Inspection Reports for Haywood House
145 N Main St. Canton, NC 28716, Canton, NC, 28716
Back to Facility ProfileDeficiencies (last 6 years)
Deficiencies (over 6 years)
9.8 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
88% worse than North Carolina average
North Carolina average: 5.2 deficiencies/yearDeficiencies per year
16
12
8
4
0
Inspection Report
Annual Inspection
Deficiencies: 9
Date: Mar 16, 2023
Visit Reason
The Adult Care Licensure Section and the Haywood County Department of Social Services conducted an annual survey and complaint investigation from 03/09/23 to 03/15/23, with an exit conference on 03/16/23. The complaint investigation was initiated by the Haywood County Department of Social Services on 03/06/23.
Complaint Details
The complaint investigation was initiated by the Haywood County Department of Social Services on 03/06/23 related to staff sleeping during shifts, resident abuse and neglect allegations, and failure to provide proper care and supervision.
Findings
The facility failed to provide training on physical restraints for staff, failed to ensure the Administrator was responsible for total operation and compliance, failed to protect residents from abuse and neglect including multiple injuries and delayed medical treatment, failed to administer medications as ordered, failed to ensure proper use of physical restraints, and failed to report allegations of neglect and abuse to the Health Care Personnel Registry in a timely manner. Additionally, the facility failed to notify the local Department of Social Services of incidents requiring emergency medical treatment for several residents.
Deficiencies (9)
Failed to provide training on physical restraints for 1 of 3 sampled staff who cared for residents with physical restraints.
Failed to ensure the Administrator was responsible for total operation of the facility and compliance with regulations, including resident rights, health care, personal care, medication administration, use of physical restraints, and reporting.
Failed to protect 4 of 4 sampled residents from physical abuse and neglect related to multiple fractures, bruising, delayed medical treatment, and lack of supervision.
Failed to provide supervision for 1 of 5 sampled residents resulting in multiple injuries including fractures and bruising.
Failed to administer medications as ordered for 1 of 8 residents and 3 of 9 sampled residents related to anticoagulant medication, pain medication, and medication to treat bone disorders.
Failed to ensure physical restraints were used only after assessment and care planning, with physician orders updated every 3 months, and restraints checked and released at required intervals for 3 of 4 sampled residents using Geri chairs with lap trays.
Failed to ensure medications were borrowed only in an emergency for 1 of 1 sampled residents related to borrowing medication from another resident without emergency.
Failed to report allegations of neglect to the Health Care Personnel Registry within 24 hours for 3 staff members found asleep during their shift and failed to report an allegation of abuse by a staff member.
Failed to notify the local county Department of Social Services for incidents involving 5 of 6 sampled residents who received injuries requiring emergency medical treatment.
Report Facts
Medication error rate: 4
Medication refills: 30
Medication refills: 6
Medication quantity: 30
Medication quantity: 20
Medication quantity: 90
Medication quantity: 30
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Personal Care Aide | Failed to complete training on physical restraints; found sleeping during 3rd shift; involved in neglect allegations. |
| Staff B | Personal Care Aide | Found sleeping during 3rd shift; involved in neglect allegations. |
| Staff C | Medication Aide | Found sleeping during 3rd shift; verbally abusive to residents; involved in dragging Resident #4 and causing injury; involved in neglect allegations. |
| Special Care Coordinator | Responsible for staff training, medication order review, reporting abuse/neglect, and care plans; failed to report neglect and abuse; lacked training on abuse investigations. | |
| Administrator | Facility Administrator | Failed to ensure proper oversight, reporting, and investigation of abuse and neglect; lacked clinical experience; did not report to HCPR; unaware of restraint policies. |
| Medication Aide Supervisor | Medication Aide Supervisor | Failed to ensure medication availability; borrowed medication from another resident; failed to clarify medication orders. |
| Personal Care Aide | PCA | Reported abuse incident involving Staff C and Resident #4; observed neglect and staff sleeping during 3rd shift. |
| Pharmacist | Contracted pharmacy staff involved in medication order processing and clarifications. | |
| Primary Care Provider | PCP | Physician involved in resident care and medication orders; unaware of some medication issues and abuse incidents. |
Inspection Report
Follow-Up
Deficiencies: 9
Date: May 29, 2019
Visit Reason
The visit was a biennial follow-up construction survey to verify correction of previously identified deficiencies.
