Listing of Facilities with Penalties
This is the list of facilities, by county names, that have been found in violation of one or more rules since January 2006.
This is the list of facilities, by county names, that have been found in violation of one or more rules since January 2006.
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| L M & S Adult Care No. 2 | FCL-001-063 | 7/14/2006 | $1,350.00 | Not corrected Type B | 10A NCAC 13G .0406 Other Staff Qualifications | Criminal background checks for 4 staff members were not done before hiring | Partial pmt. Partial pmt. Paid in Full |
$500.00 $500.00 $350.00 |
9/14/2006 10/30/2006 11/07/2006 |
| L M & S Adult Care No. 2 | FCL-001-063 | 3/20/2008 | $2,000.00 | Type B Unabated | 10A NCAC 13G .0406 (a)(5) Other Staff Qualifications; G.S. 131D-21 (2) Declaration of Residents' Rights | Healthcare registry verification was not conducted for one staff on first visit and for 3 of 6 staff on revisit | Partial pmt. | $500.00 | 5/29/2008 |
| Rainbow of Love #2 | FCL-001-112 | 1/26/2007 | $1,230.00 | Not corrected Type B | 10A NCAC 13G .0406 (a)(7) Other Staff Qualifications; G.S. 131D-21 (2) Declaration of Residents' Rights | Criminal background checks were not conducted on two staff | Referred to the Controller's Office | ||
| Rainbow of Love #3 | FCL-001-111 | 1/8/2007 | Staff Training | Not corrected Type B | 10A NCAC 13G .0406(a)(7) Other Staff Qualifications | Criminal background checks were not conducted on two staff | Facility Closed | ||
| Rainbow of Love #3 | FCL-001-111 | 1/8/2007 | Staff Training | Not corrected Type B | 10A NCAC 13G .0403 (a) Qualifications of Medication Staff | Staff administering medications had not completed the clinical skills validation prior to administration of medications. | Facility Closed | ||
| Agape Family Care | FCL-001-106 | 4/4/2007 | $1,250.00 | Type A | 10A NCAC 13G .0601 Management & Other Staff; G.S. 131D-21 (2) Declaration of Residents' Rights | Resident was left unsupervised and locked out of facility | Paid in Full | $1375.00 | 6/14/2007 |
| Alvarado's Family Care | FCL-001-101 | 6/27/2007 | $2,000.00 | Type A | 10A NCAC 13G .0901 (b) Personal Care and Supervision; G.S. 131D-21 (2) Declaration of Resident's Rights | Staff allowed Alzheimer resident to walk on facility grounds unsupervised; she was killed when struck by vehicle backing out of driveway | Partial pmt. Paid in Full |
$1,000.00 $1,000.00 |
07/18/2007 07/25/2007 |
| Angels Family Care Home II | FCL-001-078 | 11/19/2007 | $4,890.00 | Not corrected Type B | 10A NCAC 13G .1004 Medication Administration, 10A NCAC 13G .0403 (a) Qualifications of Medication Staff; G.S. 131D-21 (2) Declaration of Residents' Rights | Medications were not administered as ordered to 6 of 6 residents; facility failed to ensure staff administering medications were competency validated to administer medications | Referred to Controller's Office | ||
| Angel's Family Care Home | FCL-001-119 | 5/14/2008 | $9,000.00 | Type B Unabated | 10A NCAC 13G .0406 (a)(5)(7) Other Staff Qualifications; G.S. 131D-21 (2) Declaration of Residents' Rights | Criminal background checks were not conducted for 6 staff and Health Care Personnel registry verification did not occur for 3 staff | |||
| Angels Family Care Home | FCL-001-119 | 1/18/2008 | $2,850.00 | Not corrected Type B | 10A NCAC 13G .1004 (b) Medication Administration; G.S. 131D-21 (2) Declaration of Residents' Rights | Both staff administering medications had not completed the clinical skills validation prior to administration of medications | |||
| The Oaks of Burlington | HAL-001-011 | 10/30/2007 | $6,160.00 | Not corrected Type B | 10A NCAC 13F .1004 (a) Medication Administration; G.S. 131D-21 (2) Declaration of Residents Rights | Residents continued to not receive medications as ordered | Settlement Agreement 3/19/08 Appealed 12/3/07 |
