Inspection Reports for Parkwood Village and The Landing
1730 Parkwood Blvd W, Wilson, NC 27893, United States, NC, 27893
Back to Facility ProfileDeficiencies per Year
12
9
6
3
0
Severe
High
Moderate
Unclassified
Inspection Report
Annual Inspection
Deficiencies: 2
Feb 26, 2025
Visit Reason
The Adult Care Licensure Section conducted an annual and follow-up survey on February 26 and 27, 2025 to assess compliance with adult care home regulations.
Findings
The facility was found to have unsecured oxygen tanks stored improperly in a resident's room, posing a safety hazard. Additionally, the facility failed to maintain a current listing of residents with physician-ordered therapeutic diets for guidance of food service staff for 3 of 6 sampled residents.
Deficiencies (2)
| Description |
|---|
| Facility failed to ensure oxygen tanks were stored securely in a cylinder rack, resulting in free-standing, unsecured oxygen tanks in a resident's room. |
| Facility failed to maintain a current list with physician-ordered therapeutic or modified diets for guidance of food service for 3 of 6 sampled residents. |
Report Facts
Oxygen tanks observed unsecured: 4
Oxygen tanks total: 5
Residents with missing diet orders: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Maintenance Director | Responsible for completing room checks for residents using oxygen and ensuring oxygen tanks were stored properly. | |
| Licensed Health Professional Support nurse | Provided information about resident's oxygen use and storage. | |
| Director of Health and Wellness | Responsible for submitting dietary orders and ensuring oxygen tanks were stored properly. | |
| Administrator | Unaware of unsecured oxygen tanks and responsible for oversight of safety and diet order compliance. | |
| Medication Aide | Interviewed regarding resident's oxygen use and storage. | |
| Cook | Followed diet list to prepare residents' meals and noted removal of diet orders for some residents. | |
| Dietary Manager | Reported lack of a composed diet order list and posted individual diet orders in the kitchen. |
Inspection Report
Follow-Up
Deficiencies: 1
Jul 24, 2024
Visit Reason
The Adult Care Licensure Section and Wilson County Department of Social Services conducted a follow-up survey on July 24 and July 25, 2024 to verify correction of previous deficiencies.
Findings
The facility failed to ensure that the medication aide observed Resident #1 take her medications before documenting administration, as evidenced by three tablets found unsupervised and unsecured in the resident's room. Interviews and observations confirmed that medications were left unattended and not properly administered according to facility policy.
Deficiencies (1)
| Description |
|---|
| Failed to ensure the medication aide observed Resident #1 take her medications before documenting administration; three tablets found unsupervised and unsecured in Resident #1's room. |
Report Facts
Tablets found unsupervised: 3
Medication remaining: 7
Medication remaining: 56
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Director of Resident Care | Director of Resident Care | Interviewed regarding medication administration and facility expectations. |
| Wellness Coordinator | Wellness Coordinator | Interviewed about medication administration observations. |
Inspection Report
Annual Inspection
Deficiencies: 2
May 29, 2024
Visit Reason
The Adult Care Licensure Section conducted an annual and follow-up survey on 05/28/24 and 05/29/24 to assess compliance with medication administration and other regulatory requirements.
Findings
The facility failed to administer medications as ordered for two sampled residents, including medications for mood disorders, pain, high blood pressure, acid reflux, and constipation. Medication administration records were inaccurate, with missing documentation for omitted doses and failure to notify appropriate staff. This resulted in substantial risk for serious harm and constitutes a Type A2 Violation.
Severity Breakdown
Type A2 Violation: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| Failure to administer medications as ordered for 2 of 5 sampled residents, including missed doses of Risperdal and Depakote for mood disorders and other medications for pain, hypertension, acid reflux, and constipation. | Type A2 Violation |
| Medication administration records (MARs) were inaccurate for Resident #2, with missing documentation of omitted doses and reasons for omissions. | — |
Report Facts
Missed doses of Risperdal: 10
Missed doses of Depakote: 22
Medication delivery times: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Medication Aide (MA) | Documented medication administration and omissions; failed to notify Director of Resident Care about missing medications. | |
| Director of Resident Care (DRC) | Responsible for notification of physicians and oversight of medication administration; interviewed regarding medication omissions. | |
| Administrator | Interviewed regarding awareness and expectations for medication administration and documentation. | |
| Registered Nurse (RN) | Conducted MAR audits but did not check medications on hand. | |
| Hospice Nurse | Interviewed regarding medication orders and resident conditions. | |
| Resident #1's Mental Health Provider | Prescribed medications for Resident #2; unaware of missed medication administration until notified. | |
| Resident #2's Primary Care Provider (PCP) | Interviewed regarding medication orders and expectations for notification. |
Inspection Report
Complaint Investigation
Deficiencies: 7
Mar 22, 2024
Visit Reason
The Adult Care Licensure Section conducted a follow-up survey and complaint investigation initiated by the Wilson County Department of Social Services regarding medication administration and staff qualifications.
