Inspection Reports for Woonsocket Health Center
262 POPLAR STREET, WOONSOCKET, RI, 02895
Back to Facility ProfileDeficiencies (last 4 years)
Deficiencies (over 4 years)
5.8 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
71% worse than Rhode Island average
Rhode Island average: 3.4 deficiencies/yearDeficiencies per year
8
6
4
2
0
Census
Latest occupancy rate
79% occupied
Based on a April 2025 inspection.
Census over time
Inspection Report
Follow-Up
Deficiencies: 0
Date: May 6, 2025
Visit Reason
A follow-up to a previous recertification survey was conducted at this facility on 05/06/2025 to verify correction of prior deficiencies.
Findings
All previous deficiencies were corrected and no new deficiencies were identified during the follow-up survey.
Inspection Report
Annual Inspection
Census: 118
Capacity: 150
Deficiencies: 8
Date: Apr 1, 2025
Visit Reason
A recertification and complaint surveys were conducted from 3/31/2025 through 4/3/2025 to determine compliance with federal regulations for Long Term Care Facilities, State licensure, and emergency preparedness.
Complaint Details
Complaint surveys were conducted as part of the inspection process, with deficiencies identified related to pressure ulcer care and dialysis services.
Findings
Deficiencies were identified related to pressure ulcer treatment, dialysis care, pharmacy services, infection prevention, food safety, and life safety code compliance. Plans of correction were provided with completion dates set for 5/3/2025.
Deficiencies (8)
Failure to ensure residents with pressure ulcers receive necessary treatment and services consistent with professional standards of practice.
Failure to ensure residents who require dialysis receive services consistent with professional standards of practice and comprehensive person-centered care plans.
Failure to provide routine and emergency drugs and biologicals to residents or obtain them under an agreement with licensed personnel.
Failure to maintain emergency lighting systems in accordance with NFPA 101 Life Safety Code.
Failure to ensure food safety requirements including proper hair and beard restraints for dietary personnel.
Failure to establish an infection prevention and control program including an antibiotic stewardship program.
Failure to ensure residents receive pneumococcal immunization or education regarding benefits and side effects.
Failure to ensure residents receive influenza immunization or education regarding benefits and side effects.
Report Facts
Capacity: 150
Census: 118
Deficiencies cited: 8
Completion date: May 3, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Moulikato Velazquez | Surveyor | Named as surveyor conducting the inspection |
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Jun 27, 2024
Visit Reason
An off-site desk audit was conducted on June 27 and June 28, 2024, to review all previous deficiencies cited on April 25 and April 30, 2024, based on acceptable plans of correction and supporting documentation.
Findings
The facility was found to be in compliance with all regulations surveyed, and the previously cited deficiencies have been corrected.
Inspection Report
Annual Inspection
Census: 118
Capacity: 150
Deficiencies: 6
Date: Apr 30, 2024
Visit Reason
A recertification survey was conducted at Woonsocket Health Centre from 04/22/2024 through 04/30/2024 to determine compliance with 42 CFR Part 483 requirements for Long Term Care Facilities, including a comprehensive care plan and emergency preparedness.
Findings
The facility was found to have deficiencies related to comprehensive care plans for anticoagulation therapy monitoring, emergency preparedness including life safety code violations, and medication administration. Several care plans lacked evidence of implementation and monitoring for signs and symptoms of bleeding. Life safety deficiencies included missing ceiling tiles and combustible material storage issues. Medication errors and documentation issues were also identified.
Deficiencies (6)
Failure to develop and implement comprehensive person-centered care plans for anticoagulation therapy monitoring for signs and symptoms of bleeding.
Failure to maintain emergency carts properly stocked and in working order.
Failure to maintain smoke barrier doors and fire safety compliance with NFPA 101 Life Safety Code.
Failure to provide nursing staff with education and competency assessments related to acute changes in resident condition.
Failure to ensure residents are free from significant medication errors.
Failure to maintain sanitary and comfortable environment including cleanliness of kitchen appliances and storage areas.
Report Facts
Capacity: 150
Census: 118
Deficiencies cited: 6
Fire drills: 3
Medication errors: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Registered Nurse (RN) | Interviewed regarding care plan implementation for Resident ID #48 |
| Director of Nursing Services | DNS | Interviewed regarding care plans and emergency cart audits |
| Staff B | Licensed Practical Nurse (LPN) | Interviewed regarding emergency cart observations |
| Staff C | Licensed Practical Nurse (LPN) | Interviewed regarding emergency cart observations |
| Staff D | Registered Nurse (RN) | Interviewed regarding emergency cart observations |
| Staff E | Registered Nurse (RN) | Interviewed regarding emergency cart observations |
| Staff F | Nursing Assistant (NA) | Interviewed regarding resident breathing and notification |
| Staff G | Nurse Practitioner (NP) | Interviewed regarding medication orders and communication |
| Staff H | Physician | Interviewed regarding communication of orders |
| Staff I | Registered Nurse (RN) | Interviewed regarding medication administration |
| Staff K | Education Coordinator | Interviewed regarding resident assessment and education |
| Staff L | Nurse Practitioner (NP) | Interviewed regarding verbal orders and documentation |
| Staff M | Nurse Practitioner (NP) | Interviewed regarding verbal orders and documentation |
| Staff N | Administrator | Interviewed regarding verbal orders and documentation |
| Medical Director | Medical Director | Named in relation to education on procedures and policy implementation |
| Maintenance Director | Maintenance Director | Interviewed regarding fire drills and storage audits |
Inspection Report
Complaint Investigation
Deficiencies: 2
Date: Mar 21, 2023
Visit Reason
A Recertification Survey and Complaint Investigation was conducted from 03/20/2023 through 03/23/2023 to determine compliance with 42 CFR Part 483 requirements for Long Term Care Facilities, including a State licensure and emergency preparedness surveys.
