Inspection Reports for Homestead Hills Assisted Living
2101 Homestead Hills Drive Winston-Salem, NC 27103, Winston-Salem, NC, 27103
Back to Facility ProfileDeficiencies (last 5 years)
Deficiencies (over 5 years)
9.6 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
85% worse than North Carolina average
North Carolina average: 5.2 deficiencies/yearDeficiencies per year
16
12
8
4
0
Inspection Report
Annual Inspection
Deficiencies: 5
Date: Oct 26, 2023
Visit Reason
The Adult Care Licensure Section conducted an annual and follow-up survey on 10/25/23 through 10/26/23 at Homestead Hills Assisted Living.
Findings
The facility failed to ensure medication aides completed required medication administration training and competency validation, failed to complete licensed health professional support (LHPS) competency validations for several staff, failed to ensure tuberculosis testing upon admission for two residents, failed to complete LHPS evaluations within 30 days for one resident, and failed to administer medications as ordered for three residents.
Deficiencies (5)
Failed to ensure 5 of 6 medication aides completed medication clinical skills checklist and 4 of 6 completed required medication aide training or had verification of previous employment before administering medications.
Failed to ensure 4 of 6 staff had competency validation for licensed health professional support (LHPS) tasks including fingerstick blood sugar checks, medication administration via injections, inhalation medication, and oxygen administration.
Failed to ensure 2 of 5 sampled residents were tested for tuberculosis disease upon admission in compliance with control measures.
Failed to ensure a Licensed Health Professional Support (LHPS) evaluation was completed within 30 days of admission for 1 of 5 sampled residents with LHPS tasks.
Failed to administer medications as ordered for 3 of 5 sampled residents who had orders for blood pressure medication with parameters, an antipsychotic medication, and a medication to regulate heart rate.
Report Facts
Medication administration days: 1
Medication administration days: 21
Medication administration days: 13
Medication administration days: 4
Medication administration days: 5
Medication administration days: 19
Medication administration days: 17
Medication administration days: 2
Medication administration days: 15
Correction date: 2023
Medication administration opportunities: 27
Medication administration opportunities: 26
Medication administration opportunities: 22
Medication tablets remaining: 32
Medication tablets remaining: 0
Medication tablets remaining: 8
Medication tablets remaining: 22
Medication tablets remaining: 13
Inspection Report
Annual Inspection
Census: 20
Capacity: 66
Deficiencies: 1
Date: Sep 8, 2021
Visit Reason
The Adult Care Licensure Section conducted an annual survey of Homestead Hills Assisted Living on September 8-9, 2021.
Findings
The facility exceeded its licensed capacity by having 20 residents in a Special Care Unit (SCU) licensed for 18 beds. The total licensed capacity was 66 beds, with 18 designated for the SCU. Two residents in the SCU were assigned to assisted living beds and were not recommended to reside in a locked unit but were placed there due to availability and preference to live together.
Deficiencies (1)
Facility exceeded licensed capacity with 20 residents in a Special Care Unit licensed for 18 beds.
Report Facts
Licensed capacity: 66
Licensed SCU beds: 18
Residents in SCU: 20
Inspection Report
Capacity: 66
Deficiencies: 8
Date: Aug 7, 2019
Visit Reason
This facility was surveyed for conformance with the 2005 Rules for Licensing of Adult Care Homes of Seven or More Beds, the 1991 Rules for Licensing of Adult Care Homes of Seven or More Beds in effect at the time of initial licensure, and applicable portions of the 1991 and 2012 Editions of the North Carolina Building Codes, Institutional Occupancy.
Findings
Deficiencies were cited related to housekeeping, fire safety equipment, building equipment maintenance, and mechanical exhaust ventilation. Specific issues included excessive particulate build-up on return-air grilles, non-illuminated exit signs, emergency lights not functioning, unsecured exit signs, missing sprinkler escutcheons, doors that do not latch or drag on the floor, stored items restricting sprinkler coverage, and a non-operational mechanical exhaust system in the janitorial closet.
Deficiencies (8)
Facility has not maintained in an orderly and free of all obstructions manner; excessive particulate build-up on return-air grilles in Laundry Room/300 Hall and Residential Laundry/400 Hall.