Findings
The facility failed to ensure medication aides completed required training and clinical skills validation, resulting in medication errors and inaccurate medication administration records (MARs). The facility also failed to clarify medication orders, administer medications as ordered including controlled substances for pain and respiratory distress, and maintain accurate medication administration records. Additionally, a suspected drug diversion by a staff member was investigated but not substantiated, and the staff member was not suspended during the investigation despite pending criminal drug charges.
Complaint Details
The complaint investigation was initiated by the Wilson County Department of Social Services on 03/14/24 regarding medication administration errors and staff qualifications. The investigation included allegations of drug diversion by Staff A, a medication aide, which was reported to local law enforcement and the Health Care Personnel Registry. Staff A was not suspended during the investigation and continued to administer medications including controlled substances. The allegation was unsubstantiated but the facility failed to report the diversion to the contracted pharmacy.
Severity Breakdown
Type B Violation: 2
Type A1 Violation: 1
Deficiencies (7)
| Description | Severity |
|---|---|
| Failed to ensure documentation for medication aides completing state-approved training and clinical skills validation, resulting in medication errors and inaccurate MARs. | Type B Violation |
| Failed to ensure clarification of medication orders for a resident including a medication used to treat chronic pain. | — |
| Failed to administer medications as ordered for multiple residents including errors with topical medications, narcotics for pain and respiratory distress, and antipsychotics, resulting in undertreated symptoms and resident distress. | Type A1 Violation |
| Failed to maintain accurate medication administration records (MARs) including documentation of administration, omissions, and reasons for omissions. | — |
| Failed to ensure accurate reconciliation of controlled substances for a resident receiving morphine, resulting in missing and unaccounted for doses. | — |
| Failed to report a suspected drug diversion of a controlled substance by a staff member to the facility's contracted pharmacy. | — |
| Failed to protect residents from harm by allowing a medication aide under Health Care Personnel Registry (HCPR) investigation for drug diversion and with pending criminal drug charges to continue administering medications including controlled substances. | Type B Violation |
Report Facts
Medication errors: 3
Morphine doses documented: 12
Morphine doses missing: 18
Medication aides without training documentation: 3
Controlled substance diversion: 30
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Medication Aide | Named in medication training deficiency and suspected drug diversion investigation |
Inspection Report
Annual Inspection
Deficiencies: 1
Jul 12, 2023
Visit Reason
The Adult Care Licensure Section conducted an annual and follow-up survey on 07/11/23 through 07/12/23 to assess compliance with medication administration regulations.
Findings
The facility failed to ensure the electronic medication administration records were accurate for 2 of 5 sampled residents, including medications for pain, shortness of breath, anxiety, and blood sugar control. Documentation omissions were identified despite medication administration occurring.
Deficiencies (1)
| Description |
|---|
| Failure to ensure electronic medication administration records were accurate for 2 of 5 sampled residents, including medications for pain, shortness of breath, anxiety, and injectable medication for blood sugar. |
Report Facts
Sampled residents with medication record issues: 2
Trulicity pens on hand: 4
Morphine sulfate pre-filled syringes on hand: 31
Lorazepam doses remaining: 82
Lorazepam doses dispensed: 90
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Medication Aide | Medication aide admitted to administering medication but forgetting to document on the electronic medication administration record (eMAR) for Resident #4 | |
| Administrator | Administrator confirmed expectations for medication documentation and spoke with medication aide regarding missed documentation | |
| Memory Care Manager | Memory Care Manager stated medication aides were expected to document administration of all medications on the MAR at the time of administration | |
| Contracted Pharmacist | Pharmacist provided medication dispensing information for Residents #2 and #4 | |
| Contracted Primary Care Provider | Primary care provider emphasized importance of accurate MAR documentation for medication effectiveness and treatment guidance |
Inspection Report
Complaint Investigation
Deficiencies: 2
Jan 12, 2023
Visit Reason
The inspection was conducted as a complaint investigation (CI) with multiple visit dates from 01/12/23 through 03/13/23 to address concerns about personal care and supervision at Parkwood Village Assisted Living.
