Inspection Reports for New Horizon Senior Living Center
17024 VETERANS MEMORIAL HIGHWAY, KINGWOOD, WV, 26537
Back to Facility ProfileDeficiencies (last 24 years)
Deficiencies (over 24 years)
7.5 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
17% better than West Virginia average
West Virginia average: 9 deficiencies/year
Deficiencies per year
16
12
8
4
0
Census
Latest occupancy rate
175 residents
Based on a September 2025 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
Census over time
Inspection Report
Annual Inspection
Census: 175
Deficiencies: 0
Sep 17, 2025
Visit Reason
The inspection was conducted as an annual environmental survey with subsequent re-visits to assess compliance with environmental standards at the New Horizon Senior Living Center.
Findings
The report documents multiple annual environmental surveys and re-visits with various tags cited initially, but no tags cited on the final re-visit, indicating resolution of prior issues.
Report Facts
Census: 175
Tags Cited: 6
Inspection Report
Annual Inspection
Census: 175
Deficiencies: 3
Aug 7, 2025
Visit Reason
The inspection was an annual environmental survey and re-visit conducted to assess compliance with health, safety, and maintenance regulations at New Horizon Senior Living Center.
Findings
The facility failed to ensure preventative maintenance of equipment, specifically the kitchen ice maker was plugged into an unapproved extension cord, and failed to rehearse the emergency preparedness plan annually. Additionally, housekeeping and maintenance deficiencies were noted, including damaged carpets, missing bathroom fixtures, and cleanliness issues. Corrective actions and plans for replacement and training were outlined.
Deficiencies (3)
| Description |
|---|
| The kitchen ice maker was plugged into an unapproved extension cord. |
| The facility failed to rehearse the emergency preparedness plan annually. |
| Housekeeping and maintenance deficiencies including damaged carpet, missing towel bars and toilet paper holders, and dirty sink. |
Report Facts
Facility census: 175
Deficiency citation: 2
Inspection Report
Annual Inspection
Census: 17
Deficiencies: 5
May 6, 2025
Visit Reason
The inspection was an annual environmental survey conducted to assess compliance with health, safety, fire safety, disaster preparedness, physical facilities maintenance, and emergency preparedness requirements.
Findings
The facility failed to maintain a comprehensive emergency preparedness program, including failure to review and update the emergency plan annually, rehearse the plan with staff, and maintain current transfer agreements. Additionally, maintenance and housekeeping deficiencies were noted, such as use of an unapproved extension cord, dirty HVAC vents, and general facility disrepair.
Severity Breakdown
Class I: 2
Class II: 1
Class III: 2
Deficiencies (5)
| Description | Severity |
|---|---|
| Failed to review, update, sign, and date the emergency preparedness plan annually. | Class III |
| Failed to ensure preventative maintenance of facility equipment, including use of an unapproved extension cord for the kitchen ice maker. | Class III |
| Failed to provide maintenance and housekeeping to maintain a safe, sanitary, and accident-free living environment; dirty HVAC vents and ceiling near vents. | Class I |
| Failed to rehearse the disaster and emergency preparedness plan with all staff annually and keep documentation. | Class I |
| Failed to include current transfer agreements for transportation, food, water, and shelter in the emergency preparedness plan. | Class II |
Report Facts
Facility census: 17
Tags cited: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Rhonda Farrell | Administrator | Named in relation to verification and acknowledgment of findings during exit interview |
Inspection Report
Follow-Up
Census: 17
Deficiencies: 1
Jan 28, 2025
Visit Reason
Follow-up to Complaint #34896 to verify correction of previously cited deficiency.
Findings
The deficiency identified in the prior complaint was corrected as of the follow-up inspection.
Complaint Details
Complaint #34896 was the basis for the follow-up visit; the deficiency was corrected.
Deficiencies (1)
| Description |
|---|
| Deficiency related to complaint #34896 was corrected. |
Report Facts
Census: 17
Inspection Report
Follow-Up
Census: 17
Deficiencies: 1
Jan 28, 2025
Visit Reason
Second follow-up to Change of Ownership Survey conducted to verify correction of previously cited deficiencies.
Findings
The deficiency identified in the prior survey was corrected as of the follow-up visit.
Deficiencies (1)
| Description |
|---|
| Initial Comments - deficiency was corrected. |
Report Facts
Census: 17
Inspection Report
Complaint Investigation
Census: 14
Deficiencies: 1
Oct 29, 2024
Visit Reason
Investigation of Complaint #34896 regarding the facility's compliance with its assisted living residence license.
Findings
The licensee failed to comply with the terms of the assisted living residence's license as the license was expired at the time of inspection. The complaint was substantiated and a deficiency was cited.
Complaint Details
Complaint #34896 was substantiated during the investigation conducted on 10/29/24, resulting in a cited deficiency.
Severity Breakdown
Class II: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| The licensee failed to comply with the terms of the assisted living residence's license; the license was expired as of 09/25/24 though the administrator believed it was valid until early 2025. | Class II |
Report Facts
Census: 14
License expiration date: Sep 25, 2024
Renewal application received date: Nov 7, 2024
Inspection Report
Follow-Up
Census: 15
Deficiencies: 1
Aug 6, 2024
Visit Reason
The visit was a 1st revisit inspection conducted to verify correction of previously cited environmental deficiencies from the initial survey on April 23, 2024.
Findings
All previously cited deficiencies (0446, 0450, and 0452) were corrected as of the revisit on August 6, 2024. The facility census was 15 at both the initial and revisit inspections.
Deficiencies (1)
| Description |
|---|
| Environmental deficiencies cited on April 23, 2024, including deficiencies numbered 0446, 0450, and 0452. |
Report Facts
Deficiencies cited: 3
Facility census: 15
Inspection Report
Follow-Up
Census: 17
Deficiencies: 1
Jul 10, 2024
Visit Reason
This was a first follow-up survey to a change of ownership survey conducted on 07/10/24 to verify compliance and address cited deficiencies.
Findings
A deficiency was cited related to failure to report a major incident involving Resident #4 to the Office of Health Facility Licensure and Certification as required. The incident involved a fall resulting in a fracture. The Administrator was unaware of the reporting requirement.
Severity Breakdown
Class III: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| The licensee failed to report a major incident involving Resident #4's fall and fracture to the Office of Health Facility Licensure and Certification as soon as possible and no later than the next business day. | Class III |
Report Facts
Census: 17
Incident date: Jul 1, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Administrator | Interviewed regarding failure to report major incident |
Inspection Report
Follow-Up
Census: 24
Deficiencies: 0
May 27, 2024
Visit Reason
Revisit to Complaint #31508 to verify correction of previously cited deficiency.
Findings
The deficiency cited in the prior complaint was cleared during this revisit inspection.
Complaint Details
Complaint #31508 was investigated and the deficiency was cleared upon revisit.
Report Facts
Census: 24
Inspection Report
Routine
Census: 15
Deficiencies: 8
Apr 24, 2024
Visit Reason
Routine change of ownership survey conducted from 04/22/24 to 04/24/24 to assess compliance with health and safety regulations and facility licensing requirements.
Findings
The survey identified multiple deficiencies including incomplete annual tuberculosis screenings for employees, inadequate documentation of resident monitoring after accidents, insufficient duration and documentation of resident activities, delayed physician-signed resident health assessments, lack of RN visit logs, and housekeeping and maintenance issues such as damaged carpets and missing bathroom fixtures.
Severity Breakdown
Class II: 3
Class III: 3
Deficiencies (8)
| Description | Severity |
|---|---|
| Failed to ensure all employee health records contained results of annual tuberculosis screening for two employees. | Class III |
| Failed to provide a monthly calendar listing duration of all social and recreational activities for residents. | Class III |
| Failed to monitor and document resident's condition at least once every eight hours for 24 hours following an accident for one resident. | Class II |
| Failed to provide a minimum of one hour per day of various types of scheduled activities for residents. | — |
| Failed to ensure each resident had a written, signed, and dated health assessment by a physician within five working days following admission for two residents. | Class II |
| Failed to ensure the Registered Nurse maintained a record with an entry for each visit including date, time in/out, duties, concerns, and signature. | Class III |
| Failed to ensure tuberculin skin tests were documented completely and accurately for three employees. | Class II |
| Failed to ensure adequate housekeeping and maintenance including damaged carpet, missing towel bars, toilet paper holders, and dirty sinks. | — |
Report Facts
Census: 15
Employees with deficient TB screening: 2
Residents with deficient health assessments: 2
Employees with deficient TST documentation: 3
Deficiencies cited: 8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Employee #1 | Named in deficiency for missing annual TB screening | |
| Employee #3 | Registered Nurse | Named in deficiency for missing annual TB screening and failure to maintain RN visit log |
| Employee #14 | Named in deficiency for incomplete tuberculin skin test documentation | |
| Employee #15 | Named in deficiency for incomplete tuberculin skin test documentation | |
| Employee #16 | Named in deficiency for incomplete tuberculin skin test documentation | |
| Administrator | Interviewed regarding TB screening lapses and activity scheduling | |
| Director of Nursing | Interviewed regarding lack of 24-hour resident monitoring after accident |
Inspection Report
Routine
Census: 15
Deficiencies: 3
Apr 23, 2024
Visit Reason
The inspection was conducted as a routine environmental and physical facilities survey to assess compliance with health, safety, and maintenance regulations at New Horizon Senior Living Center.
Findings
The facility failed to document emergency evacuation training for new residents within 24 hours of admission and had multiple physical facility deficiencies including mold/mildew on sealant, improper storage in showers, damaged fixtures, missing paint, and maintenance issues. The administrator acknowledged these findings during the exit interview.
Severity Breakdown
Class I: 2
Class II: 1
Deficiencies (3)
| Description | Severity |
|---|---|
| Failed to document that within 24 hours of admission all new residents were shown how to evacuate the residence in an emergency. | Class I |
| Failed to maintain a safe, sanitary, and accident-free living environment including mold/mildew stained sealant around toilet and storage of items in resident shower. | Class I |
| Failed to keep the interior and exterior of the residence clean and in good repair including missing ceiling light fixture cover, unsealed shower floor, burnt out light, damaged wardrobe, non-working exhaust fan, missing paint, damaged toilet seat, damaged flooring, and exterior maintenance issues. | Class II |
Report Facts
Facility census: 15
Deficiencies cited: 3
Inspection Report
Complaint Investigation
Census: 18
Deficiencies: 1
Mar 27, 2024
Visit Reason
The inspection was conducted as an investigation of Complaint #31508 regarding failure to provide residents with snacks that meet their needs and choices.
Findings
The Licensee failed to ensure residents were offered evening snacks as required, affecting all 18 residents. Interviews with residents and staff confirmed snacks were not consistently offered in the evening, and the complaint was substantiated with a deficiency cited.
Complaint Details
Complaint #31508 was substantiated, and a deficiency was cited related to failure to provide snacks as requested by residents.
Deficiencies (1)
| Description |
|---|
| Failed to ensure residents were offered snacks that met their needs and choices, specifically evening snacks were not offered. |
Report Facts
Census: 18
Residents interviewed: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Employee #11 | Cook | Interviewed regarding snack provision and stated snacks were placed on a cart for aides to distribute. |
Inspection Report
Complaint Investigation
Census: 19
Deficiencies: 0
Feb 13, 2024
Visit Reason
Investigation of Complaint #30988 conducted on 02/13/2024 to determine the validity of the complaint.