Fire safety equipment not maintained in a safe and operating condition: exit sign adjacent to Room 402 not illuminated; emergency light in Sprinkler Riser Room does not illuminate; exit sign not secured outside Room 306.
Sprinkler escutcheons missing at The Carolina Hall Room/200 Hall and Room 210/200 Hall.
Entry door into Break Room/200 Hall wedged open allowing passage of fire and/or smoke.
Doors at Clean Linen/200 Hall, Room 306/300 Hall, and Room 403A/400 Hall do not latch allowing passage of fire and/or smoke.
Entry door into The Piedmont Room/300 Hall drags on the floor.
Stored items stacked too close to ceiling in Activity Storage Room/400 Hall restricting sprinkler coverage.
Mechanical exhaust system not operational in Janitorial Closet/400 Hall.
Report Facts
Licensed capacity: 66
Inspection Report
Capacity: 66
Deficiencies: 13
Date: Jul 20, 2017
Visit Reason
The facility was surveyed for conformance with the 2005 Rules for Licensing of Adult Care Homes of Seven or More Beds, the 1991 Rules for Licensing of Adult Care Homes of Seven or More Beds in effect at the time of initial licensure, and applicable portions of the 1991 and 2012 Editions of the North Carolina Building Codes, Institutional Occupancy.
Findings
Multiple deficiencies were noted including lack of current fire inspection report, bathrooms used for storage, furnishings and plumbing fixtures not maintained in good repair, hazards due to improperly stored oxygen bottles and blocked electrical panels, fire safety equipment not maintained or operating properly, failure to maintain fire resistant rated ceilings, and absence of exhaust ventilation in required areas.
Deficiencies (13)
A current copy of the Fire Inspection report was not maintained available at the facility for review.
Toilet rooms were being utilized for storage, specifically the bathroom in Room 405 (Therapy Room) was full of therapy equipment and supplies.
Furnishings were not maintained in good repair; Room 207 closet door had damage near the door knob.
Plumbing fixtures were not maintained in good repair; Room 314 toilet does not flush completely every time.
Facility was not maintained free from hazards due to oxygen bottles stored without restraint and obstruction of electrical equipment clearance.
Failure to maintain fire safety equipment in operating condition; multiple exit lights and emergency lights did not light on battery backup.
Unapproved device used to keep door open, impeding quick closing to contain smoke/fire; device removed during survey.
Fire safety doors did not latch or close properly in multiple locations including Room 314, kitchen, and service corridor.
Holes or gaps at penetrations in fire resistant rated ceilings allowing potential spread of fire and smoke.
Doors difficult to open, preventing safe and quick exiting; repaired during survey.
Kitchen hood suppression system heads not directed at cooking surfaces.
Monthly service checks for kitchen ansul system were not conducted or recorded by staff.
Absence of exhaust ventilation in required spaces; bathroom exhaust fan in Room 317 was not working.
Report Facts
Total licensed capacity: 66
Special Care Unit beds: 18
Number of oxygen cylinders improperly stored: 1
Number of exit lights/emergency lights not working on battery backup: 6
Number of conduits needing fire caulk: 2
Number of holes in ceiling over washer: 2
Inspection Report
Follow-Up
Deficiencies: 5
Date: Sep 23, 2015
Visit Reason
This report is of a Followup Survey conducted to verify correction of previously identified deficiencies at Homestead Hills Assisted Living.
Findings
The followup survey revealed that all deficiencies have not been corrected. Deficiencies include unsafe storage of portable medical oxygen cylinders, breaches in fire-rated construction compromising fire safety, and inadequate mechanical ventilation in certain facility areas.
Deficiencies (5)
Facility was not maintained in a safe manner by not properly handling portable medical oxygen cylinders, risking them becoming dangerous projectiles.
Breaches through fire-rated construction invalidated its integrity, risking fire and smoke containment failure.
Fire sprinkler escutcheon plate in Room 222 does not cover ceiling opening.
Ceiling penetrations due to gas piping and electrical installations in the Sprinkler Riser Room are not sealed.
Mechanical ventilation system is not exhausting interior air in the 300 Hall Laundry.
Inspection Report
Complaint Investigation
Capacity: 18
Deficiencies: 7
Date: Aug 4, 2015
Visit Reason
The Adult Care Licensure Section and the Forsyth County Department of Social Services conducted an initial survey and complaint investigation on August 4, 5, and 6, 2015.