Findings
The facility failed to provide adequate personal care for 3 of 5 residents sampled, including failure to meet incontinence needs timely, provide scheduled baths, and ensure proper oral care, resulting in a Type A1 violation. Additionally, the facility failed to ensure staff received required training and supervision in the special care unit, resulting in a Type A2 violation.
Complaint Details
The investigation was complaint-driven, focusing on allegations of neglect and inadequate personal care for residents, substantiated by observations, interviews, and record reviews.
Severity Breakdown
TYPE A1 VIOLATION: 1
TYPE A2 VIOLATION: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| Failure to provide personal care for 3 of 5 residents sampled, including incontinence care, bathing, and oral hygiene, resulting in skin infections and neglect. | TYPE A1 VIOLATION |
| Failure to ensure 3 of 3 staff sampled in the special care unit completed required training and supervision, including dementia-specific education, resulting in serious risk for neglect and harm. | TYPE A2 VIOLATION |
Report Facts
Visit dates: 9
Residents sampled: 5
Staff training hours: 6
Staff training hours: 20
Correction date: May 4, 2023
Inspection Report
Annual Inspection
Deficiencies: 4
Sep 17, 2021
Visit Reason
The Adult Care Licensure Section conducted an annual and follow-up survey on September 16-17, 2021 to assess compliance with adult care home regulations.
Findings
The facility was found deficient in maintaining a hazard-free environment due to unsecured oxygen cylinders in resident rooms, medication administration errors for 2 of 3 residents observed, failure to ensure compliance with self-administration of medications for one resident, and failure to implement CDC and state COVID-19 screening guidelines for residents.
Deficiencies (4)
| Description |
|---|
| Facility failed to maintain a hazard-free environment related to unsecured oxygen cylinders in two resident rooms. |
| Facility failed to administer medications as ordered for 2 of 3 residents observed during medication pass, including unavailability of vitamin D supplement and omission of laxative. |
| Facility failed to assure compliance with policies for self-administration of medications for 1 resident with orders to self-administer medications. |
| Facility failed to ensure implementation of CDC and NC DHHS COVID-19 guidance related to screening residents for COVID-19 signs and symptoms, including failure to obtain daily resident temperatures. |
Report Facts
Medication error rate: 7.4
Unsecured oxygen cylinders: 12
Medication administration observations: 27
Remaining tablets: 8
Remaining Nexium packets: 17
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Director of Resident Care | Director of Resident Care | Interviewed regarding oxygen cylinder storage, medication administration oversight, and self-administration assessments |
| Administrator | Administrator | Interviewed regarding oxygen cylinder storage, medication administration oversight, and COVID-19 policies |
| Medication Aide | Medication Aide | Interviewed regarding medication administration errors and oxygen cylinder storage |
| Personal Care Aide | Personal Care Aide | Interviewed regarding oxygen cylinder storage |
Inspection Report
Capacity: 70
Deficiencies: 10
Dec 5, 2019
Visit Reason
The facility was surveyed for conformance with the applicable portions of the 2005 Rules for Licensing of Adult Care Homes of Seven or More Beds, the 1996 (1997 Revision) Edition of the North Carolina Building Code(s), Institutional Occupancy, and the 1996 Minimum Standards and Regulations for Homes for the Aged in effect at time of initial licensure.
Findings
Multiple deficiencies were cited including lack of wiring diagram for special locking system, improper use of bathrooms for storage, unclean and unrepaired ceilings, failure to maintain fire safety systems and equipment in safe operating condition, failure to maintain electrical emergency lighting, plumbing safety issues, and damaged electrical equipment.