Findings
Several deficiencies related to fire safety and building maintenance were found not corrected, including outdated sprinkler system gauges, missing fire safety signs, obstructed exit paths, and compromised fire-rated walls and ceilings with missing or water-damaged ceiling tiles.
Deficiencies (9)
Sprinkler system gauges are over 5 years old and should be replaced or recalibrated.
The last 5 year internal investigation on both the dry pipe system and the wet pipe system is unknown; both systems should have a 5 year internal investigation done.
The electric bell did not operate when tested.
Missing identification signs including air line, alarm sign, main drain, inspector's test, control valve, and wall hydrant.
Low point drain on the front of the building needs a drum drip installed to maintain the drain without tripping the system.
Exterior exit path was not maintained uncluttered and free of obstructions; specifically, a cement block enclosure for the clothes dryer exhaust protruded over the sidewalk leaving only 2.5 feet clear.
Required one-hour fire rated walls and/or ceilings were compromised with holes and penetrations not sealed with approved materials, risking fire spread.
At least 6 fire rated 2 ft. by 2 ft. ceiling tiles were missing on the 3rd floor above buckets placed to catch water from roof leaks.
Many fire rated 2 ft. by 2 ft. ceiling tiles were stained and water damaged on the 2nd and 3rd floors.
Report Facts
Number of sprinkler system deficiencies: 5
Number of missing fire rated ceiling tiles: 6
Clearance width: 2.5
Inspection Report
Follow-Up
Deficiencies: 6
Date: Feb 7, 2019
Visit Reason
This is a Biennial Follow Up Construction Survey conducted to verify correction of previously cited deficiencies related to building code compliance, fire safety, sanitation, and physical plant requirements.
Findings
The facility failed to meet building and fire safety codes including improperly located fire alarm pull stations, overdue correction of sprinkler system deficiencies, lack of hand grips in bathrooms, exterior exit path obstructions, malfunctioning corridor doors, and compromised fire-rated walls and ceilings with missing or water-damaged ceiling tiles.
Deficiencies (6)
Fire alarm pull stations not located at each required exit; pull stations are 20 feet from exits with corridor doors in between.
Overdue correction of significant deficiencies listed in the sprinkler system inspection report dated 6-14-18.
No hand grip provided at the tub on the 2nd floor; hand grip installed on wrong fixture.
Exterior exit path not maintained free of obstructions; clothes dryer exhaust enclosure and retaining wall reduce clear sidewalk width; drain cleanout protrudes creating trip hazard.
Many corridor doors do not close quickly and latch properly to resist fire and smoke passage; smoke barrier door on Women's Hall closes properly only 2 out of 5 attempts.
Required one-hour fire rated walls and ceilings compromised with holes and penetrations not sealed; at least 6 fire rated ceiling tiles missing and many stained or water damaged on the 3rd floor.
Report Facts
Fire rated ceiling tiles missing: 6
Clear sidewalk width: 2.5
Clear sidewalk width: 3.5
Drain cleanout protrusion: 0.625
Fire barrier door closing success rate: 2
Inspection Report
Complaint Investigation
Deficiencies: 1
Date: Jan 14, 2019
Visit Reason
The Adult Care Licensure Section completed a complaint investigation on 01/14/19 to 01/15/19 regarding concerns about missed medication doses for Resident #1.
Complaint Details
Complaint investigation conducted from 01/14/19 to 01/15/19. The complaint involved failure to notify the physician of missed medication doses. The complaint was substantiated based on observations, interviews, and record reviews.
Findings
The facility failed to ensure that Resident #1's physician was notified of missed doses of valproic acid and magnesium due to medication unavailability. Multiple occurrences of missed medication administration were documented from September 2018 through January 2019, with staff and family reporting delays in medication supply and communication failures with the healthcare provider.
Deficiencies (1)
Failed to ensure physician notification of missed doses of valproic acid and magnesium due to medication unavailability.