$2,500.00 | 4/2/2008 |
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Cherry's Family Care Home #2 | FCL-008-002 | 8/27/2007 | $4,500.00 | Type A | 10A NCAC 13G .0906 Other Resident Services; G.S. 131D-21 (2) Residents' Rights | Staff failed to notify family or law enforcement when resident left and failed to return to the facility | Paid in Full | $5,040.00 | 1/3/2008 |
| Cherry's Family Care Home | FCL-080-002 | 5/14/2008 | $1,000.00 | Type A | 10A NCAC 13G .1004 (a) Medication Administration; G.S. 131D-21 (2) Declaration of Residents' Rights | Medication was not administered as ordered; resident did not receive insulin as ordered resulting in ER treatment | |||
| Cherry's Family Care Home #7 | FCL-008-018 | 11/19/2007 | $1,000.00 | Type A | 10A NCAC 13G .0909 Resident Rights; G.S. 131D-21 (4) Declaration of Residents' Rights | Facility failed to protect two residents from physical abuse by staff | Appealed 12/21/07 | ||
| River's Edge Rest Home | HAL-008-017 | 10/31/2007 | $2,000.00 | Type A | 10A NCAC 13F .0902 (b) Health Care; G.S. 131D-21 (2) Declaration of Resident's Rights | Facility failed to obtain medical referral and follow-up as needed for two residents | Referred to Controller's Office | ||
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Bladenboro Assisted Retirement Community | HAL-009-019 | 9/26/2007 | Staff Training | Type A | 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21 (2) Declaration of Residents' Rights | Residents did not receive medications as ordered | |||
| Bladenboro Assisted Retirement Community | HAL-009-019 | 2/21/2008 | $2,000.00 | Type A | 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21 (2) Declaration of Residents' Rights | Staff failed to notify physician of one insulin dependent resident' s blood sugars as ordered | |||
| Bladenboro Assisted Retirement Community | HAL-009-019 | 5/14/2008 | $3,480.00 | Type B Unabated | 10A NCAC 13F .1004 (a) Medication Administration; G.S. 131D-21(2) Declaration of Residents' Rights | Residents did not receive medications as ordered | |||
| Bladenboro Assisted Retirement Community | HAL-009-019 | 5/14/2008 | $3,480.00 | Type B Unabated | 10A NCAC 13F. 0901(a) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Residents' Rights | Residents did not receive personal care assistance with toileting, bathing, grooming and transfers; staff failed to respond to calls during third shift | |||
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Eldo Family Care Home #1 | FCL-010-002 | 04/07/2006 | $500.00 | Type A | 10A NCAC 13G .0601 Management and Other Staff | Nine (three that lived in the facility and 6 from another facility) residents were left unattended and unsupervisedby staff | Paid in Full | $500.00 | 6/8/2006 |
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Alterra Clare Bridge | HAL-011-035 | 5/3/2007 | $14,000.00 | Type A | 10A NCAC 13F .0902 (a)(b)(c) (1)(2)(3)(4) Health Care; G.S. 131D-21 (2) (4) Declaration of Residents' Rights | Facility failed to implement order for labwork; resident's decline continued with subsequent admission to hospital and death occurring later that day | Appealed 6/1/07 | ||
| Dominion Falls Unit K | FCL-011-110 | 5/3/2007 | $1,600.00 | Not corrected Type B | 10A NCAC 13G .0406 (a)(7) Other Staff Qualifications; G.S. 131D-21 (2) Declaration of Residents' Rights | Criminal backgorund check not conducted on staff hired as live-in supervisor | Referred to Controller's Office | ||
