Correction date deadline: Aug 27, 2016
Date of hire for Staff J: Jun 16, 2015
Dates of complaint initiation: Complaints initiated on May 24, 2016 and June 7, 2016.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff J | Personal Care Aide (PCA) | Named in allegations of inappropriate touching during incontinence care and failure to report to HCPR. |
| Administrator | Responsible for investigations and deciding on HCPR notifications; admitted failure to report incident. | |
| Resident Care Coordinator (RCC) | Conducted investigation and provided information to Administrator. |
Inspection Report
Follow-Up
Census: 51
Deficiencies: 2
Date: Mar 9, 2016
Visit Reason
Staff with the Adult Care Licensure Section and Clay County DSS conducted a follow-up survey on March 8-9, 2016 to assess compliance with staffing requirements in the Special Care Unit.
Findings
The facility failed to assure minimum staffing was provided in the Special Care Unit from 1/29/16 through 1/31/16 and from 2/13/16 through 2/21/16 for multiple days on first, second, and third shifts. Staffing shortages impacted resident care, including shortened or missed showers and delayed assistance. The facility has since hired new staff and implemented measures to improve staffing coverage.
Deficiencies (2)
Failed to assure minimum staffing was provided in the Special Care Unit from 1/29/16 through 1/31/16 and from 2/13/16 through 2/21/16 for 5 days on first shift, for 6 days on second shift, and for 7 days on third shift out of 12 sampled days.
Failed to assure all residents received care and services which were adequate, appropriate, and in compliance with relevant federal and state laws and rules related to Special Care Unit staff.
Report Facts
Census: 51
Staff hours required: 50
Staff hours worked: 41.5
Staff hours required: 51
Staff hours worked: 42.5
Staff hours required: 40.8
Staff hours worked: 34.5
Residents requiring assistance: 48
Residents requiring three person assist: 1
Residents requiring two person assist: 5
Inspection Report
Annual Inspection
Census: 50
Deficiencies: 4
Date: Oct 14, 2015
Visit Reason
The Adult Care Licensure Section and the Clay County Department of Social Services conducted an annual survey on 10/14/15 through 10/15/15 to assess compliance with adult care home regulations.
Findings
The facility failed to maintain cleanliness in several resident rooms, with evidence of unclean surfaces and inadequate housekeeping staffing. Additionally, the facility failed to ensure that at least one staff member on the premises at all times had current CPR certification, and third shift staffing levels did not meet special care unit requirements based on census.
Deficiencies (4)
Facility failed to keep clean various surfaces in 3 of 10 resident rooms on the 200 hallway, including stains on bathroom floors and shower curtains.
Facility failed to assure one staff person was on the premises at all times with current CPR certification for 4 of 13 days on third shift.
Facility failed to assure third shift staffing hours met special care unit staffing requirements based on census.
Facility failed to assure all residents received care and services which were adequate, appropriate, and in compliance with relevant laws related to CPR training.
Report Facts
Days without CPR certified staff on third shift: 4
Third shift staff scheduled: 4
Resident census: 50
Required third shift staff: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Supervisor/Medication Aide | Named in CPR certification deficiency; lacked documentation of current CPR certification |
| Staff D | Supervisor | Made the employee schedule and scheduled staff for third shift |
Inspection Report
Follow-Up
Deficiencies: 1
Date: Aug 25, 2015
Visit Reason
Follow-up survey conducted to verify correction of previously identified deficiencies at Hayesville House.
Findings
Not all deficiencies were corrected; specifically, hoses on shower wands in the Beauty Salon lacked vacuum breakers, posing a risk of siphoning contaminated water into the water system.
Deficiencies (1)
Hoses on the shower wands in the Beauty Salon were long enough to reach the sink basins and lacked vacuum breakers, risking contamination of the water system.
Report Facts
Number of hoses observed: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Dennis Harrell | Conducted the follow-up survey |
Inspection Report
Capacity: 60
Deficiencies: 14
Date: May 13, 2015
Visit Reason
The facility was surveyed for conformance with the 2005 Rules for the Licensing of Adult Care Homes and the 2002 North Carolina Building Code for Institutional Unrestrained Occupancies during a Biennial Construction Survey.
Findings
The inspection identified multiple deficiencies including lack of correction of sprinkler system issues, absence of vacuum breakers on shower hoses, emergency release switch cover secured improperly, sagging exit gate, malfunctioning smoke barrier doors, compromised fire rated walls and ceilings, non-functioning emergency lights, corridor doors not resisting fire and smoke, failure of emergency magnetic lock release alarms, and lack of monthly fire extinguisher inspections.
Deficiencies (14)
No hydraulic plate attached to the dry pipe system.
No pipe stand installed under the 4" dry pipe system.
The following gauges need replaced: 1-suction, 2-air & 5-water gauges.
No ½" auto ball check installed on the 4" Fire Department Connection line.
A 5 year internal inspection needs performed.
Hoses on the shower wands in the Beauty Salon were long enough to reach the sink basins and there were no vacuum breakers provided.
Cover over the required emergency release switch at the exit gate in the courtyard was secured with a plastic tyrap, making the switch inaccessible.
Gate post had sagged at the exit gate from the courtyard making the gate very difficult to open.
Cross-corridor smoke barrier doors near room 303 are equipped with latching hardware but one door failed to latch closed when activated by the fire alarm system.
Required one-hour fire rated walls and/or ceilings were compromised in several locations including holes in ceiling of hot water room and missing or not tightly fitted sprinkler escutcheon in kitchen.
Battery powered emergency light in the entry foyer would not work when tested.
A corridor door (door to nurse station) was cut into 2 pieces like a Dutch door and had a significant gap where the 2 pieces meet, unable to resist passage of fire and smoke.
Several of the "screamer" covers for the emergency magnetic lock release switches failed to sound when opened.
Fire extinguisher in the kitchen is not being inspected monthly as required; it had not been inspected this year.
Report Facts
Deficiencies listed in sprinkler system inspection: 5
Facility licensed capacity: 60
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