Findings
The complaint was unsubstantiated, and no deficiencies were cited during the investigation.
Complaint Details
Complaint #30988 was investigated and found to be unsubstantiated with no deficiencies cited.
Report Facts
Census: 19
Inspection Report
Follow-Up
Census: 21
Deficiencies: 0
Dec 4, 2023
Visit Reason
This document is a first follow-up visit to the annual survey conducted to verify that all previously cited deficiencies have been corrected.
Findings
All deficiencies identified in the prior annual survey were cleared as of the follow-up visit on 12/04/2023.
Report Facts
Census: 21
Inspection Report
Complaint Investigation
Census: 24
Deficiencies: 0
Nov 8, 2023
Visit Reason
Investigation of Complaint #29611 conducted on 11/08/2023 from 10:15 PM to 12:15 PM.
Findings
The complaint was substantiated, but no deficiencies were cited during the investigation.
Complaint Details
Complaint #29611 was substantiated; however, no deficiencies were identified or cited.
Report Facts
Census: 24
Inspection Report
Annual Inspection
Deficiencies: 0
Sep 27, 2023
Visit Reason
The document is an annual survey inspection report for New Horizon Senior Living Center conducted to assess compliance with health and safety regulations.
Findings
The report indicates that a previous citation was cleared during the annual survey completed on 09/27/23. No current deficiencies or citations are noted in this document.
Inspection Report
Annual Inspection
Census: 24
Deficiencies: 5
Sep 27, 2023
Visit Reason
Annual survey conducted from 09/25/23 to 09/27/23 to assess compliance with staffing, physical environment, resident death documentation, and use of monitoring devices at New Horizon Senior Living Center.
Findings
The facility was found deficient in maintaining adequate staffing levels, ensuring a safe and sanitary physical environment, clarifying resident death documentation, and providing written notice of video monitoring devices to residents. Multiple instances of inadequate staffing were documented, unsafe housekeeping and maintenance issues were observed, and the resident admission agreement lacked disclosure of video monitoring.
Deficiencies (5)
| Description |
|---|
| Failed to maintain adequate staffing levels to care for residents, with multiple days having fewer aides than required. |
| Failed to ensure adequate housekeeping and maintenance, including presence of personal belongings behind furniture, carpet damage, torn furniture, missing bathroom fixtures, and dirty sink. |
| Failed to clarify the circumstances of a resident's death; documentation only stated 'ceased to breathe' without further explanation. |
| Failed to maintain a safe, sanitary, and accident-free living environment; laundry room was unlocked with access to poisonous chemicals and sharp tools. |
| Failed to provide written notice to residents or legal representatives about the use of video monitoring devices in common areas at the time of admission. |
Report Facts
Census: 24
Deficiencies cited: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Administrator #01 | Administrator | Acknowledged inadequate staffing and lack of awareness about video monitoring disclosure. |
| Registered Nurse (RN) / Director of Nursing (DON) #05 | Registered Nurse / Director of Nursing | Acknowledged inadequate staffing levels and discussed resident death documentation. |
| Maintenance #03 | Maintenance Staff | Confirmed use of video cameras to monitor residents' activities in common areas. |
Inspection Report
Annual Inspection
Census: 24
Deficiencies: 0
Sep 26, 2023
Visit Reason
The inspection was conducted as an annual environmental survey of the New Horizon Senior Living Center.
Findings
The facility had no deficiencies cited during this annual environmental inspection.
Report Facts
Census: 24
Inspection Report
Complaint Investigation
Census: 22
Deficiencies: 1
Jul 18, 2023
Visit Reason
Complaint investigation for Complaint #28702 conducted on 07/18/23 to assess allegations related to resident safety and well-being.
Findings
The Licensee, Administrator, and Registered Nurse failed to protect residents from skin tears caused by a facility dog. Multiple residents sustained skin tears due to the dog, and the complaint was substantiated with deficiencies cited.
Complaint Details
Complaint #28702 was substantiated following investigation. The dog caused skin tears on at least two residents (#6 and #21), with multiple staff and anonymous employee interviews confirming the incidents.
Severity Breakdown
Class II I: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to protect residents from skin tears caused by a facility dog. | Class II I |
Report Facts
Resident identifiers: 2
Census: 22
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Administrative Assistant #2 | Administrative Assistant | Interviewed regarding dog causing skin tears on residents. |
| Director of Nursing #5 | Director of Nursing | Interviewed regarding dog causing skin tears on residents. |
Inspection Report
Follow-Up
Deficiencies: 1
Mar 14, 2023
Visit Reason
This was a revisit inspection to verify correction of previously cited deficiencies at New Horizon Senior Living Center.
Findings
The revisit inspection found that citations were corrected as of the exit date. The report includes a plan of correction for prior deficiencies related to safety and supervision.
Deficiencies (1)
| Description |
|---|
| The Center did not implement programs in an environment that is safe and appropriate for the needs of the consumers, including lack of alarms on outside doors and inadequate awake-night supervision on weekends. |
Report Facts
Center census: 6
Sample size: 3
Inspection Report
Annual Inspection
Census: 29
Deficiencies: 11
Sep 7, 2022
Visit Reason
Annual survey conducted from 08/30/22 to 09/07/22 to assess compliance with regulatory requirements for New Horizon Senior Living Center.
Findings
The facility was found deficient in multiple areas including personnel records lacking required tuberculosis screening documentation, inadequate housekeeping and maintenance, failure to update service plans annually, improper handling of resident death belongings and documentation, failure to respond to complaints in writing within required timeframes, staffing deficiencies related to CPR and first aid training, incomplete transfer documentation, missing annual health assessments including TB screening, failure to conduct weekly nursing assessments for residents with nursing care needs, and failure to document resident weights upon admission and monthly thereafter.
Deficiencies (11)
| Description |
|---|
| Personnel records lacked results of pre-employment and annual tuberculosis screening for six employees. |
| Inadequate housekeeping and maintenance including personal belongings behind furniture, carpet damage, missing bathroom fixtures, and dirty sink. |
| Service plans were not updated annually or as indicated by significant change for two residents. |
| Failure to release resident belongings and funds to estate administrator or executor upon death and lack of documentation for three residents. |
| Failure to respond in writing within four days to complaints for four residents. |
| Failure to document date, time, circumstances of death and person to whom body was released for one resident. |
| One or more employees on night shifts lacked current CPR and first aid training. |
| Failure to prepare and retain transfer summary documentation for four residents. |
| Failure to have written, signed, and dated health assessments including TB screening within required timeframes for two residents. |
| Failure to ensure weekly nursing assessments and documentation for two residents with nursing care needs. |
| Failure to weigh residents upon admission and monthly thereafter and document weights for two residents. |
Report Facts
Facility census: 29
Employees missing TB screening: 6
Residents with outdated service plans: 2
Residents with missing death belongings release documentation: 3
Residents with complaint response failures: 4
Night shifts without CPR and first aid trained staff: 15
Residents with missing transfer documentation: 4
Residents with missing or late health assessments: 2
Residents with missing weekly nursing assessments: 2
Residents with missing weight documentation: 2
Inspection Report
Annual Inspection
Census: 30
Deficiencies: 0
Aug 2, 2022
Visit Reason
Annual environmental inspection of New Horizon Senior Living Center conducted on August 2, 2022.
Findings
No deficiencies were cited during this annual environmental inspection.
Report Facts
Census: 30
Deficiencies cited: 0
Inspection Report
Plan of Correction
Deficiencies: 1
Mar 30, 2022
Visit Reason
This document is a plan of correction submitted by New Horizon Senior Living Center following a prior inspection to address cited deficiencies.
Findings
The report states that credible evidence was accepted in place of an onsite revisit and that the citation has been cleared.
Deficiencies (1)
| Description |
|---|
| Initial Comments - Credible evidence accepted in place of an onsite revisit. Citation has been cleared. |
Inspection Report
Follow-Up
Census: 30
Deficiencies: 1
Jan 26, 2022
Visit Reason
This was a first follow-up visit to the annual survey to verify correction of previous deficiencies related to employee orientation and training.
Findings
The facility failed to provide and maintain a record of training to new employees prior to scheduling them to work unsupervised within the first 15 days of employment for one employee. The employee completed the missing orientation items on the day of the survey. The facility has implemented a plan to ensure all employees complete orientation within 15 days of hire and are not permitted to work unsupervised until completion.
Severity Breakdown
Class II: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failed to provide and maintain a record of training to new employees prior to scheduling them to work unsupervised within the first 15 days of employment for one employee (#10). | Class II |
Report Facts
Census: 30
Employee records reviewed: 8
Employee identifier: 10
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Employee #10 | Named in deficiency for incomplete orientation training | |
| Administrative Assistant #26 | Administrative Assistant | Interviewed regarding resident care and employee training |
Inspection Report
Annual Inspection
Census: 26
Deficiencies: 10
Sep 9, 2021
Visit Reason
Annual survey conducted from 09/07/21 to 09/09/21 to assess compliance with state regulations for New Horizon Senior Living Center.
Findings
The facility failed to maintain adequate staffing levels according to care needs assessments across day, evening, and night shifts. Deficiencies were found in housekeeping and maintenance, employee training and orientation, incident reporting, and personnel records including fingerprinting and PPD screening. Activity calendars lacked documentation of activity completion. Plans of correction were submitted to address these issues.
Deficiencies (10)
| Description |
|---|
| Failed to ensure day shifts were adequately staffed according to care needs assessments, with multiple days in July and August 2021 having fewer direct care staff than required. |
| Failed to maintain accurate staffing records reflecting actual employees on duty and their positions. |
| Failed to ensure adequate housekeeping and maintenance, including presence of personal belongings behind furniture, carpet damage, missing bathroom fixtures, and dirty sink. |
| Failed to report a major incident involving a resident fall with head injury to the Office of Health Facility Licensure and Certification as required. |
| Failed to ensure monthly activity calendars listed time, duration, and documentation of whether activities took place. |
| Failed to provide and maintain records of training for new employees prior to unsupervised work within 15 days of employment for three of four new employees reviewed. |
| Failed to ensure one employee with current first aid and CPR training was on duty at all times during night shifts in July and August 2021. |
| Failed to maintain confidential personnel records including fingerprinting and pre-employment PPD screening for employees prior to hire. |
| Failed to ensure night shift staffing met minimum requirements of one additional direct care staff for every 18 residents with two or more special care needs. |
| Failed to ensure evening shift staffing met minimum requirements of one additional direct care staff for every 15 residents with two or more special care needs. |
Report Facts
Census: 26
Direct Care Staff Deficiency Days: 26
Employees without fingerprint clearance prior to hire: 2
Employees without PPD screening prior to hire: 3
Inspection Report
Complaint Investigation
Census: 32
Deficiencies: 0
Aug 4, 2021
Visit Reason
The inspection was conducted in response to Complaint #25347 to investigate alleged deficiencies at the facility.
Findings
The report indicates that deficiencies were corrected during the inspection. No specific deficiencies or severity levels are detailed in the document.
Complaint Details
Complaint #25347 was investigated and deficiencies were corrected.