| Dominion Falls Unit K | FCL-011-110 | 5/3/2007 | $1,600.00 | Not corrected Type B | 10A NCAC 13G .0406 (a)(5) Other Staff Qualifications; G.S. 131D-21 (2) Declaration of Residents' Rights | Healthcare registry verification was not conducted for staff hired as live-in supervisor | Referred to Controller's Office | ||
| Dominion Falls Family Care Home | FCL-011-139 | 4/6/2006 | $500.00 | Type A | 10A NCAC 13G .0909 Resident Rights; 13G .0601 Management and Other Staff; G.S. 131D-21 (2) Declaration of Residents' Rights | Staff left two residents alone and unsupervised | Paid in Full | $500.00 | 4/23/2007 |
| Dominion Falls Family Care Home Unit N (6) Previously known as Sunrise Family Care Home #5 | FCL-011-240 | 11/1/2007 | $2,000.00 | Type A | 10A NCAC 13G .0901 Personal Care and Supervision; G.S. 131D-21 (2) Declaration of Residents' Rights | Facility failed to supervise incompetent resident who left the facility unattended; law enforcement not notified about absence and guardian not notified until next day | Referred to Controller's Office | ||
| Dominion Falls Family Care Home Unit O (6) Previously known as Sunrise Family Care Home #6 | FCL-011-239 | 11/1/2007 | $8,500.00 | Type A | 10 NCAC 13G .0901 (b) Personal Care and Supervision; G.S. 131D-21 (2) Declaration of Residents' Rights | Facility failed to supervise resident; resident left facility without signing self out of facility and facility failed to contact law enforcement when resident did not return | Referred to Controller's Office | ||
| Haywood Heights FCH | FCL-011-207 | 2/21/2008 | $2,000.00 | Type A | 10A NCAC 13G .0317(d) Building Service Equipment; G.S. 131D-21 (2) Declaration of Residents' Rights | Facility failed to maintain hot water temperatures in safe range for resident use in resident bathrooms | Paid in Full | $2,000.00 | 4/14/2008 |
| Marjorie McCune Memorial Ctr. | HAL-011-011 | 11/17/2006 | $2,800.00 | Not corrected Type B | 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21 (2) Declaration of Residents' Rights | Insulin not administered as ordered due to blood sugar levels not monitored as ordered for four residents | Paid in Full | $2,800.00 | 12/13/2006 |
| Marjorie McCune Memorial Ctr. | HAL-011-011 | 01/23/2006 | $3,000.00 | Type A | 10A NCAC 13F .0909 Resident Rights; 13F .0902 Health Care; G.S. 131D-21 (2)(4) Declaration of Residents' Rights | Resident receiving Coumadin did not have lab work performed as ordered | Paid in Full | $3,000.00 | 6/19/2006 |
| Marjorie McCune Memorial Ctr. | HAL-011-011 | 04/10/2006 | $900.00 | Type A | 10A NCAC 13F .0902 Health Care; 13F .0909 Residents Rights; G.S. 131D-21 Declaration of Residents' Rights | Resident receiving Coumadin did not have lab work performed as ordered | Paid in Full | $900.00 | 6/30/2006 |
| Plemmons FCH #2 | FCL-011-036 | 6/27/2007 | $3,920.00 | Not corrected Type B | 10A NCAC 13G .0406 (a)(7) Other Staff Qualifications; G.S. 131D-21 (2) Declaration of Residents' Rights | Criminal background check not conducted on two of two staff employed by facility | Partial Payment Paid in Full |
$920.00 $3507.44 |
8/9/2007 06/13/2008 |
| Richmond Hill Rest Home #3 | HAL-011-190 | 07/14/2006 | Staff Training | Type A | 10A NCAC 13F .0601 Management of Facilities with a Capacity or Census of Seven to Thirty Residents; 13F .0909 Residents Rights;G.S. 131D-21 (4) Declaration of Residents' Rights | Staff left residents alone and unsupervised to attend meeting. | Training Completed | 2/7/2007 | |
| Richmond Hill Rest Home #4 | HAL-011-189 | 06/02/2006 | $1,000.00 | Type A | 10A NCAC 13F .0902 Health Care (a)(b)(c); 13F .0909 Residents' Rights; G.S. 131D-21 (2) Declaration of Residents' Rights | Resident receiving Coumadin did not have lab work performed as ordered | Paid in Full | $1,000.00 | 7/21/2006 |