Deficiencies (10)
| Description |
|---|
| Facility did not have a wiring diagram for the special locking system located adjacent to the fire alarm panel. |
| One of the community bathrooms (SCU Spa) was being utilized for storage of Christmas decorations, clothing, walkers, paint cans, and other items. |
| Outside premises not maintained in a clean condition; a section of exterior soffit had fallen out leaving a large hole for pests and elements to enter. |
| Ceilings were not kept clean and in good repair, including water stains and peeling tape in multiple rooms and hallways. |
| Failure to maintain building's fire safety systems in a safe condition; missing escutcheon plates, gaps at sprinkler heads, unsealed cable penetrations, and fire caulk fallen out. |
| Failure to maintain facility's fire safety equipment in safe operating condition; doors not latching properly and door propped open. |
| Failure to maintain electrical emergency/safety lighting equipment in safe operating condition; emergency lights did not illuminate on battery test. |
| Failure to install and maintain plumbing piping with minimum 2" air gap; icemaker drain line resting almost directly on floor drain grate. |
| Failure to install and maintain required plumbing safety devices; damaged vacuum breaker on utility sink. |
| Electrical equipment not maintained in safe and operating condition; light switch not secure to the wall in SCU Spa. |
Report Facts
Total licensed capacity: 70
Inspection Report
Capacity: 70
Deficiencies: 9
Oct 4, 2017
Visit Reason
The facility was surveyed for conformance with the applicable portions of the 2005 Rules for Licensing of Adult Care Homes of Seven or More Beds, the 1996 (1997 Revision) Edition of the North Carolina Building Code(s), Institutional Occupancy, and the 1996 Minimum Standards and Regulations for Homes for the Aged in effect at time of initial licensure during a Construction Section Biennial Survey.
Findings
Multiple deficiencies were cited including failure to maintain current sanitation and fire safety inspection reports, hazards related to unsecured oxygen cylinders, incomplete documentation of fire safety rehearsals, emergency exit signs not illuminating on backup power, smoke barrier doors not fitting properly, fire sprinkler issues, unsafe electrical extension cord use, plumbing concerns, and inadequate exhaust ventilation in several areas.
Deficiencies (9)
| Description |
|---|
| Facility failed to maintain current annual sanitation and fire safety inspection reports. |
| Building was not maintained free of hazards; unsecured portable medical oxygen cylinder at SCU Nurse Station. |
| Facility failed to document all aspects of fire plan rehearsals; records lacked description of rehearsal activities. |
| Emergency exit signs near Bedroom 108, Bedroom 216, and Dining did not illuminate on backup power; emergency light in dining area failed backup illumination. |
| Smoke barrier doors on 100 Hall had gaps preventing proper smoke and fire containment. |
| Fire sprinkler escutcheon plate missing near Bedroom 108; fire sprinkler head debris-loaded with lint in SCU Dining. |
| Extension cords used in Kitchen Office and Bedroom 405 instead of permanent wiring. |
| Ice machine drain in Kitchen lacked required air gap, risking contamination. |
| Facility failed to provide adequate exhaust ventilation in multiple areas including 100 Hall Residents Laundry, 100 Hall Resident Bathroom, 200 Hall including Public Unisex Restrooms, Bulk Laundry, and 300 Hall Housekeeping, resulting in odors. |
Report Facts
Licensed bed capacity: 70
Inspection Report
Annual Inspection
Deficiencies: 7
May 12, 2016
Visit Reason
The Adult Care Licensure Section conducted an annual, follow-up survey and complaint investigation on 05/10/16 - 05/12/16. The complaint investigation was initiated by Wilson County Department of Social Services on 02/23/16.
Findings
The facility was found deficient in multiple areas including tuberculosis testing and criminal background checks for staff, cleanliness and maintenance of kitchen and food storage areas, medication order clarifications, self-administration of medications compliance, follow-up on medication review recommendations, and special care unit staff training requirements.
Complaint Details
Complaint investigation initiated by Wilson County Department of Social Services on 02/23/16.