Report Facts
Census: 32
Inspection Report
Complaint Investigation
Census: 32
Deficiencies: 0
Jun 9, 2021
Visit Reason
The inspection was conducted as a complaint survey for Windy Hill Village from June 8 to June 9, 2021.
Findings
No deficiencies were cited during the complaint investigation. The Ombudsman was notified via e-mail.
Complaint Details
Complaint Survey Complaint ID: WV00025553. No deficiencies cited. Ombudsman notified via e-mail.
Report Facts
Census: 32
Inspection Report
Complaint Investigation
Census: 32
Deficiencies: 4
Jun 8, 2021
Visit Reason
The inspection was conducted as a complaint survey (Complaint ID: WV00025347) from 06/07/21 to 06/08/21 to investigate deficiencies cited related to resident care and facility operations.
Findings
The facility failed to ensure service plans reflected residents' current needs, maintain daily records of foods served, keep medications locked and inaccessible to residents, and maintain adequate housekeeping and maintenance. Specific findings included a resident eloping without updated care plan, missing daily meal records, medication powder left in a resident's room without an order, and physical environment issues such as carpet damage and missing bathroom fixtures.
Complaint Details
Complaint Survey ID WV00025347 conducted from 06/07/21 12:00 p.m. to 06/08/21 4:30 p.m. Census was 32. Deficiencies were cited.
Severity Breakdown
Class I: 1
Class II: 1
Class III: 1
Deficiencies (4)
| Description | Severity |
|---|---|
| Service plan did not reflect resident's increased monitoring needs after elopement incident. | Class II |
| Failed to maintain a daily record of actual foods served for each meal. | Class III |
| Medications not kept in locked storage; antifungal powder found in resident's room without physician order. | Class I |
| Inadequate housekeeping and maintenance including damaged carpet, missing towel bars, and dirty sink. | — |
Report Facts
Resident Census: 32
Resident Identifier: 32
Resident Identifier: 22
Dates missing daily menus: 11
Inspection Report
Routine
Census: 30
Deficiencies: 0
Jan 19, 2021
Visit Reason
The inspection was conducted as an infection control survey to assess compliance with infection control standards at the facility.
Findings
No deficiencies were cited during this infection control survey conducted on January 19, 2021.
Report Facts
Census: 30
Inspection Report
Routine
Census: 25
Deficiencies: 0
Sep 21, 2020
Visit Reason
The inspection was conducted as a routine visit from September 21 to September 24, 2020, to assess compliance with regulatory standards at New Horizon Senior Living Center.
Findings
No deficiencies were cited during this inspection.
Inspection Report
Annual Inspection
Census: 29
Deficiencies: 0
Jul 17, 2020
Visit Reason
The inspection was an annual environmental survey conducted to assess compliance with health and safety regulations at the New Horizon Senior Living Center.
Findings
The survey found no tags cited on 7/17/2020 with a census of 29 residents. A prior survey on 06/26/2020 cited tag 0490 with concerns noted, but no deficiencies were listed in this report.
Report Facts
Census: 29
Sample size: 100
Inspection Report
Annual Inspection
Census: 29
Deficiencies: 2
Jun 26, 2020
Visit Reason
The inspection was an annual environmental survey conducted to assess compliance with health and safety regulations, including water temperature standards and facility maintenance.
Findings
The facility failed to maintain hot water temperatures within the required range, with a visitor bathroom sink measuring 117 degrees Fahrenheit, creating an unsafe environment. Additionally, housekeeping and maintenance deficiencies were noted, including damaged carpet, missing bathroom fixtures, and cleanliness issues.
Severity Breakdown
Class II: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| Hot water temperature in the visitor bathroom sink was 117 degrees Fahrenheit, exceeding the maximum allowed temperature of 115 degrees. | Class II |
| Inadequate housekeeping and maintenance including personal belongings behind dresser, iron burn and bleach spots on carpet, torn chair, missing towel bar and toilet paper holder, and dirty sink. | — |
Report Facts
Census: 29
Hot water temperature: 117
Hot water temperature after correction: 115
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Neal Likens | Maintenance person | Performed corrective action to adjust hot water temperatures |
Inspection Report
Complaint Investigation
Census: 28
Deficiencies: 0
Jun 18, 2020
Visit Reason
The inspection was conducted as a complaint investigation following an unsubstantiated complaint #24085.
Findings
The complaint investigation was completed with no substantiated findings reported in this document.
Complaint Details
Complaint investigation conducted from 06/16/20 to 06/18/20 for complaint #24085, which was found to be unsubstantiated.
Report Facts
Census: 28
Inspection Report
Complaint Investigation
Census: 28
Deficiencies: 0
Jun 18, 2020
Visit Reason
The inspection was conducted in response to complaint #24086, with the survey team entering on 06/16/20 and exiting on 06/18/20.
Findings
The complaint investigation was completed and found to be unsubstantiated. The report does not list any deficiencies or violations.
Complaint Details
Complaint #24086 was investigated from 06/16/20 to 06/18/20 and was determined to be unsubstantiated.
Report Facts
Census: 28
Inspection Report
Annual Inspection
Census: 29
Deficiencies: 0
Jun 18, 2019
Visit Reason
The inspection was conducted as an annual licensure survey of the New Horizon Senior Living Center.
Findings
No deficiencies were cited during the annual licensure survey conducted on June 17-18, 2019.
Report Facts
Census: 29
Inspection Report
Annual Inspection
Census: 29
Deficiencies: 0
Jun 12, 2019
Visit Reason
The visit was conducted as an annual licensure survey focusing on environmental aspects of the facility.
Findings
No deficiencies were cited during this annual licensure survey.
Report Facts
Census: 29
Inspection Report
Annual Inspection
Census: 34
Deficiencies: 0
Jun 11, 2018
Visit Reason
The visit was conducted as an Annual Licensure Survey focusing on the annual environmental inspection of the facility.
Findings
No deficiencies were cited during this annual environmental licensure survey.
Report Facts
Census: 34
Deficiencies cited: 0
Inspection Report
Annual Inspection
Census: 34
Deficiencies: 0
May 31, 2018
Visit Reason
The visit was conducted as an annual licensure survey of the New Horizon Senior Living Center.
Findings
No deficiencies were cited during this annual licensure survey.
Report Facts
Census: 34
Inspection Report
Complaint Investigation
Census: 36
Deficiencies: 0
Mar 5, 2018
Visit Reason
The inspection was conducted as a complaint investigation based on complaint number WV00019850.
Findings
The report does not provide detailed findings or deficiencies related to the complaint investigation; only the complaint investigation is documented.
Complaint Details
Complaint #: WV00019850; investigation conducted on March 5-6, 2018 with a census of 36 residents.
Report Facts
Census: 36
Inspection Report
Annual Inspection
Census: 38
Deficiencies: 0
Jun 29, 2017
Visit Reason
The inspection was conducted as an Annual Licensure Survey for the facility.
Findings
The survey conducted from June 26-29, 2017 found no deficiencies at the facility.
Report Facts
Census: 38
Inspection Report
Annual Inspection
Census: 37
Deficiencies: 0
Jun 7, 2017
Visit Reason
The inspection was conducted as an annual licensure survey for Windy Hill Village to assess environmental conditions and compliance with regulatory standards.
Findings
No deficiencies were cited during this annual licensure survey, indicating compliance with applicable regulations at the time of inspection.
Report Facts
Census: 37
Inspection Report
Annual Inspection
Census: 35
Deficiencies: 0
Jun 30, 2016
Visit Reason
The inspection was conducted as an Annual Licensure Survey for the facility.
Findings
The report documents the annual licensure survey conducted from June 27-30, 2016, with a census of 35 residents. No specific deficiencies or severity levels are detailed in the provided page.
Report Facts
Census: 35
Inspection Report
Annual Inspection
Census: 33
Deficiencies: 1
Jun 13, 2016
Visit Reason
The inspection was conducted as an Annual Licensure Survey to assess compliance with licensing requirements for the New Horizon Senior Living Center.
Findings
The facility was found deficient in maintaining the interior of the residence clean and in good repair, specifically noting separation of floor tiles exposing a damp subfloor and a slight urine odor in the bathroom of room 112. Housekeeping and maintenance issues were also noted, including carpet damage and missing bathroom fixtures.
Deficiencies (1)
| Description |
|---|
| The licensee failed to maintain the interior of the residence clean and in good repair, including separated floor tiles exposing damp subfloor and urine odor in bathroom of room 112. |
Report Facts
Census: 33
Date of survey: Jun 13, 2016
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kayla Hess | Administrator/RN | Named in staff section related to facility operations |
| Marlene Zinn | Housekeeping Supervisor | Present during tour and inspection, acknowledged condition of floor |
| Cheri Long | Resident Care Coordinator/Assistant Administrator | Named in staff section related to facility operations |
Inspection Report
Complaint Investigation
Census: 36
Deficiencies: 0
Feb 24, 2016
Visit Reason
The inspection was conducted as a complaint investigation and a follow-up related to Complaint #WV00015000 occurring January 26-28, 2016 and the follow-up on February 24, 2016.
Findings
The report documents a complaint investigation and a follow-up visit at New Horizon Senior Living Center with a census of 36 residents. Specific deficiencies or findings are not detailed in the provided text.
Complaint Details
Complaint #WV00015000 was investigated from January 26-28, 2016, with a follow-up on February 24, 2016. Census was 36 during both visits.
Report Facts
Census: 36
Inspection Report
Complaint Investigation
Census: 36
Deficiencies: 3
Jan 26, 2016
Visit Reason
The inspection was conducted as a complaint investigation related to concerns about the care and safety of Resident #C1, including failure to protect the resident's physical and mental well-being and issues with dietary management and feeding practices.
Findings
The facility failed to protect Resident #C1, who had swallowing difficulties and required a pureed diet, from choking hazards and improper feeding practices. The resident's spouse fed the resident foods not ordered by the physician despite warnings. The service plan was not updated to reflect dietary changes, and staff were not adequately instructed to ensure only trained staff fed the resident. Additionally, housekeeping and maintenance deficiencies were noted in the facility environment.
Complaint Details
Complaint # WV00015000 investigated January 26-28, 2016, with a census of 36 residents. The complaint involved failure to protect Resident #C1 from choking hazards and improper feeding by family members despite physician orders and facility policies.
Severity Breakdown
Class II: 2
Deficiencies (3)
| Description | Severity |
|---|---|
| Failure to protect the physical and mental well-being of Resident #C1, including improper feeding practices leading to choking incidents. | Class II |
| Failure to update the service plan to reflect Resident #C1's current needs and dietary orders. | Class II |
| Inadequate housekeeping and maintenance, including damaged carpet, missing towel bars, and dirty sinks. | — |
Report Facts
Resident census: 36
Dietary order changes: 5
Oxygen saturation: 62
Date of inspection: Jan 26, 2016
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Employee #6 | Witnessed Resident #C1's choking episode and feeding observations | |
| Employee #2 | Housekeeper who reported resident's combative behavior during feeding | |
| Employee #3 | Registered nurse who noted resident's frequent choking | |
| Employee #18 | Resident care coordinator who reported family refusal to serve pureed foods | |
| Employee #21 | Observed resident's spouse feeding resident against orders | |
| Employee #25 | Observed resident's spouse bringing and feeding unauthorized foods | |
| Administrator | Provided statements about diet order changes and lack of follow-up on feeding restrictions |
Inspection Report
Routine
Census: 37
Deficiencies: 0
Jun 23, 2015
Visit Reason
Routine inspection of New Horizon Senior Living Center conducted on June 23, 2015.