| Shadybrook Living Center | HAL-011-155 | 11/22/2006 | $6,000.00 $12,000.00 |
Type A | 10A NCAC 13F.1004 (a) Medication Administration; 10A NCAC 13F .1010 Pharmaceutical Services; G.S. 131D-21 (2)(4) Declaration of Residents' Rights | Resident with respiratory congestion did not receive ordered antibiotic timely | Settlement Agreement 5/24/07 Appealed 12/19/2006 | Paid in Full $6,000.00 | 3/6/2008 |
| Shadybrook Living Center | HAL-011-155 | 11/22/2006 | Training $7,500.00 |
Not corrected Type B | 10A NCAC 13F .0902(a)(b)(c)(3)(4) Health Care;G.S. 131D-21 (2)(4) Declaration of Residents' Rights | Resident did not have blood sugar levels monitored as ordered and did not receive ordered amount of insulin | Settlement Agreement 5/24/07 Training Appealed 12/19/2006 | Training Completed 3/27/08 | |
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Glenda's Plantation | FCL-012-021 | 2/21/2008 | $1,000.00 | Type A | 10A NCAC 13G .0901 Personal Care & Supervision; G.S. 131D-21 (2) Declaration of Residents' Rights | Staff failed to supervise residents left in vehicle during shopping excursion; one disoriented resident wandered into roadway | Paid in Full | $1,000.00 | 4/14/2008 |
| Longview Assisted Living | HAL-012-022 | 01/23/2006 | $1,350.00 | Not corrected Type B | 10A NCAC
13F .1001 Medication Administration Policies and Procedures;
13F .1004(a) Medication
Administration; G.S. 131D-21 (2) Declaration of Residents' Rights |
Residents did not receive medications as ordered | Paid in Full | $1,350.00 | 1/5/2007 |
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Concord House | HAL-013-031 | 06/02/2006 | $3,420.00 | Not corrected Type B | 10A NCAC 13F .1004(e) Medication Administration; G.S. 131D-21 (2) Declaration of Residents' Rights | Residents did not receive medications as ordered | Paid in Full | $3,420.00 | 1/8/2007 |
| Concord House | HAL-013-031 | 09/14/2006 | $6,000.00 $12,000.00 |
Type A | 10A NCAC 13F .1004 Medication Administration; G.S. 131D-21 Declaration of Residents' Rights | Resident did not receive medications as ordered, suffered withdrawal effects requiring hospitalization | Settlement Agreement 10/17/07 Appealed 10/13/06 |
||
| Concord House | HAL-013-031 | 6/19/2008 | $20,000.00 | Type A | 10A NCAC 13F .0901 (c ) Personal Care and Supervision; 10A NCAC 13F .0909 Resident Rights; G.S.131D-21 (2) Declaration of Residents' Rights | Staff failed to provide resuscitation when resident discovered unresponsive. | |||
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Walden House | HAL-018-015 | 11/19/2007 | $4,000.00 | Type A | 10 NCAC 13F .0901(b) Personal Care & Supervision; G.S. 131D-21 (2) Declaration of Residents' Rights | Facility failed to supervise two residents who were confused and disoriented who would leave the building and cross nearby four-lane highway. | Paid in Full | $4,000.00 | 12/12/2007 |
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Jones Family Care #4 | FCL-017-030 | 01/26/2006 | $1,000.00 | Type A | 10A NCAC 13G .0901(b) Personal Care and Supervision; G.S. 131D-21 Declaration of Residents' Rights | Resident locked out of facility and left unsupervised until staff returned. | Paid in Full | $1,000.00 | 3/8/2006 |
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Brooks Family Care Home | FCL-023-024 | 09/14/2006 | $2,340.00 | Not corrected Type B | 10A NCAC 13G .1002 Medication Orders; 13G .1004 Medication Administration | Medication orders were not clarified and meds administered without orders for one resident | Paid in Full | $2,340.00 | 11/2/2006 |
