Inspection Reports for Morning Star Special Care Unit

Multiple deficiencies were cited including non-compliance with emergency release switch requirements, lack of current fire and building safety inspection reports, inadequate bathroom privacy, unsafe and unclean premises, failure to conduct fire safety rehearsals quarterly on each shift, malfunctioning emergency lighting and exit signs, fire safety equipment not maintained or inspected, plumbing issues, and lack of exhaust ventilation in specified areas.

The complaint investigation revealed that Staff A dragged Resident #1 backwards down the hallway in a seated position by her arms. The incident was witnessed by other staff who did not intervene or immediately report the abuse. Staff A was terminated and charged with a felony.

The facility failed to ensure food safety due to contamination in the walk-in cooler and ice buildup in the walk-in freezer. Additionally, a resident was abused by staff dragging her down the hallway, and the facility failed to ensure pre-admission screenings were completed for residents in the Special Care Unit.

The facility failed to administer medications as ordered by a licensed prescribing practitioner for 1 of 5 sampled residents (Resident #3). Specifically, staff administered metoprolol without obtaining the resident's heart rate as ordered, despite the order to hold the medication if heart rate was less than 60. Documentation of heart rate prior to administration was missing for January through March 2020.

The facility had multiple deficiencies including failure to ensure medication aides received proper training and certification, inadequate supervision of residents leading to falls, failure to notify physicians of wound care issues, failure to administer medications as ordered, and failure to maintain proper medication labeling and infection control.

The facility has not maintained the fire safety components in a safe and operating condition, as evidenced by the fire alarm control panel indicating a trouble Supervisory Mode/Sprinkler Supervise for Zone 7, and the facility is operating with a fire watch.

Multiple deficiencies were cited related to the physical plant, including unsafe exterior grounds, poor housekeeping and furnishings, lack of required hand grips, unsafe building equipment and fire safety components, and inadequate exhaust ventilation in bathrooms and laundry areas.

The fire alarm system was found not to be maintained in a safe and operating condition, with the fire alarm panel indicating trouble, maglocks reengaging when the system was silenced, and smoke detectors in the dining room failing to initiate the fire alarm when tested with canned smoke.

The fire alarm system was found not to be maintained in a safe and operating condition, with the fire alarm panel indicating trouble, maglocks reengaging when the alarm was silenced, and smoke detectors in the dining room failing to initiate the alarm when tested.

The fire alarm system was found not to be maintained in a safe and operating condition. Specifically, the fire alarm panel indicated trouble though it operated when tested, and maglocks reengaged improperly when the fire alarm system was silenced, potentially preventing safe exit during an emergency. Repairs are in progress but not yet completed.

The facility had unresolved deficiencies related to the fire alarm system not being maintained in a safe and operating condition, including a fire alarm panel indicating trouble, maglocks reengaging improperly, and smoke detectors in the dining room failing to initiate the alarm. Additionally, the hot water temperature was found below the required minimum at one fixture.

The survey found multiple deficiencies related to physical plant conditions including lack of current fire inspection reports, damaged ceilings, walls, and furniture, malfunctioning door hardware and fire alarm system, non-operating emergency lights, sprinkler system obstructions, unsafe windows, out-of-service water heaters and coolers, broken toilet paper dispenser, and inadequate hot water temperature. Additionally, outside premises were not maintained in a clean and safe condition.

The facility failed to ensure tuberculosis testing for staff and residents was complete and compliant, competency validation for Licensed Health Professional Support tasks was missing for several staff, diabetic care training was not provided to medication aides prior to insulin administration, special care unit staff did not receive required orientation and training, infection prevention training was not completed by medication aides, medication aides lacked required training and competency evaluations, and controlled substance screening was not completed for several staff.

Complaint investigation was conducted as part of the survey. The facility failed to protect residents from abuse by allowing staff who had been reported to be aggressive and abusive with residents while providing care to continue to work as the Supervisor. Specific incidents involved residents #1, #2, and #5 being assaulted or slapped, resulting in injuries and emergency room visits. The facility failed to report these allegations to the Health Care Personnel Registry.

The facility failed to maintain floors and walls in good repair, failed to maintain cleanliness and odor control, failed to ensure tuberculosis testing for staff and residents, failed to verify staff qualifications and training, failed to provide adequate personal care and supervision, failed to report abuse allegations, and failed to ensure proper medication administration and infection control training.

One previously cited deficiency related to building equipment safety was not corrected. The facility's special locking magnetic exit doors failed to meet NC State Building Code requirements because the locks re-energize when the fire alarm system is silenced.

The facility failed to provide current annual sanitation and fire safety inspection reports, maintain clean and repaired walls, ceilings, and floors, and ensure building equipment such as exit door locks, exit signs, and emergency lighting were safe and operational.

Multiple physical plant deficiencies were identified including lack of current fire and safety inspection reports, inadequate bathroom privacy, poor housekeeping and maintenance, failure to rehearse fire safety plans quarterly, malfunctioning fire safety equipment, unsafe building conditions, use of prohibited portable electric heaters, and inadequate exhaust ventilation.

The visit included a complaint investigation as part of the annual survey conducted on 6/30/15 - 7/01/15.

The facility failed to assure that staff qualifications, physician orders implementation, special care unit staff training, infection control training, and pre-employment drug screening requirements were met. Specifically, two of three sampled staff lacked documented Health Care Personnel Registry checks upon hire, physician orders for one resident were not implemented, two staff lacked required special care unit training, one medication aide did not complete the mandated infection control course, and one staff member did not have documented pre-employment drug screening.