Findings
The inspection found no deficiencies at the facility during the visit.
Report Facts
Census: 37
Inspection Report
Annual Inspection
Census: 39
Deficiencies: 0
Jun 1, 2015
Visit Reason
The inspection was conducted as an annual licensure survey of the New Horizon Senior Living Center from June 15 to June 17, 2015.
Findings
The report documents the annual licensure survey with a census of 39 residents. No specific deficiencies or severity levels are detailed in the provided page.
Report Facts
Census: 39
Inspection Report
Annual Inspection
Census: 35
Deficiencies: 0
Jun 18, 2014
Visit Reason
The document is an annual licensure survey conducted at New Horizon Senior Living Center from June 16-18, 2014.
Findings
The report summarizes the annual licensure survey findings for the facility, noting the census during the inspection. No specific deficiencies or severity levels are detailed in the provided text.
Report Facts
Census: 35
Inspection Report
Annual Inspection
Census: 33
Deficiencies: 5
Jun 4, 2014
Visit Reason
The inspection was conducted as an Annual Licensure Survey on June 4 and 5, 2014 to assess compliance with state regulations for the New Horizon Senior Living Center.
Findings
The facility was found deficient in maintaining and reviewing its disaster and emergency preparedness plan, housekeeping and maintenance standards, pest control, mattress condition, and proper storage of hazardous materials. Several physical facility issues were noted including damaged mattresses, inadequate housekeeping supplies storage, and a missing dumpster lid.
Severity Breakdown
CLASS I: 1
CLASS III: 3
Deficiencies (5)
| Description | Severity |
|---|---|
| Failed to maintain and annually review disaster and emergency preparedness plan. | CLASS III |
| Failed to ensure adequate housekeeping and maintenance; observed damaged carpet, torn chair, missing towel bars, and dirty sink. | — |
| Failed to keep residence free of insects, rodents, and vermin; dumpster missing lid allowing animal access. | CLASS III |
| Failed to ensure each resident has a bed and mattress in good repair; five mattresses found torn or cracked. | CLASS III |
| Failed to ensure housekeeping supplies (toxic or hazardous materials) are stored in locked facilities; bleach bottle accessible in women's bathroom. | CLASS I |
Report Facts
Census: 33
Mattresses needing replacement: 5
New mattresses to be purchased: 5
Date of survey: Jun 4, 2014
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Eva Haskiell | Assistant | Named in relation to emergency preparedness policy review and facility staff |
| Marlene Zinn | Housekeeping Supervisor | Acknowledged mattress conditions and participated in facility tour |
| Tonya Lambert | Resident Care Coordinator | Acknowledged missing dumpster lid and bleach bottle storage issues |
Inspection Report
Annual Inspection
Census: 33
Deficiencies: 0
Jun 4, 2014
Visit Reason
The document reports on the annual licensure survey conducted at New Horizon Senior Living Center on June 4 and 5, 2014, with a follow-up survey on July 10, 2014.
Findings
The annual survey and follow-up found that all citations were corrected by the follow-up date. The miscellaneous report lists staff members and notes a waiver for Day Care.
Report Facts
Census: 33
Census: 32
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Eva Haskiell | Assistant | Named in miscellaneous report related to housekeeping and administrative assistant roles |
| Marlene Zinn | Housekeeping Supervisor | Named in miscellaneous report related to resident care |
| Tonya Lambert | Resident Care Coordinator | Named in miscellaneous report; noted to have a waiver for Day Care |
Inspection Report
Annual Inspection
Census: 41
Deficiencies: 0
Aug 27, 2013
Visit Reason
The inspection was conducted as an Annual Licensure Survey from June 24 to 27, 2013, to assess compliance with regulatory requirements for the New Horizon Senior Living Center.
Findings
The report documents the findings from the annual licensure survey and a follow-up survey, noting census counts of 41 and 42 respectively. Specific deficiencies or severity levels are not detailed in the provided text.
Report Facts
Census: 41
Census: 42
Inspection Report
Annual Inspection
Census: 41
Deficiencies: 9
Jun 27, 2013
Visit Reason
Annual licensure survey conducted from June 24-27, 2013 to assess compliance with state regulations for New Horizon Senior Living Center.
Findings
The facility was found deficient in multiple areas including accurate record keeping, medication administration, staffing levels, medication security, infection control, housekeeping, and physical environment maintenance. Several residents' medication administration records were incomplete or inaccurate, staffing was insufficient on multiple shifts, and medications including controlled substances were not properly secured. Housekeeping and maintenance issues were noted, such as damaged carpets and unclean areas. Infection control practices were inadequate with shared personal items unlabeled and improperly stored.
Severity Breakdown
Class I: 6
Class II: 2
Deficiencies (9)
| Description | Severity |
|---|---|
| Failure to maintain accurate records and reports, including incomplete post incident observation forms and nursing notes. | Class II |
| Inadequate housekeeping and maintenance including damaged carpet, missing bathroom fixtures, and unclean sinks. | — |
| Insufficient staffing levels on day, evening, and night shifts to meet residents' care needs. | Class I |
| Medications not administered according to physician orders for three residents. | Class I |
| Medication cart left unlocked and syringes with insulin unlabeled and improperly stored. | Class I |
| Failure to securely protect Schedule II drugs with two locks as required. | Class I |
| Failure to provide resident care and services using appropriate infection control techniques; shared personal items unlabeled and used by multiple residents. | Class I |
| Failure to monitor and document residents' condition at required intervals following accidents or illness. | Class II |
| Toxic substances not stored in locked storage; cleaning supplies and bleach found in unlocked areas accessible to residents. | Class I |
Report Facts
Residents with two or more care needs: 36
Medication pass duration: 3.5
Medication pass duration: 3
Medications administered during 8:00 a.m. pass: 309
Facility census: 41
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Employee #4 | Licensed Practical Nurse | Observed signing off medications prior to administration and leaving medication cart unlocked. |
| Employee #2 | Registered Nurse | Observed leaving medication cart unlocked. |
| Employee #9 | Acknowledged use of unlabeled personal items for multiple residents and cleaning practices. |
Inspection Report
Annual Inspection
Census: 39
Deficiencies: 2
Jun 6, 2013
Visit Reason
The inspection was conducted as an Annual Licensure Survey focusing on environmental and physical facility compliance.
Findings
The facility failed to maintain hot water temperatures within the required range of 105°F to 115°F at all hot water sources, with recorded temperatures exceeding this range. Additionally, housekeeping and maintenance deficiencies were noted, including damaged carpets, missing bathroom fixtures, and cleanliness issues.
Severity Breakdown
CLASS II: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| Hot water temperatures exceeded the maximum allowed temperature of 115°F at multiple resident bathroom sinks. | CLASS II |
| Inadequate housekeeping and maintenance including damaged carpet, missing towel bars and toilet paper holders, and dirty sinks. | — |
Report Facts
Census: 39
Hot water temperature: 117.8
Hot water temperature: 117.6
Hot water temperature: 116.8
Hot water temperature: 130
Hot water temperature: 124.9
Hot water temperature: 112
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Assistant Residential Care Coordinator (ARCC) | Acknowledged temperature readings during the inspection | |
| Administrator | Discussed temperature readings and corrective actions at exit conference |
Inspection Report
Annual Inspection
Census: 39
Deficiencies: 0
Jun 6, 2013
Visit Reason
The inspection was conducted as an Annual Licensure Survey to assess environmental conditions and compliance at the facility.
Findings
The report documents the findings from the annual licensure survey and a follow-up survey, noting the census at the time of each visit. Specific deficiencies or severity levels are not detailed in the provided text.
Report Facts
Census: 39
Census: 39
Inspection Report
Annual Inspection
Census: 33
Deficiencies: 5
Jul 10, 2012
Visit Reason
The annual licensure survey was conducted on July 9-10, 2012, to assess compliance with health care standards and regulations at New Horizon Senior Living Center.
Findings
The survey identified multiple deficiencies including failure to ensure transfer summaries accompany residents, inadequate medication availability and administration documentation, failure to maintain adequate housekeeping and maintenance, and improper infection control practices such as recapping needles without proper sharps containers.
Severity Breakdown
Class I: 2
Class II: 1
Deficiencies (5)
| Description | Severity |
|---|---|
| Failure to ensure a summary of information accompanies each resident at the time of transfer to another health care facility. | Class II |
| Failure to ensure all resident medications are available and administered according to physician's orders. | Class I |
| Failure to maintain adequate housekeeping and maintenance required to carry out services, including damaged carpet, missing bathroom fixtures, and unclean sinks. | — |
| Failure to ensure proper documentation of medication administration, with multiple residents having undocumented medication administration. | — |
| Failure to ensure appropriate infection control techniques, including recapping needles without a sharps container in the resident's room. | Class I |
Report Facts
Census: 33
Transfers without summary documentation: 4
Residents with undocumented medication administration: 3
Medication entries not documented: 8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jane Cost | RN, HFNS II | Surveyor |
| Louise Hall | RN, HFNS II | Surveyor |
| JD | Supervising Registered Nurse | Named in medication administration and infection control findings |
| HA | Licensed Practical Nurse | Named in medication administration and infection control findings |
| TW | Licensed Practical Nurse | Named in medication administration documentation deficiency |
Inspection Report
Annual Inspection
Census: 33
Deficiencies: 0
Jul 9, 2012
Visit Reason
The inspection was conducted as an Annual Licensure Survey to assess compliance with regulatory requirements for the New Horizon Senior Living Center.
Findings
The report indicates that deficiencies were identified during the annual survey conducted on July 9-10, 2012, but these deficiencies were corrected by the follow-up survey on August 27, 2012, with technical assistance provided.
Report Facts
Census: 33
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jane Cost | RN, HFNS II | Surveyor during the Annual Licensure Survey |
| Louise Hall | RN, HFNS II | Surveyor during the Annual Licensure Survey |
| Betty Marine | LSW, HFS II | Surveyor during the Survey Follow-Up |
Inspection Report
Annual Inspection
Census: 31
Deficiencies: 16
Jun 13, 2012
Visit Reason
The inspection was conducted as an Annual Licensure Survey focusing on environmental conditions of the facility.
Findings
The licensee failed to maintain the interior and exterior of the residence clean and in good repair, with issues including worn paint on bathroom doors, damaged walls, broken furniture, soiled equipment, chipped tiles, stained ceiling tiles, and a rusted exit door.