| Openview Retirement Center | HAL-023-004 | 01/23/2006 | $2,000.00 | Type A | 10A NCAC 13F .0307 Fire Alarm System; 13F .0901(b) Personal Care and Supervision; 13F .1212(a) Reporting of Accidents and Incidents; 13F .0407(a) Other Staff Qualifications | Staff failed to respond timely to resident in need of emergency medical services. Room was locked and staff did not have key | Paid in Full | $2,000.00 | 3/28/2006 |
| Openview Retirement Home | HAL-023-004 | 1/18/2008 | Staff Training | Type A | 10A NCAC 13F .0901(b)(c) Personal Care and Supervision; G.S. 131D-21 (2) Declaration of Residents' Rights | Resident with history of leaving previous placements without notice left facility during early morning hours; another resident informed staff of resident's absence | Training Completed 3/5/08 | ||
| Alterra Sterling House Of Shelby | HAL-023-011 | 10/30/2007 | $16,000.00 | Type A | 10A NCAC 13F .0901(b)(c) Personal Care and Supervision; G.S. 131D-21 (2) Declaration of Residents' Rights | Facility staff failed to administer CPR when resident found unresponsive | Paid in Full | $16,000.00 | 11/28/2007 |
| Unique Living | HAL-023-034 | 1/22/2007 | $16,000.00 | Type A | 10A NCAC 13F .0901 Personal Care & Supervision; 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21 (2)(4) Declaration of Residents' Rights | Resident wandered from facility, was returned and left again on same day; later found dead | Appealed
02/20/2007 Upheld 07/31/2007 Paid in Full |
$18,850.99 | 2/5/2008 |
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Lake Waccamaw Senior Living | HAL-024-009 | 1/12/2007 | $4,000.00 | Type A | 10A NCAC 13F .0901 (b) Personal Care & Supervision; G.S. 131D-21 (2) Declaration of Residents' Rights | Residents (two) wandered from facility without staff's knowledge | Paid in Full | $4,000.00 | 2/9/2007 |
| Lake Waccamaw Senior Living | HAL-024-009 | 1/9/2007 | $4,860.00 | Not corrected Type B | 10A NCAC 13F .1004 (a) Medication Administration; G.S. 131D-21 (2) Declaration of Residents' Rights | Medications were not administered as ordered | Paid in Full | $4,860.00 | 1/25/2007 |
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Alterra Sterling House of New Bern | HAL-025-012 | 2/23/2007 | $2,500.00 | Type A | 10A NCAC 13F .901 (b) Personal Care & Supervision: G.S. 131D-21 (2) Declaration of Residents' Rights | Resident wandered from facility without staff's knowledge | Paid in Full | $2,500.00 | 3/22/2007 |
| Christian Care of New Bern | HAL-025-018 | 1/9/2007 | $1,000.00 | Type A | 10A NCAC 13F .0906 (f)(4) Other Resident Care & Services; G.S. 131D-21 Declaration of Residents' Rights | Staff failed to identify resident's failure to return to facility and did not notify family or law enforcement abt. missing status | Paid in Full | $1.000.00 | 2/1/2007 |
| Croatan Village Assisted Living | HAL-025-020 | 1/9/2007 | $3,500.00 | Type A | 10A NCAC 13F .0901 (a)(h)(4) Personal Care & Supervision; G.S. 131D-21 (2) Declaration of Residents' Rights | Resident wandered from the facility without staff's knowledge | Paid in Full | $3,500.00 | 2/9/2007 |
| Homeplace of Newbern | HAL-025-014 | 01/12/2006 | $2,000.00 | Type A | 10A NCAC 13F .0305 Physical Environment; 13F .1304 Special Care Unit Bldg. Requirements; G.S. 131D-21 (2) Declaration of Residents' Rights | Two residents(confused/disoriented) wandered from the facility without staff's knowledge | Paid in Full | $2,000.00 | 2/2/2006 |
| Magnolia Place of New Bern | HAL-025-019 | 3/23/2007 | $2,500.00 | Type A | 10A NCAC 13F .1004 (a) Medication Administration; G.S. 131D-21 (2) Declaration of Residents' Rights | Staff failed to notify physician when one resident with dementia refused all medications and as result required hospitalization. | Paid in Full | $2,500.00 | 5/30/2007 |