Complaint Details
The visit was a complaint investigation triggered by allegations related to staff competency, diabetic care, medication administration, infection control, and restraint use.
Findings
The facility failed to ensure competency validation for medication aides, proper diabetic training, accurate therapeutic diet implementation, physician orders and care planning for restraints, infection control for blood glucose monitoring, annual infection control training for medication aides, and medication administration training and competency. Medication administration errors and improper restraint use were also noted.
Deficiencies (7)
Failed to assure 5 of 6 sampled staff were competency validated by a registered nurse by return demonstration prior to performing required tasks such as Fingerstick Blood sugars, insulin injections, application of anti-embolic hose, Oxygen administration and nebulizer medication.
Failed to assure 4 of 6 staff received training by a licensed health professional on care of diabetic residents prior to administering insulin.
Failed to ensure therapeutic diets (no concentrated sweets and mechanical soft) were served as ordered by the physician for 2 of 5 sampled residents in the Memory Care Unit.
Failed to obtain a physician's order, provide assessment and care planning, and document attempted alternatives to restraints for 1 of 1 sampled residents prior to use of restraints (furniture placed against bed).
Failed to assure adequate and appropriate infection control measures were implemented for blood glucose monitoring regarding use of shared glucometers for 3 of 4 sampled residents with orders for glucose monitoring.
Failed to assure all medication aides received annual in-service training for infection control, safe practices for injections and glucose monitoring for 3 of 5 sampled staff.
Failed to assure 3 of 5 sampled medication aides hired after 10/1/13 had successfully completed the 15 hour medication administration training and 1 of 5 completed the Medication Clinical Skills Validation prior to administering medications.
Report Facts
Residents receiving fingerstick blood sugar checks: 9
Residents in Memory Care Unit: 18
Medication administration observations: 28
Medication Aides sampled: 6
Residents sampled for therapeutic diet: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Medication Aide | Named in competency validation and medication administration findings. |
| Staff B | Medication Aide | Named in infection control training and competency findings. |
| Staff C | Medication Aide | Named in competency validation, diabetic care training, infection control training, and medication administration findings. |
| Staff D | Medication Aide | Named in competency validation and diabetic care training findings. |
| Staff E | Medication Aide | Named in competency validation, diabetic care training, infection control training, and medication administration findings. |
| Staff F | Medication Aide | Named in competency validation findings. |
| Resident Care Director | Licensed Practical Nurse | Named in multiple interviews regarding competency validation, infection control, medication administration, and restraint findings. |
| Director of Nursing | Registered Nurse | Named in multiple interviews regarding competency validation, infection control, medication administration, and restraint findings. |
| Administrator | Named in interviews regarding restraint and infection control findings. |
Inspection Report
Capacity: 66
Deficiencies: 9
Date: Jul 29, 2015
Visit Reason
The inspection was a Biennial Construction Survey conducted to assess compliance with the 1991 Rules for the Licensing of Domiciliary Homes, the 2005 Rules for Adult Care Homes of Seven or More Beds, and the 1991 North Carolina State Building Code.
Findings
Multiple deficiencies were found related to building safety and maintenance, including failure of fire alarm notification components, improper handling and storage of medical oxygen cylinders, fire doors wedged open, breaches in fire-rated construction, unsealed ceiling penetrations, exterior and interior doors not maintained for proper operation or privacy, and inadequate mechanical ventilation in certain areas.
Deficiencies (9)
Fire Alarm notification components failed to operate safely during testing.
Portable medical oxygen cylinders were not properly secured, posing a projectile hazard.
Fire doors were wedged open, preventing proper containment of smoke and fire.
Breaches through fire-rated construction invalidated fire containment integrity.
Fire sprinkler escutcheon plates did not cover ceiling openings in certain rooms.
Ceiling penetrations due to gas piping and electrical installations were not sealed.
Exterior exit door was difficult to open due to dragging and required excessive force.
Interior corridor door for Room 403A did not latch, compromising privacy.
Mechanical ventilation system was not exhausting interior air in Laundry and Breakroom Bathrooms.
Report Facts
Licensed bed capacity: 66
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