Deficiencies (last 3 years)
Deficiencies (over 3 years)
3.7 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
10% better than New Hampshire average
New Hampshire average: 4.1 deficiencies/yearDeficiencies per year
4
3
2
1
0
Inspection Report
Routine
Deficiencies: 3
Feb 28, 2025
Visit Reason
The inspection was conducted to assess compliance with regulatory requirements related to resident assessments, medication management, infection prevention, and control practices at Merrimack County Nursing Home.
Findings
The facility failed to ensure accurate Minimum Data Set (MDS) assessments for several residents, failed to remove expired medications and label multidose vials properly, and did not follow Enhanced Barrier Precautions for a resident with an indwelling catheter.
Severity Breakdown
Level of Harm - Potential for minimal harm: 1
Level of Harm - Minimal harm or potential for actual harm: 2
Deficiencies (3)
| Description | Severity |
|---|---|
| Failure to ensure accurate Minimum Data Set (MDS) assessments for residents #9, #27, #103, and #157. | Level of Harm - Potential for minimal harm |
| Failure to ensure expired medications were removed and multidose vials labeled with open/expiration dates in medication rooms and carts for residents #31, #33, #36, #112, #126, and #152. | Level of Harm - Minimal harm or potential for actual harm |
| Failure to follow Enhanced Barrier Precautions (EBP) for resident #225 with an indwelling catheter. | Level of Harm - Minimal harm or potential for actual harm |
Report Facts
Residents in sample: 35
Medication rooms observed: 4
Medication carts observed: 7
Residents affected: 4
Residents affected: 6
Residents affected: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Reimbursement Coordinator | Confirmed inaccurate MDS coding for residents #9, #27, #103, and #157 |
| Staff B | Registered Nurse | Confirmed expired medication in Young Adult/Hospice medication room |
| Staff C | Registered Nurse | Confirmed expired medication in 3rd floor medication room |
| Staff D | Licensed Practical Nurse | Confirmed unlabeled multidose vials on medication cart |
| Staff F | Registered Nurse | Confirmed expired medications not removed from 4 South medication room |
| Staff G | Infection Preventionist | Confirmed resident #225 was not on Enhanced Barrier Precautions |
| Staff H | Licensed Nursing Assistant | Admitted failure to follow Enhanced Barrier Precautions for resident #225 |
| Staff I | Licensed Practical Nurse | Confirmed resident #225 had a catheter |
Inspection Report
Complaint Investigation
Deficiencies: 2
Mar 13, 2024
Visit Reason
The inspection was conducted following a complaint investigation related to a resident elopement incident during and after a fire alarm at the facility.
Findings
The facility failed to ensure adequate supervision during and after a fire alarm, resulting in a resident eloping and being found hypothermic outside the facility. Additionally, the facility failed to maintain proper infection control practices during wound dressing changes for another resident.
Complaint Details
The complaint investigation was substantiated by findings that a resident eloped during a fire alarm due to inadequate supervision, resulting in hypothermia and hospitalization.
Severity Breakdown
Level of Harm - Immediate jeopardy to resident health or safety: 1
Level of Harm - Minimal harm or potential for actual harm: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| Failure to ensure residents received adequate supervision during and after a fire alarm, resulting in resident elopement and hypothermia. | Level of Harm - Immediate jeopardy to resident health or safety |
| Failure to maintain infection control practices during wound dressing changes, specifically not changing gloves or performing hand hygiene between removing old dressing and applying new dressing. | Level of Harm - Minimal harm or potential for actual harm |
Report Facts
Resident sample size: 39
Residents affected: 1
Residents affected: 1
Initial body temperature: 33.5
Initial body temperature: 92.3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff D | Administrator | Interviewed regarding fire alarm incident and resident elopement |
| Staff F | Licensed Nurse Assistant | Interviewed; did not perform resident census check after fire alarm |
| Staff E | Licensed Nurse Assistant | Interviewed; did not perform resident census check after fire alarm |
| Staff A | Registered Nurse | Observed and interviewed regarding failure to perform hand hygiene during wound dressing change |
| Staff C | Director of Nursing | Interviewed regarding facility policy on hand hygiene and glove use |
| Staff B | Infection Preventionist | Interviewed regarding facility policy on hand hygiene and glove use |
Inspection Report
Complaint Investigation
Deficiencies: 2
Mar 13, 2024
Visit Reason
The inspection was conducted following a complaint related to inadequate supervision during and after a fire alarm, which resulted in a resident eloping and subsequent hospitalization for hypothermia.