| Riverstone | HAL-025-026 | 3/20/2008 | Staff Training | Type B Unabated | 10A NCAC 13F .1004 (a) Medication Administration; G.S. 131D-21 (2) Declaration of Residents' Rights | Medications were not administered as ordered including sliding scale insulin for 3 of 3 residents on two separate inspections | Training completed 05/16/ 2008 | ||
| The Courtyards at Berne Village | HAL-025-015 | 5/3/2007 | $1,000.00 | Type A | 10A NCAC 13F .0901 Personal Care & Supervision; G.S. 131D-21 (2)(4) Declaration of Residents' Rights | Resident (confused/disoriented) wandered from facility, was returned and left again on same day without staff knowledge. | Referred to Controller's Office | ||
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Jean's Rest Home | FCL-026-029 | 1/16/2008 | $1,720.00 | Not corrected Type B | 10A NCAC 13G .0317 (d) Building Service Equipment; G.S. 131D-21 (2) Declaration of Residents' Rights | Hot water temperatures were not maintained in a safe range for resident use | Appealed 02/15/2008 | ||
| Forest Hills Rest Home | HAL-026-003 | 01/23/2006 | $2,700.00 | Not corrected Type B | 10A NCAC 13F .1004 Medication Administration G.S. 131D-21 (2) Declaration of Residents' Rights | Staff administering medications had not completed the clinical skills validation prior to administration of medications. | Paid in Full | $2,700.00 | 3/29/2006 |
| Forest Hills Rest Home | HAL-026-003 | 01/23/2006 | $3,000.00 | Type A | 10A NCAC 13F .1004 Medication Administration; G.S. 131D-21 (2) Declaration of Residents' Rights | Medications were not administered as ordered. | Paid in Full | $3,000.00 | 3/29/2006 |
| Len-Care of Cedar Creek, Inc | HAL-026-041 | 8/27/2007 | $4,000.00 | Type A | 10A NCAC 13F .1004 (a) Medication Administration; G.S. 131D-21 (2)(4) Declaration of Residents' Rights | Medications were not administered as ordered with significant errors including residents did not receive coumidin as ordered; other resident did not receive medication for seizure disorder; residents' medications not administered based on unavailability | Referred to Controller's Office | ||
| Len-Care of Cedar Creek, Inc | HAL-026-041 | 8/27/2007 | $1,200.00 | Not corrected Type A | 10A NCAC 13F .1004 (a) Medication Administration; G.S. 131D-21 (2)(4) Declaration of Residents' Rights | Medications were not administered as ordered with significant errors including failure to adminster residents' coumidin and insulin as ordered and failure to notify physician of when resident's blood sugars were high; residents had documentation of medications not administered based on unavailablity | Referred to Controller's Office | ||
| Cross Creek Manor Assisted Living, LLC | HAL-026-050 | 6/19/2008 | $2,940.00 | Type B Unabated | 10A NCAC 13F .0311 (d) Other Requirements; G.S. 131D-21 (2) Declaration of Residents' Rights | Hot water temperatures were not maintained in a safe range for resident use | |||
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Davie Place | HAL-030-003 | Amended letter sent 1/2/2008 11/19/2007 | $18,000.00 | Type A | 10A NCAC 13F .0901 (b) Personal Care & Supervision; G.S. 131D-21 (2) Declaration of Residents' Rights | Resident utilizing oxygen was consistently noncompliant to facility's smoking policy; she continued to smoke in room with oxygen resulting in explosion | Settlement Agreement 4/4/08; Appealed 12/19/2007 |
||
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Friendly Rest Home, Inc | HAL-032-003 | 3/20/2008 | $6,160.00 | Type B Unabated | 10A NCAC 13F .0902 (b) Health Care; G.S. 131D-21 Declaration of Residents' Rights | Physicians were not notified for residents' health care needs including pressure sores, psychiatric care, PT and podiatry services | Paid in Full Settlement Agreement 6/18/2008; Appealed 03/24/2008 | $2,000.00 | 6/30/2008 |