Deficiencies (16)
| Description |
|---|
| Bathroom doors in the Day Room have paint worn/scraped off parts of the lower third. |
| Scrape on the wall inside the women's bathroom down to the sheet rock. |
| One of five windows in the Day Room is cracked with wall board exposed under the sill. |
| Broken wooden chair on the porch off the Day Room. |
| Old bench outside by the exterior kitchen door with wood in need of painting and/or repair. |
| Floor fan is very soiled with debris and particles hanging from the wire. |
| Wet white towels/sheets noted by the ice machine due to a leak. |
| Hamilton Beach blender base has dried yellow debris. |
| Dining Room wall by the Activity calendar is scraped and in need of painting. |
| Several tiles in the Shower Room are chipped/broken with some pieces missing. |
| Three shower curtains are worn and cracked. |
| Brown water stains on some tiles due to hard water. |
| Lower door frame going into next room is discolored and has chipped/broken tile. |
| Ceiling tiles with discolored water stains in hallway by room #104, above door by room #108, and above entrance area. |
| Resident bathroom light cover for room #105 is open and not closed, with duct tape hanging from the cover. |
| Exit door in hallway by rooms 106 and 107 is rusted across the bottom with light visible through pinpricks. |
Report Facts
Census: 31
Sample Size: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sharron Ball | Surveyor | Conducted the Annual Licensure Survey |
| Administrator | Acknowledged issues during the tour on 6/13/12 |
Inspection Report
Annual Inspection
Census: 31
Deficiencies: 0
Jun 12, 2012
Visit Reason
The inspection was conducted as an Annual Licensure Survey focusing on environmental conditions at the New Horizon Senior Living Center.
Findings
The report documents the annual environmental survey conducted on June 12-13, 2012, with a follow-up survey on August 27, 2012, noting that deficiencies identified were corrected and technical assistance was provided.
Report Facts
Census: 31
Census: 33
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sharron Ball | Surveyor | Conducted the annual licensure survey |
| Betty Marine | LSW, HFS II | Conducted the follow-up environmental survey |
Inspection Report
Complaint Investigation
Census: 31
Deficiencies: 0
Jun 6, 2012
Visit Reason
The inspection was conducted as a complaint investigation for complaint #WV00007145 from June 4-6, 2012.
Findings
The complaint investigation was unsubstantiated with no deficiencies cited.
Complaint Details
Complaint #WV00007145 was investigated from June 4-6, 2012, with a census of 31. The complaint was found to be unsubstantiated.
Report Facts
Census: 31
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Beverly Randolph | RN, HFNS II | Surveyor for the complaint investigation |
Inspection Report
Annual Inspection
Census: 29
Deficiencies: 0
Jul 6, 2011
Visit Reason
The inspection was conducted as an annual licensure survey of the New Horizon Senior Living Center.
Findings
No deficiencies were cited during the survey. Technical assistance was provided to the facility.
Report Facts
Census: 29
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jane Cost | RN, HFNS II | Surveyor during the annual licensure survey |
| Louise Hall | RN, HFNS II | Surveyor during the annual licensure survey |
Inspection Report
Annual Inspection
Census: 28
Deficiencies: 0
Jun 21, 2011
Visit Reason
The visit was conducted as an Annual Licensure Survey focusing on environmental aspects of the facility.
Findings
No deficiencies were cited during the inspection. Technical assistance was provided to the facility.
Report Facts
Census: 28
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Randy Akers | HFSI | Surveyor conducting the annual licensure survey |
Inspection Report
Annual Inspection
Census: 26
Deficiencies: 0
Aug 11, 2010
Visit Reason
The visit was conducted as an annual licensure survey and a follow-up survey to assess compliance with regulatory requirements at New Horizon Senior Living Center.
Findings
The report documents the annual licensure survey conducted June 22-24, 2010, and a follow-up survey on August 11, 2010, with census counts of 29 and 26 respectively. No specific deficiencies or severity levels are detailed in the provided text.
Report Facts
Census: 29
Census: 26
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jane Cost | RN, HFNS II | Surveyor for both annual licensure and follow-up surveys |
| Louise Hall | RN, HFNS II | Surveyor for both annual licensure and follow-up surveys |
Inspection Report
Annual Inspection
Census: 30
Deficiencies: 4
Jul 21, 2010
Visit Reason
Annual Licensure Survey conducted to assess compliance with state regulations including fire safety and physical facility maintenance.
Findings
The facility was found deficient in fire safety due to inoperable emergency lights and improper use of extension cords powering the fire alarm system. Additionally, physical facility issues included a damaged ceiling from a water leak and roof heaving from weather damage.
Severity Breakdown
Class I: 2
Class II: 2
Deficiencies (4)
| Description | Severity |
|---|---|
| Most emergency lights were found to be inoperable. | Class I |
| A portion of the fire alarm system was powered by a power strip plugged into an extension cord. | Class I |
| Damaged ceiling in Resident #104's room due to a recent water leak; ceiling was soft and sagging. | Class II |
| Several areas of the facility roof have begun heaving from apparent weather damage. | Class II |
Report Facts
Census: 30
Deficiencies cited: 4
Quotes for roof repair: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jason T. Lintner | Surveyor | Conducted the annual licensure survey |
| J. Stockil | Responsible for replacing dead batteries in emergency lights | |
| M. Zinn | Housekeeper | Responsible for monthly monitoring of emergency lights |
Inspection Report
Annual Inspection
Census: 30
Deficiencies: 1
Jul 20, 2010
Visit Reason
The inspection was conducted as an Annual Licensure Survey to assess compliance with regulatory requirements for the New Horizon Senior Living Center.
Findings
Deficiencies were identified during the annual survey, and technical assistance was provided. A follow-up survey was conducted on September 1, 2010, to verify correction of deficiencies, which were confirmed to be corrected.
Deficiencies (1)
| Description |
|---|
| Deficiencies identified during the annual licensure survey |
Report Facts
Census at annual survey: 30
Census at follow-up survey: 26
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jason T. Lintner | Surveyor | Conducted both the annual licensure survey and the follow-up survey |
Inspection Report
Annual Inspection
Census: 29
Deficiencies: 5
Jun 24, 2010
Visit Reason
Annual licensure survey conducted June 22-24, 2010 to assess compliance with health and safety, administrative, medication storage, and dietary regulations.
Findings
The facility was found deficient in completing criminal background checks prior to hiring, securing medications including Schedule II drugs, and providing physician-ordered therapeutic diets. Additionally, housekeeping and maintenance issues were noted, including damaged carpets and missing bathroom fixtures.
Severity Breakdown
Class I: 3
Class II: 1
Deficiencies (5)
| Description | Severity |
|---|---|
| Failure to ensure criminal background checks were completed prior to hiring. | Class II |
| Failure to assure resident medications are stored in a locked room or cabinet accessible only to licensed staff. | Class I |
| Failure to assure Schedule II medications are properly maintained under double lock. | Class I |
| Failure to provide physician ordered therapeutic diets as required. | Class I |
| Failure to ensure adequate housekeeping and maintenance, including damaged carpet, missing towel bars, and dirty sinks. | — |
Report Facts
Census: 29
Residents confused: 20
Residents who wander: 3
Number of employee records reviewed: 4
Schedule II medication bottles observed: 7
Schedule II medication bottles observed: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| J.S. | Administrator | Named in findings related to background checks, medication storage, and dietary compliance. |
| J.C. | Licensed Practical Nurse (LPN) | Named in medication storage deficiencies and interview statements. |
| J.D. | Registered Nurse (RN) | Responsible for conducting periodic unannounced medication room checks. |
| J.Z. | Cook | Unable to provide reference for providing specific amounts of food for therapeutic diets. |
Inspection Report
Complaint Investigation
Census: 29
Deficiencies: 0
Feb 24, 2010
Visit Reason
The inspection was conducted as a complaint investigation at New Horizon Senior Living Center on February 24, 2010.
Findings
The report documents a complaint investigation and a subsequent follow-up survey. The follow-up survey on April 1, 2010, indicated that deficiencies identified during the complaint investigation were corrected.
Complaint Details
Complaint investigation #WV00005516 was conducted on February 24, 2010, with a census of 29. A follow-up survey was conducted on April 1, 2010, with a census of 27, and deficiencies were corrected.
Report Facts
Census: 29
Census: 27
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jane Cost | RN, HFNS II | Surveyor during complaint investigation |
| Louise Hall | RN, HFNS II | Surveyor during complaint investigation and follow-up survey |
Inspection Report
Complaint Investigation
Census: 29
Deficiencies: 0
Feb 24, 2010
Visit Reason
The inspection was conducted as a complaint investigation and subsequent follow-up visits related to complaint #WV00005389.
Findings
The report indicates that all deficiencies identified during the complaint investigation and follow-up visits were corrected by the final inspection date.
Complaint Details
Complaint #WV00005389 was investigated starting December 14, 2009, with follow-up visits on February 1, 2010, and February 24, 2010. All deficiencies were corrected by the last follow-up.
Report Facts
Census: 32
Census: 29
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jane Cost | RN HFNS II | Surveyor involved in complaint investigation and follow-up visits |
| Louise Hall | RN HFNS II | Surveyor involved in complaint investigation and follow-up visits |
Inspection Report
Complaint Investigation
Census: 29
Deficiencies: 1
Feb 24, 2010
Visit Reason
The inspection was conducted as a complaint investigation regarding medication administration practices at the facility.
Findings
The supervising registered nurse failed to ensure that medications were administered only by appropriately licensed health care professionals. Specifically, an LPN admitted to pouring medications and placing them on dinner trays for residents, and at times delegating medication administration tasks to aides. A plan of correction was directed to provide training and conduct unannounced medication pass observations.
Complaint Details
Complaint Investigation #WV00005516 conducted on February 24, 2010. The complaint involved medication administration practices and was substantiated by findings.
Severity Breakdown
CLASS I: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to ensure resident medications are administered only by appropriately licensed health care professionals. | CLASS I |
Report Facts
Census: 29
Residents involved: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| AM | LPN | Stated she poured medications for two residents and delegated medication administration tasks. |
| Jane Cost | RN, HFNS II | Surveyor involved in the complaint investigation. |
| Louise Hall | RN, HFNS II | Surveyor involved in the complaint investigation. |
Inspection Report
Complaint Investigation
Census: 29
Deficiencies: 3
Feb 1, 2010
Visit Reason
The inspection was conducted as a complaint investigation and follow-up related to allegations concerning medication administration, billing practices, and facility maintenance.
Findings
The facility was found deficient in providing full disclosure of costs related to Activities of Daily Living (ADLs), proper medication administration and documentation, and maintaining a safe and clean environment. The administrator and nursing staff failed to implement corrective actions as required by the directed plan of correction.
Complaint Details
Complaint #WV00005389 initiated the investigation due to concerns about medication administration and billing practices. The complaint was substantiated with findings of improper medication administration and inadequate billing disclosures.
Deficiencies (3)
| Description |
|---|
| Failure to provide full disclosure of all costs charged to residents including specific information on monthly ADL charges. |
| Failure to administer medications according to physician orders and document administration properly. |
| Failure to maintain a safe, clean, and appropriate environment including housekeeping and maintenance issues such as damaged carpet, missing bathroom fixtures, and clutter. |
Report Facts
Census during complaint investigation: 32
Census during follow-up: 29
Sample size: 3
Date of completion for corrective actions: Jan 31, 2010
Charge for additional ADLs: 100
Medication dosage: 25
Medication frequency: 6
Maximum doses: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jane Cost | RN HFNS II | Surveyor during complaint investigation and follow-up |
| Louise Hall | RN HFNS II | Surveyor during complaint investigation and follow-up |
| JS | Administrator | Named in billing and disclosure deficiencies related to ADL charges |
| JJ | Licensed Practical Nurse (LPN) | Named in medication administration deficiency for administering Benadryl without proper documentation |
| Rhonda | Prior administrator mentioned in relation to billing explanations |
Inspection Report
Complaint Investigation
Census: 32
Deficiencies: 3
Dec 14, 2009
Visit Reason
Complaint Investigation #WV00005389 was conducted to investigate concerns related to resident billing practices and medication administration at New Horizon Senior Living Center.