Complaint Details
The complaint investigation was substantiated with findings of Immediate Jeopardy under 42 CFR §483.25 related to resident supervision and 42 CFR §483.80 related to infection prevention and control during a norovirus outbreak affecting 4 of 4 units and multiple residents.
Findings
The facility was found to have Immediate Jeopardy deficiencies related to failure to ensure adequate supervision to prevent resident elopement and failure to maintain an infection prevention and control program during a norovirus outbreak affecting multiple residents.
Deficiencies (2)
Facility failed to ensure that a resident received adequate supervision to prevent elopement.
Facility failed to maintain an infection prevention and control program to help prevent transmission of communicable diseases and infections related to a norovirus outbreak.
Report Facts
Residents affected by norovirus outbreak: 15
Residents affected by norovirus outbreak: 9
Residents affected by norovirus outbreak: 3
Missed antibiotic doses: 3
Residents identified at risk for elopement: 1
Residents assessed for ESBL infection: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Peter Pezzelli | Administrator | Signed Plan of Correction and involved in survey interviews |
| Registered Nurse (RN), Staff A | Nurse working when resident eloped, interviewed about supervision and elopement policy | |
| Director of Nursing Services (DNS) | Acknowledged resident left without staff awareness and discussed elopement policy | |
| Social Worker, Staff D | Interviewed about notification attempts and resident elopement | |
| Nurse Practitioner (NP), Staff C | Interviewed about resident drug use education and medication orders | |
| Registered Nurse (RN), Staff B | Interviewed about last sighting of resident before elopement | |
| Director of Nursing Services (DNS) | Responsible for infection control audits and education | |
| Licensed Practical Nurse, Staff G | Interviewed about infection control practices during norovirus outbreak | |
| Infection Preventionist | Interviewed about infection control program and norovirus outbreak management | |
| Administrator of Clinical Services | Interviewed about infection control and outbreak response |
Inspection Report
Follow-Up
Deficiencies: 0
Date: Mar 29, 2022
Visit Reason
A follow up survey to the annual State/Federal survey was conducted at this facility to verify correction of previous deficiencies.
Findings
All former citations were corrected, and no new deficiencies were identified during this follow-up survey.
Inspection Report
Complaint Investigation
Deficiencies: 7
Date: Jan 27, 2022
Visit Reason
A Recertification and Complaints Investigation Survey was conducted at Woonsocket Health Centre from 1/24/2022 through 1/27/2022 to determine compliance with 42 CFR Part 483 requirements for Long Term Care Facilities, including state licensure and emergency preparedness surveys.
Complaint Details
The survey was a combined Recertification and Complaints Investigation Survey, triggered by complaints regarding quality of care and medication errors.
Findings
Deficiencies were cited related to failure to meet professional standards of quality in care, including issues with physician orders for flushing hepatic drains, quality of care regarding weight changes and respiratory status, skin integrity and pressure ulcer care, medication administration errors, infection prevention and control, and proper use of personal protective equipment (PPE).
Deficiencies (7)
Failure to ensure services met professional standards of quality regarding physician orders for hepatic drain treatments for Resident ID #266.
Failure to ensure treatment and care in accordance with professional standards for weight change and respiratory status for Resident ID #51.
Failure to provide necessary treatment and services to prevent pressure ulcers for Resident ID #92.
Failure to maintain acceptable parameters of nutritional status and hydration for Residents ID #57 and #96.
Failure to ensure medication error rates were below 5% and proper medication administration practices for Resident ID #2.
Failure to ensure medication storage rooms and medication carts were clean and properly maintained.
Failure to establish and maintain an infection prevention and control program including proper use of PPE and hand hygiene.
Report Facts
Date survey completed: Jan 27, 2022
Weight gain: 15.2
Medication error rate: 9.68
Loose pills observed: 79
Pressure ulcer stage: 4
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff Nurse A | Staff Nurse | Interviewed regarding lack of current order to flush hepatic drain |
| Director of Nursing Services | DNS | Interviewed regarding weight change notification policy |
| Staff E | Nurse Practitioner | Interviewed regarding resident weight gain and oxygen therapy |
| Staff F | Nurse | Acknowledged resident heels were not offloaded as ordered |
| Staff N | Housekeeping Staff | Observed wearing PPE and cleaning medication carts |
| Staff O | Housekeeping Staff | Observed removing gown, gloves, and goggles after cleaning |
| Staff P | Nurse | Observed not wearing mask while folding laundry |
| Staff C | Nurse | Acknowledged oxygen order did not include liter flow |
| Staff I | Licensed Pharmacist | Indicated medications should not be crushed as per pharmacy label |
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