Report Facts
Medication administration occurrences: 3
Medication administration occurrences: 1
Medication administration occurrences: 60
Medication administration occurrences: 3
Medication administration occurrences: 59
Medication administration occurrences: 30
Medication administration occurrences: 31
Medication administration occurrences: 18
Medication administration occurrences: 0
Medication administration occurrences: 3
Medication administration occurrences: 0
Medication administration occurrences: 14
Medication administration occurrences: 22
Medication administration occurrences: 14
Medication administration occurrences: 9
Medication supply duration: 23
Medication supply duration: 31
Medication supply quantity: 60
Medication out of supply duration: 21
Inspection Report
Capacity: 60
Deficiencies: 11
Date: Nov 15, 2018
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, Institutional Occupancy, as part of a Construction Section Biennial Survey.
Findings
The survey identified multiple deficiencies including failure to meet building code requirements for fire alarm pull stations, lack of current sanitation and fire safety reports, missing hand grips in bathrooms, corridor obstructions, housekeeping hazards, incomplete fire safety rehearsals, fire alarm system trouble conditions, compromised fire rated walls and ceilings, and inadequate hot water system temperature.
Deficiencies (11)
Fire alarm pull stations not located at each required exit; pull stations were 20 feet from exits with corridor doors in between.
No documentation indicating correction of significant deficiencies listed in the sprinkler system inspection report dated 6-14-18.
No hand grip provided at the tub on the 2nd floor.
Corridors not free of obstructions; furniture and items stored reducing clear width to about 3 feet on the 3rd floor.
Exterior exit path cluttered with limbs, yard debris, buckets, removed gate, cement block enclosure, retaining wall, water diverters, and protruding drain cleanout presenting trip and fall hazards.
Fire drill rehearsals not conducted quarterly on each shift as required; records lacked descriptions of rehearsals.
Fire alarm system showing a 'Trouble 3rd floor' condition (corrected during survey).
Many corridor doors prevented from closing and latching properly, holes at latchsets on multiple doors, and missing coordinator on smoke barrier doors.
Combination exit sign/emergency light at courtyard gate not illuminated and test switch missing.
Required one-hour fire rated walls and ceilings compromised with unsealed penetrations, missing and water damaged ceiling tiles.
Relief valve on one water heater badly leaking resulting in hot water temperature of only 74 degrees F (below required minimum).
Report Facts
Total licensed capacity: 60
Date of survey: Nov 15, 2018
Sprinkler system inspection date: Jun 14, 2018
Hot water temperature: 74
Inspection Report
Follow-Up
Deficiencies: 6
Date: Apr 18, 2017
Visit Reason
This is a biennial follow-up construction survey conducted to verify correction of previously identified deficiencies in the facility.
Findings
Several deficiencies were found not corrected, including missing latch assemblies on fire doors exposing sharp edges, compromised one-hour fire rated walls and ceilings with unsealed holes, corridor doors not closing and latching properly to resist fire and smoke, and exit doors lacking illuminated exit signs.
Deficiencies (6)
Part of the latch assembly was missing on the 1 hour doors to the laundry, exposing sharp edges.
Part of the latch assembly was missing on both smoke barrier doors near the elevator.
One-hour fire rated walls and ceilings were compromised with holes and penetrations not sealed with approved materials, including holes in the ceiling of the med room and wall in the employee lounge.
Many corridor doors are prevented from closing quickly and latching to resist fire and smoke, including smoke barrier doors near room 109 and near the elevator.
One smoke barrier door will not unlatch unless both the panic hardware and latchnolt at the top of the door are pressed simultaneously.
Exit doors to stairways on 2nd and 3rd floors are not marked with illuminated exit signs; existing exit signs are located more than 10 feet away in the corridor.
Inspection Report
Capacity: 60
Deficiencies: 14
Date: Jan 11, 2017
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
The survey identified multiple deficiencies including lack of current fire safety inspection reports, housekeeping hazards such as missing keys and drain grates, fire safety rehearsal records lacking descriptions, compromised fire rated walls and ceilings, malfunctioning fire safety doors, missing emergency lighting, unmarked exit doors, missing electrical cover plates, and use of prohibited portable electric heaters.