Findings
The investigation found that the facility failed to provide full disclosure of costs related to Activities of Daily Living (ADLs) charges, lacked itemization of ADL charges on resident bills, and family members were confused about these charges. Additionally, there were medication administration deficiencies, including improper administration and documentation of PRN Benadryl to a resident, and failure to follow physician orders and proper medication record keeping.
Complaint Details
Complaint Investigation #WV00005389 focused on concerns about undisclosed ADL charges and improper medication administration. The complaint included a report from a resident's family member that the resident was given Benadryl without a proper order and was sedated when visited.
Severity Breakdown
Class I: 2
Deficiencies (3)
| Description | Severity |
|---|---|
| Failure to provide full disclosure of all costs charged to residents including specific information regarding monthly additions for Activities of Daily Living (ADLs). | — |
| Failure to ensure medications are administered according to physician orders, including improper administration of PRN Benadryl to Resident #18. | Class I |
| Failure to maintain proper medication administration records documenting each dose given to residents. | Class I |
Report Facts
Census: 32
ADL Charges: 100
Medication Dosage: 25
Medication Frequency: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jane Cost | RN HFNS II | Surveyor involved in complaint investigation |
| Louise Hall | RN HFNS II | Surveyor involved in complaint investigation |
| JS | Administrator | Named in findings related to billing and ADL charges |
| JJ | Licensed Practical Nurse (LPN) | Named in medication administration deficiency related to Benadryl |
Inspection Report
Complaint Investigation
Census: 29
Deficiencies: 0
Nov 3, 2009
Visit Reason
The inspection was conducted as a complaint investigation identified by complaint #WV00005289.
Findings
The complaint investigation was partially substantiated, but no deficiencies were cited during the survey.
Complaint Details
Complaint #WV00005289 was partially substantiated with no deficiencies cited.
Report Facts
Census: 29
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jane Cost | RN, HFNS II | Surveyor involved in complaint investigation |
| Louise Hall | RN, HFNS II | Surveyor involved in complaint investigation |
Inspection Report
Complaint Investigation
Census: 30
Deficiencies: 0
Sep 21, 2009
Visit Reason
The inspection was conducted as a complaint investigation identified by complaint number WV00005165.
Findings
The complaint investigation was unsubstantiated and no deficiencies were found during the inspection.
Complaint Details
Complaint investigation #WV00005165 was unsubstantiated with no deficiencies identified.
Report Facts
Census: 30
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jane Cost | RN HFNS II | Surveyor involved in complaint investigation |
| Louise Hall | RN HFNS II | Surveyor involved in complaint investigation |
Inspection Report
Follow-Up
Census: 27
Deficiencies: 3
Aug 3, 2009
Visit Reason
This is a first follow-up visit to the annual survey conducted on May 18-20, 2009, to verify correction of previously cited deficiencies.
Findings
The facility failed to ensure adequate housekeeping, maintenance, and implementation of policies and procedures as required. Multiple deficiencies were noted including unsafe environment, inadequate housekeeping, lack of updated policies on fingerprinting, medication handling, incident reporting, and resident belongings documentation. The facility submitted plans of correction with completion dates of August 28, 2009, but some policies were not fully implemented or updated as required.
Deficiencies (3)
| Description |
|---|
| Failure to implement programs in a safe and appropriate environment for consumers, including lack of awake night staff on weekends and unsecured doors. |
| Inadequate housekeeping and maintenance including personal belongings behind furniture, iron burns and bleach spots on carpet, torn furniture, missing towel bars and toilet paper holders, and dirty sinks. |
| Failure to implement/revise policies and procedures consistent with regulatory requirements, including fingerprinting documentation, medication handling, incident reporting, and resident belongings documentation. |
Report Facts
Census: 27
Sample Size: 3
Regulatory Tags Cited: 8
Completion Date: Aug 28, 2009
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jane Cost | RN HFNS II | Surveyor for annual and follow-up surveys |
| Louise Hall | RN HFNS II | Surveyor for annual and follow-up surveys |
| RC | Regional Director | Interviewed regarding pharmacy medication handling policies |
Inspection Report
Annual Inspection
Census: 27
Deficiencies: 0
Jun 15, 2009
Visit Reason
The visit was conducted as an Annual Licensure Survey to assess the environment and compliance of the New Horizon Senior Living Center.
Findings
The inspection found no deficiencies or technical assistance needs during the annual licensure survey.
Report Facts
Census: 27
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Keith Carpenter | Named in the report as part of the inspection team | |
| Jason Lintner | Named in the report as part of the inspection team |
Inspection Report
Annual Inspection
Census: 27
Deficiencies: 9
May 20, 2009
Visit Reason
Annual licensure survey conducted May 18-20, 2009 to assess compliance with state regulations for New Horizon Senior Living Center.
Findings
The facility was found deficient in multiple areas including failure to complete criminal background checks prior to hire, inadequate housekeeping and maintenance, failure to provide required employee training, unsecured resident medical records, improper medication storage and handling, failure to monitor residents after incidents, incomplete nursing progress notes, and failure to document disposition of resident belongings after death.
Severity Breakdown
Class II: 3
Class III: 3
Deficiencies (9)
| Description | Severity |
|---|---|
| Administrator failed to ensure employee criminal background checks by the West Virginia State Police were completed prior to hire and results maintained on file. | Class II |
| Facility failed to ensure adequate housekeeping and maintenance; observed personal belongings behind dresser, iron burns and bleach spots on carpet, torn chair, missing towel bars and toilet paper holders, and dirty sink. | — |
| Employees did not receive required training on care of residents with nursing care needs; written training content was incomplete or unavailable. | — |
| Resident medical records were maintained on open shelves in a common hallway, accessible to anyone. | Class III |
| Medications were not appropriately locked; aides had access to medication room and keys during night shifts when no nurse was on duty. | — |
| Facility failed to assure all discontinued or outdated Schedule II, III, IV, and V drugs were destroyed in presence of pharmacist and registered nurse with proper documentation. | Class III |
| Failure to monitor and document resident condition every 4 or 8 hours following incidents or illness as required. | Class II |
| Registered nurse failed to complete comprehensive weekly progress notes for residents with nursing care needs, including those with insulin dependent diabetes. | Class II |
| Failure to ensure disposition of resident belongings at time of death included a written, signed statement by legal representative. | Class III |
Report Facts
Employees without documented criminal background checks: 8
Facility census: 27
Incident reports with inadequate monitoring: 4
Schedule II, III, IV, V medications destroyed: 16
Residents with incomplete weekly progress notes: 3
Closed death records without signed verification: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| KD | Aide | Named in deficiency for lack of documented criminal background check. |
| SH | Aide | Named in deficiency for lack of documented criminal background check. |
| JW | Aide | Named in deficiency for lack of documented criminal background check. |
| AW | Aide | Named in deficiency for lack of documented criminal background check. |
| BM | Director of Plant Operations | Named in deficiency for lack of documented criminal background check. |
| MS | Cook/Housekeeping | Named in deficiency for lack of documented criminal background check. |
| HT | Registered Nurse | Named in deficiency for lack of documented criminal background check. |
| SW | Administrator | Named in deficiency for lack of documented criminal background check. |
Inspection Report
Complaint Investigation
Census: 27
Deficiencies: 0
May 20, 2009
Visit Reason
This document reports on a complaint investigation and a subsequent follow-up visit related to complaint #WV00004746 at New Horizon Senior Living Center.
Findings
The report documents the complaint investigation conducted on March 4, 2009, and the first follow-up visit on May 18-20, 2009, with census counts of 28 and 27 respectively. Specific findings or deficiencies are not detailed in the provided text.
Complaint Details
Complaint investigation #WV00004746 was conducted on March 4, 2009, followed by a first follow-up visit on May 18-20, 2009. Census was 28 at the initial investigation and 27 at follow-up. Surveyors involved were Jane Cost, RN HFNS II and Louise Hall, RN HFNS II.
Report Facts
Census: 28
Census: 27
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jane Cost | RN HFNS II | Surveyor during complaint investigation and follow-up |
| Louise Hall | RN HFNS II | Surveyor during complaint investigation and follow-up |
Inspection Report
Complaint Investigation
Census: 27
Deficiencies: 2
May 18, 2009
Visit Reason
The inspection was conducted as a complaint investigation based on complaint investigation numbers WV00004926, WV00004934, and WV00004869 during May 18-20, 2009.
Findings
The investigation found that the facility failed to maintain a safe, sanitary living environment and failed to ensure resident bedrooms were used only for housing residents. Specific deficiencies included a 2 x 4 inch hole in drywall, inadequate housekeeping and maintenance, and unauthorized use of a resident room by a former interim administrator.
Complaint Details
Complaint Investigation #WV00004869 was partially substantiated with related deficiencies cited. CI #4926 was unsubstantiated, and CI #4934 was substantiated with no related deficiencies cited.
Severity Breakdown
Class II: 1
Class III: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| Failed to maintain a safe, sanitary living environment; 2 x 4 inch hole in drywall in room 118 behind the headboard. | Class II |
| Failed to assure resident bedrooms are used only for housing residents; room #108 was used by a prior interim administrator. | Class III |
Report Facts
Complaint Investigation Numbers: 3
Hole size: 8
Census: 27
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jane Cost | RN, HFNS II | Surveyor involved in complaint investigation |
| Louise Hall | RN, HFNS II | Surveyor involved in complaint investigation |
| John Stockil | Prior Interim Administrator | Used resident room #108 as living quarters during investigation period |
| Rhonda Cox | Regional Director of Operations | Interviewed regarding unauthorized use of resident room by Mr. Stockil |
Inspection Report
Complaint Investigation
Census: 27
Deficiencies: 0
May 18, 2009
Visit Reason
The inspection was conducted as a complaint investigation based on complaint investigation numbers WV00004926, WV00004934, and WV00004869 during May 18-20, 2009, followed by a complaint follow-up on July 13, 2009.
Findings
The complaint investigation identified deficiencies which were subsequently corrected by the follow-up visit on July 13, 2009. The follow-up confirmed that all deficiencies were corrected.
Complaint Details
Complaint investigation involved three complaint investigation numbers WV00004926, WV00004934, and WV00004869. The follow-up visit confirmed all deficiencies were corrected.
Report Facts
Complaint Investigation Numbers: 3
Census: 27
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jane Cost | RN, HFNS II | Surveyor during complaint investigation and follow-up |
| Louise Hall | RN, HFNS II | Surveyor during complaint investigation and follow-up |
Inspection Report
Annual Inspection
Census: 27
Deficiencies: 0
May 18, 2009
Visit Reason
The inspection was conducted as an annual licensure survey of the New Horizon Senior Living Center from May 18-20, 2009.
Findings
The report documents the annual licensure survey and subsequent follow-up visits, noting census counts and surveyor names. No specific deficiencies or severity levels are detailed in the provided text.