Deficiencies (7)
| Description |
|---|
| Facility failed to assure 2 of 5 staff sampled were tested upon employment for tuberculosis disease in compliance with control measures. |
| Facility failed to assure 1 of 6 sampled staff had a criminal background check in accordance with regulations upon rehire. |
| Facility failed to assure the reach-in cooler, walk-in freezer, walk-in cooler, kitchen appliances, ice machine, floors and walls in the kitchen were cleaned, in good repair and free of contamination. |
| Facility failed to clarify and verify medication orders for 1 of 5 residents who was being administered medications not included on the resident's current FL-2. |
| Facility failed to assure compliance with policies for self-administration of medications for 2 of 2 sampled residents with orders to self-administer medications. |
| Facility failed to follow up on medication review recommendations for 2 of 6 residents sampled related to medications for high cholesterol and underactive thyroid and medications for anxiety. |
| Facility failed to assure 2 of 3 staff responsible for personal care and supervision within the special care unit completed 20 hours of training specific to the population being served within 6 months of employment. |
Report Facts
Staff sampled for TB testing: 5
Staff sampled for criminal background check: 6
Medication administration records reviewed: 5
Self-administration compliance residents sampled: 2
Special care unit staff sampled: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff C | Medication Aide | Named in findings for missing TB test and criminal background check upon rehire |
| Staff E | Nurse Aide / Medication Aide | Named in findings for missing TB test |
| Staff A | Medication Aide | Named in findings for incomplete special care unit training |
| Staff B | Nurse Aide | Named in findings for incomplete special care unit training |
Inspection Report
Follow-Up
Deficiencies: 5
Dec 3, 2015
Visit Reason
This report is of a follow-up survey conducted to verify correction of previously identified deficiencies at Parkwood Village.
Findings
The follow-up survey found that not all deficiencies were corrected, including issues with fire safety such as unsealed smoke barrier wall penetrations, improper caulking, fire rated doors being held open by magnets, corridor doors not closing properly, and lack of vacuum breakers on hoses reaching sink basins.
Deficiencies (5)
| Description |
|---|
| Sampling tube for the duct mounted smoke detector in the attic above room 301 was very dirty. |
| Required one-hour fire rated smoke barrier wall was compromised with unsealed sleeves and improper caulking. |
| Fire rated door to the laundry held open by a permanent magnet, preventing proper closing. |
| Many corridor doors not closing well or latching to resist fire and smoke passage; kitchen to dining room door held open by permanent magnet. |
| No vacuum breakers provided on hoses long enough to reach sink basins, including hair wash wand in Beauty Salon. |
Inspection Report
Capacity: 70
Deficiencies: 12
Sep 23, 2015
Visit Reason
The facility was surveyed for conformance with the applicable portions of the 2005 Rules for Licensing of Adult Care Homes of Seven or More Beds, the 1996 (1997 Revision) Edition of the North Carolina Building Code(s), Institutional Occupancy, and the 1996 Minimum Standards and Regulations for Homes for the Aged in effect at time of initial licensure. This was a Biennial Construction Survey.
Findings
Multiple deficiencies were identified including noncompliance with magnetic locking emergency release switches, lack of current sanitation report, corridor obstructions, unsafe building equipment conditions such as dirty smoke detector sampling tubes, smoke barrier doors not fitting or being propped open, compromised fire rated smoke barrier walls, improper storage of oxygen cylinders and items near sprinkler heads, clogged air conditioning drains, lack of vacuum breakers on hoses, and lack of staff supervision for range use in the Activities Kitchen.
Deficiencies (12)
| Description |
|---|
| Emergency release switches adjacent to magnetically locked exit doors in the Special Care Unit were momentary push-button type instead of required on/off type. |
| Current sanitation report for the building was not available for review. |
| Corridor at the laundry was obstructed to about 54 inches of clear space, potentially delaying evacuation; corrected during survey. |
| Sampling tube for duct mounted smoke detector in attic above room 301 was very dirty. |
| Smoke barrier doors did not fit well enough to contain smoke and fire; gaps of about ½ inch and 3/8 inch noted; many corridor doors were propped open or did not latch properly. |
| One-hour fire rated smoke barrier wall compromised by unsealed penetrations and sleeves in attic above room 302. |
| Fire rated door to laundry was wedged open, preventing self-closing as required. |
| Portable medical oxygen cylinders stored unsecured in room 204. |
| Items stored within 8 inches of fire sprinkler head in special care storage room, violating clearance requirements. |
| Main drain for air conditioning unit in attic clogged causing condensate overflow into emergency drain pan. |
| No vacuum breakers provided on hoses long enough to reach sink basins at beauty salon and exterior can wash area. |
| No switch provided to control operation of range in Activities Kitchen; range accessible to residents without staff supervision. |
Report Facts
Total licensed beds: 70
Clear corridor space: 54
Gap in smoke barrier door: 0.5
Gap in smoke barrier door: 0.375
Storage clearance: 8
Loading inspection reports...