Deficiencies (14)
Most recent Fire Marshal building safety inspection report was dated 12-18-2015; annual inspections required.
No key onsite to allow entry into front hall Business office and file room to survey for hazards.
Missing drain grate on a 4 inch drain through sidewalk from 3rd floor presenting trip and fall hazard.
Hasp and padlock on outside of walk-in cooler door could trap someone inside.
Sink removed in 3rd floor storage behind nurse station with drain sealed by foam, potentially allowing noxious odors and bacteria.
Waste traps dry in toilet and sink near riser room, allowing noxious odors and bacteria.
Part of latch assembly missing on 1 hour doors to laundry exposing sharp edges.
Fire safety rehearsal records lacked description of what the rehearsal involved.
Fire rated walls and ceilings compromised with holes and missing tiles in multiple locations throughout facility.
Many corridor doors do not close and latch properly, including smoke barrier doors, allowing fire and smoke to spread.
Battery powered emergency light in 2nd floor stairway would not work when tested.
Exit doors to stairway on 2nd and 3rd floors not marked with illuminated exit signs; signs located more than 10 feet away.
Cover plate missing on electrical junction box in 2nd floor linen storage.
Portable electric heater found in use in elevator room, violating prohibition on portable electric heaters.
Report Facts
Total licensed capacity: 60
Inspection Report
Annual Inspection
Deficiencies: 1
Date: Dec 12, 2016
Visit Reason
The Adult Care Licensure Section and the Haywood County Department of Social Services conducted an annual survey and complaint investigation on December 6, 2016 and December 12, 2016.
Complaint Details
The visit included a complaint investigation related to medication aide qualifications. The medication aide (Staff C) had administered medications without passing the required competency exam within the required timeframe. Staff C failed the exam on 12/6/16 after the 60-day deadline had passed.
Findings
The facility failed to assure that one of five medication aides completed the medication competency examination within 60 days of hire, allowing the aide to administer medications without proper certification, which placed residents at risk.
Deficiencies (1)
Facility failed to assure 1 of 5 medication aides completed the medication competency examination within 60 days of hire as a medication aide.
Report Facts
Medication aides: 5
Days to complete competency exam: 60
Hire date: Dec 2, 2015
Job description change date: Sep 1, 2016
Exam attempt date: Dec 6, 2016
Correction deadline: Jan 26, 2017
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff C | Medication Aide | Failed to complete medication competency examination within 60 days of hire and administered medications without proper certification |
| Executive Director | Interviewed regarding Staff C's work schedule, exam attempts, and facility procedures for medication aide competency | |
| Business Office Manager | Interviewed regarding personnel file audits and staffing records management |
Inspection Report
Annual Inspection
Deficiencies: 2
Date: Jan 23, 2015
Visit Reason
Staff with the Adult Care Licensure Section and Haywood County DSS conducted an annual survey on-site January 21-23, 2015 to assess compliance with adult care home regulations.
Findings
The facility failed to assure medications were administered as ordered for 4 of 6 sampled residents and failed to provide a reasonable response to a resident's request for discontinuation of a prescribed medication. Multiple medication administration deficiencies were identified including delays, missing orders, and failure to administer medications such as Oxycod/Apap, Fentanyl Patches, gabapentin, capsaicin cream, CMPD cream, Brimonidine Solution, beta-carotene, Dulcolax, Seroquel, Haldol, and Senna.
Deficiencies (2)
Failed to assure medications including Oxycod/Apap, Fentanyl Patches, gabapentin, capsaicin cream, CMPD cream, Brimonidine Solution, beta-carotene, Dulcolax, Seroquel, Haldol, and Senna were administered as ordered for 4 of 6 sampled residents.
Failed to assure 1 of 6 sampled residents received a reasonable response to the request for a prescribed medication (Oxybutynin) to be discontinued by the prescribing physician.
Report Facts
Sampled residents: 6
Residents with medication deficiencies: 4
Residents with rights violation: 1
Correction date for Type B Violation: 2015
Correction date for Type A2 Violation: 2015
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