Report Facts
Census: 27
Census: 27
Census: 30
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jane Cost | RN HFNS II | Surveyor for annual licensure survey and follow-up visits |
| Louise Hall | RN HFNS II | Surveyor for annual licensure survey and follow-up visits |
Inspection Report
Complaint Investigation
Census: 30
Deficiencies: 4
Apr 1, 2009
Visit Reason
The inspection was conducted as a complaint investigation regarding the facility's failure to assure the physical and mental well-being of residents, specifically concerning wound care and nursing documentation for Resident #21.
Findings
The investigation found deficiencies in wound care management, including failure to properly document and evaluate a skin tear, inadequate communication and nursing documentation, and failure to ensure treatments were completed as ordered by the physician. Additionally, housekeeping and maintenance issues were noted from earlier observations.
Complaint Details
Complaint Investigation #WV00004798 conducted on April 1, 2009, with a census of 30 residents. Surveyors were Jane Cost, RN HFNS II and Louise Hall, RN HFNS II.
Severity Breakdown
Class II: 2
Class I: 1
Deficiencies (4)
| Description | Severity |
|---|---|
| Failure to assure the physical and mental well-being of residents, including inadequate wound care and documentation for Resident #21's skin tear. | Class II |
| Failure to maintain adequate housekeeping and maintenance, including damaged carpet, missing bathroom fixtures, and unclean sink. | — |
| Failure to keep current documentation regarding resident's health status, changes, and staff responses. | Class II |
| Failure to ensure treatments were completed as ordered by the resident's physician, including missed dressing changes. | Class I |
Report Facts
Resident census: 30
Skin tear size: 2
Days wound not evaluated: 5
Days embedded gauze remained: 9
Training completion date: May 1, 2009
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| BL | LPN | Facility LPN who confirmed embedded gauze in wound and described painful removal process. |
| JG | LPN | Weekend LPN who discovered multiple gauze pieces stuck to wound and did not notify supervising nurse or physician. |
| DG | TLC Hospice RN | Hospice nurse who visited Resident #21 and documented wound care but did not remove adhered gauze. |
| BF | LPN | Facility LPN who documented wound status on March 22, 2009. |
| SW | LPN | Facility LPN who documented initial skin tear on March 17, 2009. |
| Jane Cost | RN HFNS II | Surveyor for complaint investigation. |
| Louise Hall | RN HFNS II | Surveyor for complaint investigation. |
Inspection Report
Complaint Investigation
Census: 30
Deficiencies: 0
Apr 1, 2009
Visit Reason
The inspection was conducted as a complaint investigation identified by #WV00004798 on April 1, 2009, followed by a complaint follow-up visit on May 18-20, 2009.
Findings
The report documents a complaint investigation and a subsequent follow-up visit at New Horizon Senior Living Center. Specific findings or deficiencies are not detailed in the provided text.
Complaint Details
Complaint investigation #WV00004798 was conducted on April 1, 2009, with a census of 30. A first follow-up to this complaint investigation occurred May 18-20, 2009, with a census of 27.
Report Facts
Census: 30
Census: 27
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jane Cost | RN HFNS II | Surveyor during complaint investigation and follow-up |
| Louise Hall | RN HFNS II | Surveyor during complaint investigation and follow-up |
Inspection Report
Complaint Investigation
Census: 28
Deficiencies: 6
Mar 4, 2009
Visit Reason
The inspection was conducted due to complaints and concerns regarding medication administration, staffing adequacy, housekeeping, and resident safety at the assisted living facility.
Findings
The facility failed to ensure medications were administered only by licensed nurses or approved personnel, had inadequate staffing to meet resident care and housekeeping needs, and did not maintain a safe and clean environment. Deficiencies included unapproved aides administering medications, delayed insulin administration, insufficient housekeeping staff, and improper use of restraints.
Complaint Details
The complaint investigation revealed concerns about medication administration by unlicensed personnel, delayed insulin injections, inadequate staffing, and poor housekeeping. Family members reported medication errors and insufficient care. The facility was found to have multiple deficiencies related to these complaints.
Severity Breakdown
Class I: 2
Class II: 3
Deficiencies (6)
| Description | Severity |
|---|---|
| Licensed nurses or approved medication assistive personnel were not consistently used to administer medications; aides and uncertified personnel administered medications including injections. | Class II |
| Failure to maintain accurate medication administration records and documentation of physician orders. | Class II |
| Insulin administration was delayed and improperly documented; family members were asked to administer insulin due to lack of staff. | — |
| Inadequate staffing levels to meet residents' care needs including bathing, dressing, feeding, and supervision. | Class I |
| Insufficient housekeeping staff leading to unsanitary conditions in resident bathrooms and common areas. | Class II |
| Residents were restrained by use of geri-chair trays for safety without proper justification or documentation. | Class I |
Report Facts
Census: 28
Residents requiring bathing and dressing assistance: 23
Residents requiring feeding assistance: 12
Residents documented as incontinent: 16
Residents documented as confused and wandering: 7
Residents requiring assistance with walking: 4
Days aide administered medications: 9
Days CMA administered medications: 4
Days Med Tech administered medications: 4
Housekeeper scheduled days: 5
Housekeeper scheduled hours: 8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| CB | Aide | Administered medications without being tested or approved as AMAP; trained CMA; involved in medication administration deficiencies |
| HT | Registered Nurse | Supervising nurse aware of unapproved medication administration; involved in medication administration deficiencies |
| MD | Certified Medical Assistant | Hired and administered medications including injections without proper authorization |
| MB | Medication Technician | Administered medications including injections without proper training or approval |
| RC | Acting Administrator | Authorized unlicensed personnel to administer medications; failed to ensure compliance with regulations |
| MZ | Housekeeper | Only housekeeper employed; position not replaced when absent |
Inspection Report
Complaint Investigation
Census: 31
Deficiencies: 0
Feb 18, 2009
Visit Reason
The inspection was conducted as a complaint investigation and subsequent follow-up to address concerns raised in complaint #WV00004567 during visits on January 5 and 12, 2009, and a follow-up visit on February 18, 2009.
Findings
The complaint investigation and follow-up found deficiencies which were subsequently corrected, and technical assistance was provided to the facility.
Complaint Details
Complaint #WV00004567 was investigated on January 5 and 12, 2009, with a follow-up visit on February 18, 2009. Deficiencies identified during the complaint investigation were corrected by the follow-up visit.
Report Facts
Census: 30
Census: 31
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jane Cost | RN HFNS II | Surveyor during complaint investigation and follow-up |
| Louise Hall | RN HFNS II | Surveyor during complaint investigation and follow-up |
Inspection Report
Complaint Investigation
Census: 30
Deficiencies: 3
Jan 12, 2009
Visit Reason
The inspection was conducted as a complaint investigation on January 5 and 12, 2009, to review concerns regarding documentation of residents' health status and medication administration.
Findings
The facility failed to ensure documentation reflected residents' current health status and staff responses, and medications were not always administered according to physician orders. Specific deficiencies included lack of documentation for a resident's hospital transfer, failure of RN review and co-signing of medication entries by LPNs, and administration of medications without signed physician orders.
Complaint Details
Complaint investigation #WV00004567 conducted on January 5 and 12, 2009, found substantiated deficiencies related to documentation and medication administration.
Severity Breakdown
Class I: 2
Class II: 1
Deficiencies (3)
| Description | Severity |
|---|---|
| Failure to ensure documentation reflects the resident's current health status, changes, and staff responses. | Class II |
| Failure to ensure resident medications are administered as required by law, including RN review and co-signing of hand-written medication entries. | Class I |
| Failure to keep signed physician orders for medications administered, including verbal orders not obtained timely. | Class I |
Report Facts
Census: 30
Deficiencies cited: 3
Medication administration errors: 11
Days delay: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jane Cost | RN HFNS II | Surveyor involved in complaint investigation. |
| Louise Hall | RN HFNS II | Surveyor involved in complaint investigation. |
| TJ | LPN | Mentioned in relation to receiving telephone call about resident #25 and medication administration. |
| VH | Approved Medication Assistive Personnel (AMAP) | Initialed medication administration records and involved in medication administration deficiencies. |
| JC | LPN | Completed hand-written medication entries and involved in medication administration deficiencies. |
| HT | RN | Signed nurse's note regarding resident transfer. |
| AM | LPN | Documented nursing notes related to insulin administration. |
Inspection Report
Complaint Investigation
Census: 31
Deficiencies: 9
Jul 23, 2008
Visit Reason
The inspection was conducted as a complaint investigation from July 21-23, 2008, to review compliance with licensing and regulatory requirements related to staff licensing, training, housekeeping, resident care, and safety.
Findings
The facility was found deficient in multiple areas including failure to ensure all licensed staff had current professional licenses, inadequate housekeeping and maintenance, insufficient staff training and orientation, lack of required documentation for resident transfers, incomplete and outdated resident service plans, failure to provide weekly nursing documentation for some residents, and unsafe storage of toxic and hazardous materials accessible to confused residents.
Complaint Details
Complaint Investigation WV #00004238 conducted July 21-23, 2008. Census at time of investigation was 31 residents. Surveyors included Donna Williamson, HFNSI; Louise Hall, HFNSII; Jane Cost, HFNSII.
Severity Breakdown
Class I: 2
Class II: 6
Deficiencies (9)
| Description | Severity |
|---|---|
| Administrator failed to ensure all licensed staff have current professional licenses and maintain documentation. | Class II |
| Failure to ensure adequate housekeeping and maintenance required to carry out services, including damaged carpet, missing bathroom fixtures, and dirty sinks. | — |
| Administrator failed to ensure one employee with current first aid and CPR training is on duty at all times. | Class I |
| Failure to provide and maintain records of training to new employees within the first fifteen days of employment. | Class II |
| Failure to provide and maintain records of annual in-service training to all staff on required topics. | Class II |
| Failure to provide supportive documentation for required information sent at time of resident transfer or discharge. | Class II |
| Failure to ensure resident assessment and service plans reflect current needs and are updated as indicated. | Class II |
| Failure to provide weekly documentation of intermittent nursing care for applicable residents. | Class II |
| Failure to keep toxic substances or hazardous materials separate from food, drugs and inaccessible to confused residents; observed unlocked maintenance closet and housekeeping cart with hazardous materials. | Class I |
Report Facts
Employees without current first aid training: 17
Employees without current CPR training: 12
Days without employee with current first aid and/or CPR training: 44
New employees without required training within 15 days: 4
Tenured employees without required annual training: 4
Residents confused: 24
Residents who wander: 8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| MD | LPN | Hired May 1, 2008; license lapsed June 30, 2008; administered medications without valid license. |
| JC | LPN | Stated residents #23 and #24 were full codes requiring CPR until July 3, 2008. |
| JH | AMAP | Tenured employee lacking documented training on wound care, blood glucose monitoring, Coumadin therapy, and oxygen therapy. |
| VH | AMAP | Tenured employee lacking documented training on blood glucose monitoring, Coumadin therapy, and wound care. |
| SH | AMAP | Tenured employee lacking documented training on blood glucose monitoring, Coumadin therapy, oxygen therapy, and wound care. |
| LS | Aide | Tenured employee lacking documented training on Coumadin therapy, oxygen therapy, and wound care. |
Inspection Report
Annual Inspection
Census: 31
Deficiencies: 0
Jul 21, 2008
Visit Reason
The inspection was conducted as an Annual Licensure Survey from July 21-23, 2008 to assess compliance with regulatory requirements at New Horizon Senior Living Center.