| Love and Care Family Care Home II | FCL-032-082 | 3/20/2008 | $1,500.00 | Type A | 10A NCAC 13G .0601 (b) Management and Other Staff; G.S. 131D-21 (2) Declaration of Residents' Rights | Staff left facility leaving two residents unsupervised in facility | Paid in Full | $1,667.49 | 6/30/2008 |
| Camellia Gardens | HAL-032-071 | 9/26/2007 | Staff Training | Type A | 10A NCAC 13F .1004 (a)(1) Medication Administration; G.S. 131D-21 (2) Declaration of Residents' Rights | Resident did not receive medication as ordered | |||
| The Meadows of Oak Grove | HAL-032-063 | 2/13/2007 | $1,500.00 | Type A | G.S. 131D-21 (2)(4) Declaration of Residents' Rights | Staff reacted to resident aggression by physical "choking of resident" and verbal threat; facility did not remove staff from resident care during investigation of incident | Referred to Controller's Office | ||
| South Point Manor | HAL-032-072 | 1/12/2007 | $1,000.00 | Type A | 10A NCAC 13F .0311 Other Requirements; G.S. 131D-21 (2) Declaration of Residents' Rights | Hot water temperatures were not maintained in safe range in residents' bathrooms | Paid in Full | $1,000.00 | 2/14/2007 |
| Durham Ridge | HAL-032-080 | 11/19/2007 | $1,000.00 | Type A | 10A NCAC 13F .0901 (b) Personal Care & Supervision; G.S. 131D-21 (2) Declaration of Residents' Rights | Resident from Special Care Unit was escorted out of secured unit and left unsupervised. Resident found 6 miles from facility | Paid in Full | $1,000.00 | 11/28/2007 |
| Durham Ridge Assisted Living | HAL-032-080 | 5/14/2008 | $2,940.00 | Type B Unabated | 10A NCAC 13F .0902 (b) Health Care; G.S. 131D-21 (2) Declaration of Residents' Rights | Facility failed to assure follow-ups and referrals occurred to meet health care needs for five residents | |||
| Durham Ridge Assisted Living | HAL-032-080 | 5/14/2008 | $6,540.00 | Type B Unabated | 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Residents' Rights | Residents did not receive medications or treatments as ordered | |||
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Golden Care | HAL-031-003 | 09/14/2006 | $2,960.00 | Not corrected Type B | 10A NCAC 13F .0407(a)(5) Other Staff Qualifications; 13F .0507 Training on Cardio-Pulmonary Resuscitation; G.S. 131D-21 (2) Declaration of Residents' Rights | Criminal background checks had not been done for 3 staff members before hiring; 10 staff members did not have CPR training; 9 shifts did not have a staff member on duty that was CPR qualified | Paid in Full | $2,960.00 | 11/7/2006 |
| Moore's Family Care Home #1 | FCL-031-005 | 5/3/2007 | $1,000.00 | Type A | 10A NCAC 13G .0909 Resident Rights; G.S. 131D-21 (4) Declaration of Residents' Rights | Facility failed to protect resident from physical abuse and exploitation by staff and residents | Paid in Full | $1,000.00 | 5/11/2007 |
| Moore's Family Care Home #1 | FCL-031-005 | 6/27/2007 | $1,000.00 | Type A | 10A NCAC 13G .0317(d) Building Service Equipment; G.S. 131D-21 (2) Declaration of Resident's Rights | Hot water temperatures were not maintained in safe range in two residents' bathrooms | Paid in Full | $1,000.00 | 7/2/2007 |
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Britthaven of Tarboro | HAL-033-001 | 9/26/2007 | $3,000.00 | Type A | 10A NCAC 13F .0901 Personal Care and Supervision; G.S. 131D-21 (2) Declaration of Residents' Rights | Staff failed to supervise smoking of residents whose behaviors demonstrated need for increase supervision | Paid in Full | $3,000.00 | 10/11/2007 |
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| NaRu Family Care Home #1 (6) | FCL-034-071 | 11/1/2007 | $1,000.00 | Type A | 10A NCAC 13G .0317 (d) Building Service Equipment; G.S. 131D-21 (2) Declaration of Residents' Rights | Hot water temperatures were not maintained in safe range for resident use | Paid in Full | $1,000.00 | 12/28/2007 |