Findings
The facility failed to ensure adequate supervision of residents during and after a fire alarm, leading to a resident elopement and hypothermia requiring hospital treatment. Additionally, the facility failed to maintain proper infection control practices during wound dressing changes for one resident.
Complaint Details
The complaint investigation found that during a fire alarm on 3/13/24, the facility failed to conduct a resident census check after the alarm was cleared, leading to Resident #99 eloping and being found hours later with hypothermia. The facility updated policies and conducted staff education and mock drills following the incident.
Severity Breakdown
Level of Harm - Immediate jeopardy to resident health or safety: 1
Level of Harm - Minimal harm or potential for actual harm: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| Failure to ensure residents received adequate supervision during and after a fire alarm, resulting in resident elopement and hypothermia. | Level of Harm - Immediate jeopardy to resident health or safety |
| Failure to maintain infection control practices during wound dressing changes, specifically not changing gloves or performing hand hygiene between removing old dressing and applying new dressing. | Level of Harm - Minimal harm or potential for actual harm |
Report Facts
Resident sample size: 39
Resident affected: 1
Resident observed: 1
Initial body temperature: 33.5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff D | Administrator | Interviewed regarding fire alarm incident and resident elopement |
| Staff F | Licensed Nurse Assistant | Interviewed about failure to conduct resident census check after fire alarm |
| Staff E | Licensed Nurse Assistant | Interviewed about failure to conduct resident census check after fire alarm |
| Staff A | Registered Nurse | Observed and interviewed regarding failure to perform hand hygiene during wound dressing change |
| Staff C | Director of Nursing | Interviewed regarding facility policy on hand hygiene and glove use |
| Staff B | Infection Preventionist | Interviewed regarding facility policy on hand hygiene and glove use |
Inspection Report
Routine
Deficiencies: 4
Mar 2, 2023
Visit Reason
The inspection was conducted to assess compliance with regulatory requirements related to medication management, feeding assistant program appropriateness, and COVID-19 testing among residents.
Findings
The facility was found deficient in limiting PRN psychotropic medication orders to 14 days without documented rationale for extension, maintaining proper medication refrigerator temperature logs, preventing administration of expired medications, ensuring feeding assistants only assist appropriate residents, and timely COVID-19 testing of symptomatic residents.
Severity Breakdown
Level of Harm - Minimal harm or potential for actual harm: 4
Deficiencies (4)
| Description | Severity |
|---|---|
| Failure to ensure PRN orders for psychotropic medications were limited to 14 days or properly documented for extension for 3 of 5 residents. | Level of Harm - Minimal harm or potential for actual harm |
| Failure to ensure medication rooms had temperature recordings for refrigerators containing influenza vaccinations and insulin pens; expired insulin vial found in medication cart. | Level of Harm - Minimal harm or potential for actual harm |
| Failure to ensure Paid Feeding Assistants provided dining assistance only for residents without complicated feeding problems for 1 of 3 residents. | Level of Harm - Minimal harm or potential for actual harm |
| Failure to perform timely COVID-19 testing on a symptomatic resident. | Level of Harm - Minimal harm or potential for actual harm |
Report Facts
Residents reviewed for psychotropic medication side effects: 39
Residents with PRN psychotropic medication order issues: 3
Medication rooms without temperature recordings: 2
Medication carts with expired insulin vial: 1
Residents fed by Paid Feeding Assistants reviewed: 3
Residents with complicated feeding problems fed by PFAs: 1
Residents reviewed for COVID-19 testing: 4
Residents not tested timely for COVID-19: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Registered Nurse | Confirmed findings related to PRN psychotropic medication orders for Resident #31 |
| Staff B | Registered Nurse | Confirmed findings related to PRN psychotropic medication orders for Resident #205 and medication room temperature recordings |
| Staff D | Assistant Director of Nurses | Confirmed PRN order for Lorazepam without stop date for Resident #177 and medication room temperature findings |
| Staff G | Licensed Practical Nurse | Observed administering expired insulin to Resident #96 |
| Staff H | Unit Manager | Confirmed Resident #30 was assisted at meals by PFAs |
| Staff I | Hairdresser | Completed PFA training and assisted Resident #30 with feeding |
| Staff J | Assistant Food Service Manager | Completed PFA training and assisted Resident #30 with feeding |
| Staff E | Infection Preventionist | Confirmed Resident #10 was not tested for COVID-19 until 1/23/23 |
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