Findings
The report includes findings from the annual licensure survey, a complaint investigation, and a follow-up survey. Deficiencies were identified during the complaint investigation and annual survey but were corrected by the follow-up visit on September 25, 2008.
Complaint Details
Complaint investigation WV #00004238 was conducted July 21-23, 2008 with a census of 31. Specific substantiation status is not stated.
Report Facts
Census: 31
Census: 35
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Louise Hall | RN, HFNS II | Surveyor during annual licensure survey, complaint investigation, and follow-up |
| Jane Cost | RN, HFNS II | Surveyor during annual licensure survey, complaint investigation, and follow-up |
| Donna Williamson | RN, HFNS I | Surveyor during annual licensure survey, complaint investigation, and follow-up |
Inspection Report
Annual Inspection
Census: 28
Deficiencies: 0
Jun 2, 2008
Visit Reason
The visit was conducted as an Annual Licensure Survey to assess the environment of the New Horizon Senior Living Center.
Findings
No deficiencies were found during the survey. Only technical assistance was provided.
Report Facts
Census: 28
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Keith Carpenter | Surveyor | Conducted the Annual Licensure Survey |
Inspection Report
Annual Inspection
Census: 33
Deficiencies: 0
Jul 19, 2007
Visit Reason
The visit was conducted as an annual licensure survey of the New Horizon Senior Living Center.
Findings
No deficiencies were found during the survey. Technical assistance was provided to the facility.
Report Facts
Census: 33
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jane Cost | RN HFNS II | Surveyor during the annual licensure survey |
| Louise Hall | RN HFNS II | Surveyor during the annual licensure survey |
| Martha Tarley | RN HFNS I | Surveyor during the annual licensure survey |
Inspection Report
Annual Inspection
Census: 26
Deficiencies: 0
May 24, 2007
Visit Reason
The document is an annual licensure survey conducted to assess environmental compliance at the New Horizon Senior Living Center.
Findings
The survey focused on environmental aspects and noted the census at the time of inspection. No specific deficiencies or severity levels are detailed in the report.
Report Facts
Census: 26
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Garry Taylor | Named in the report as associated with the annual licensure survey |
Inspection Report
Annual Inspection
Census: 31
Deficiencies: 6
Jul 12, 2006
Visit Reason
The inspection was conducted as an annual licensure survey to assess compliance with environmental, safety, housekeeping, disaster preparedness, and physical facility regulations at New Horizon Senior Living Center.
Findings
The survey identified multiple deficiencies including failure to maintain a safe environment, inadequate housekeeping and maintenance, lack of staff knowledge of disaster preparedness plans, incomplete disaster rehearsals, improper storage of protective underwear, and hot water temperatures exceeding regulatory limits.
Severity Breakdown
Class I: 3
Class II: 1
Deficiencies (6)
| Description | Severity |
|---|---|
| Failure to maintain a safe and appropriate environment for consumers, including unsecured outside doors and lack of awake staff on weekend nights. | — |
| Inadequate housekeeping and maintenance, including personal belongings left behind furniture, carpet damage, missing bathroom fixtures, and dirty sinks. | — |
| Staff did not know the location of the disaster and emergency preparedness plan at all times. | Class I |
| Failure to conduct a planned disaster rehearsal including all staff annually. | Class I |
| Improper storage of clean protective underwear in resident toilet rooms, creating potential for cross contamination. | Class I |
| Hot water temperatures measured at 124°F, exceeding the required maximum of 115°F. | Class II |
Report Facts
Census: 31
Staff participation: 8
Hot water temperature: 124
Completion date: Jul 12, 2006
Completion date: Jul 13, 2006
Completion date: Aug 8, 2006
Completion date: Sep 12, 2006
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Garry Taylor | Named as part of the annual licensure survey team | |
| Evelyn Jennings | Assistant Director of OEM | Met with assistant administrator to plan disaster rehearsal |
Inspection Report
Annual Inspection
Census: 31
Deficiencies: 0
Jul 12, 2006
Visit Reason
The inspection was conducted as an annual licensure survey to assess environmental compliance at the New Horizon Senior Living Center.
Findings
The report indicates that deficiencies were identified during the annual licensure survey, which were subsequently corrected as noted in the follow-up survey. Technical assistance was also provided.
Report Facts
Census at annual survey: 31
Census at follow-up survey: 16
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Garry Taylor | Surveyor during the annual licensure survey | |
| Keith Carpenter | Surveyor during the follow-up survey |
Inspection Report
Annual Inspection
Census: 30
Deficiencies: 0
Jul 6, 2006
Visit Reason
The visit was conducted as an annual licensure survey of the New Horizon Senior Living Center.
Findings
The report documents the completion of the annual licensure survey with no specific deficiencies detailed in the provided text.
Report Facts
Census: 30
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Myra McClead | HFNSII Surveyor | Named as a surveyor for the annual licensure survey |
| Jane Cost | HFNSII Surveyor | Named as a surveyor for the annual licensure survey |
Inspection Report
Complaint Investigation
Census: 31
Deficiencies: 0
May 17, 2006
Visit Reason
The inspection was conducted as a complaint investigation (Complaint Investigation WV00002745) at New Horizon Senior Living Center.
Findings
No deficiencies were cited during the complaint investigation conducted on May 17, 2006.
Complaint Details
Complaint Investigation WV00002745 was conducted with no deficiencies cited.
Report Facts
Census: 31
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jane Cost | HFNS II | Surveyor during the complaint investigation |
| Louise Hall | HFNS II | Surveyor during the complaint investigation |
| Myra McClead | HFNS II | Surveyor during the complaint investigation |
Inspection Report
Annual Inspection
Census: 35
Deficiencies: 0
Aug 8, 2005
Visit Reason
The visit was conducted as an annual licensure survey of the New Horizon Senior Living Center.
Findings
The report lists the annual licensure survey with no specific deficiencies or findings detailed in the document.
Report Facts
Census: 35
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jane Cost | HFNSII | Named as part of the survey team |
| Louise Hall | HFNSII | Named as part of the survey team |
| Myra McClead | HFNSI | Named as part of the survey team |
Inspection Report
Annual Inspection
Census: 34
Deficiencies: 0
Jul 26, 2005
Visit Reason
The visit was conducted as an annual licensure survey to assess environmental conditions at the facility.
Findings
The report documents the results of the annual licensure survey conducted on July 26, 2005, with a census of 34 residents. No specific deficiencies or severity levels are detailed in the provided text.
Report Facts
Census: 34
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Keith Carpenter | Surveyor | Conducted the annual licensure survey |
Inspection Report
Follow-Up
Census: 32
Deficiencies: 0
Sep 30, 2004
Visit Reason
This document is a first follow-up visit to the annual survey conducted to verify correction of previously identified deficiencies.
Findings
The follow-up survey found that all previously cited deficiencies have been corrected as of the date of this visit.
Report Facts
Census: 32
Inspection Report
Annual Inspection
Census: 33
Deficiencies: 2
Jun 30, 2004
Visit Reason
Annual survey conducted June 28-30, 2004 to assess compliance with staffing and facility requirements at New Horizon Senior Living Center.
Findings
The facility was found deficient in staffing adequacy, failing to provide sufficient licensed nursing staff to administer medications at all times. Additionally, housekeeping and maintenance issues were noted, including damaged carpets, missing bathroom fixtures, and unclean areas.
Severity Breakdown
Class I: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| Failure to staff the facility adequately to provide residents with all required care and services, including medication administration coverage. | Class I |
| Inadequate housekeeping and maintenance, including damaged carpet, missing towel bars and toilet paper holders, and unclean sink. | — |
Report Facts
Census: 33
Residents with PRN medications: 27
Licensed Practical Nurse staffing hours: 8
Licensed Practical Nurse staffing hours: 8
Licensed Practical Nurse weekend coverage hours: 14
Distance from facility: 3
Carpet replacement deadline: Sep 30, 2004
Plan of Correction completion date: Sep 30, 2004
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| CS | Registered Nurse and Administrator | Interviewed regarding staffing and medication administration |
Inspection Report
Renewal
Census: 33
Deficiencies: 0
Jun 28, 2004
Visit Reason
The visit was a re-licensure survey conducted to assess compliance with licensing requirements.
Findings
No deficiencies were found during the re-licensure survey, and technical assistance was provided.
Report Facts
Census: 33
Inspection Report
Annual Inspection
Census: 6
Deficiencies: 10
Jun 18, 2003
Visit Reason
Annual survey conducted at New Horizon Senior Living Center to assess compliance with health, safety, housekeeping, maintenance, and nursing care regulations.
Findings
The survey identified deficiencies related to safety and supervision of adolescent consumers, inadequate housekeeping and maintenance issues such as damaged carpet and missing bathroom fixtures, and incomplete nursing documentation and training requirements.
Deficiencies (10)
| Description |
|---|
| The Center did not implement programs in a safe environment; adolescent girls' bedrooms had outside doors without alarms and no awake staff on weekend nights. |
| Inadequate housekeeping and maintenance including personal belongings behind dresser, iron burns and bleach spots on carpet, torn chair, missing towel bar and toilet paper holder, and dirty sink. |
| Nine residents lacked photos with their medication administration records for proper identification. |
| PRN medications lacked parameters for administration including temperature range for fever. |
| Incident and accident forms did not consistently document preventative actions or assessments when no preventative action was possible. |
| Service plans were not updated at least annually or with significant changes, lacking dates and signatures. |
| Complaint procedure did not include written response to complainants within 24 hours. |
| Opened food containers in refrigerator were not consistently covered, labeled, and dated. |
| Registered nurse assessments were incomplete or not timely for residents receiving ongoing nursing care. |
| Staff required eight additional hours of training related to care of residents receiving ongoing nursing care. |
Report Facts
Center census: 6
Sample size: 3
Residents without photos in MAR: 9
Additional training hours required: 8
Carpet replacement deadline: Sep 30, 2004
Inspection Report
Deficiencies: 8
Jul 9, 2002
Visit Reason
The inspection was conducted to assess the physical facilities and equipment, specifically focusing on the cleanliness and maintenance of floors and the overall environment of the New Horizon Senior Living Center.
Findings
The inspection found that floors throughout the facility were soiled, stained, and difficult to clean due to unsealed openings and damaged tiles. Additional issues included soiled baseboards, stained carpets, and damaged furniture, indicating inadequate housekeeping and maintenance.
Deficiencies (8)
| Description |
|---|
| Corridor floor covering and base boards are soiled in the corners and at meeting edges throughout. |
| The 12 x 12 vinyl tiles at the entrance to the central shower are soiled and stained. |
| The floor covering in room 104 has unsealed openings between tile sections making the floor unnecessarily difficult to clean. |
| The 12 X 12 vinyl floor tile in room 103 is stained and has tile glue coming up between the tile sections making the floor difficult to clean. |
| The floor is soiled in the corners of the beauty shop room. |
| Room 127 has floor covering which is very soiled and stained under the beds. |
| Room 126 has stained and soiled floor covering. |
| Room 119 has rust colored stains on the floor. |
Report Facts
Additional housekeeping hours: 60
Additional maintenance hours: 60
Rooms stripped per week: 2
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