| Hines Good Samaritan Home | FCL-034-077 | 6/27/2007 | $1,770.00 | Not corrected Type B | 10A NCAC 13G .0405 Test For Tuberculosis; G.S. 131D-21 (2) Declaration of Resident's Rights | Four of five staff members providing personal care had not been tested for tuberculosis | Paid in Full | $1,770.00 | 1/16/2008 |
| The Homestead | HAL-034-032 | 6/19/2008 | $9,240.00 | Type B Unabated | 10A NCAC 13F .1004 (a) Medication Administration; G.S. 131D-21 (2) Declaration of Residents' Rights | Resident did not receive insulin medication as ordered; facility continued with medication problem for extended period | Paid in Full | $9,240.00 | 6/30/2008 |
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Alston Family Care Home | FCL-035-008 | 07/14/2006 | $2,040.00 | Not corrected Type B | 10A NCAC 13G .0405 Test For Tuberculosis; G.S. 131D-21 (2) Declaration of Residents' Rights | Personal care staff (2) had not been tested for tuberculosis | Paid in Full | $2,040.00 | 9/18/2006 |
| Louisburg Gardens | HAL-035-013 | 5/7/2007 | $2,300.00 | Not corrected Type B | 10A NCAC 13F .0902 (b) Health Care; G.S. 131D-21 (2) Declaration of Residents' Rights | Facility failed to ensure four of four residents received timely referral and follow-up for health care needs due to facility not informing practitioners or providing necessary information to ensure services provided | Settlement Agreement 09/05/2007 Combined with Type A & Not corrected Type B Penalties Appealed 05/16/2007 | Training Completed $3,250.00 | 12/26/2007 |
| Louisburg Gardens | HAL-035-013 | 6/27/2007 | $4,000.00 | Type A | 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21 (2) Declaration of Resident's Rights | Facility failed to provide supervision in accordance to assessed needs and current symptoms for three residents exhibiting aggressive or sexually inappropriate behaviors | Settlement Agreement 09/05/2007 Combined with Type A & Not corrected Type B Penalties Appealed 07/23/2007 | Training Completed $3,250.00 | 12/26/2007 |
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| South Haven Long Term | HAL-036-005 | 5/11/2007 | $3,060.00 | Not corrected Type B | 10A NCAC 13F .0407(a)(2) Other Staff Qualifications; G.S. 131D-21 (2) Declaration of Resident's Rights | Facility unable to effectively execute procedures in response to fire drill | Paid in Full | $3,060.00 | 1/3/2008 |
| Country Time Inn | HAL-036-018 | 5/3/2007 | $4,000.00 | Rescind Type A Violation Type A |
10A NCAC 13F .0311 (d) Other Requirements; G.S. 131D-21 (2) Declaration of Residents' Rights | Hot water temperatures were not maintained in a safe range for use by residents | Training Completed 3/20/08; Settlement Agreement 1/24/08 Training Appealed 05/25/2007 | ||
| Moses Manor Inc. | HAL-036-001 | 1/12/2007 | $55.00 | Not corrected Type B | 10A NCAC 13F .0406 Test for Tuberculosis; G.S. 131D-21 (2) Declaration of Resident Rights | Personal care staff (5) had not been tested for tuberculosis | Referred to Controller's Office | ||
| Rosewood Assisted Living | HAL-036-004 | 5/14/2008 | $3,240.00 | Type B Unabated | 10A NCAC 13F .1004 (a) Medication Administration; G.S. 131D-21 (2) Declaration of Residents' Rights | Medications were not administered as ordered; continued problems with ensuring finger stick blood sugars were taken as ordered and as result insulin not administered as ordered | |||
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| R&M Family Care Home | FCL-038-004 | 01/12/2006 | $1,000.00 | Type A | 10A NCAC 13G .0801 (c)(d) Resident Assessment; 13G .1002(a) Medication Orders; 13G .1004(a) Medication Administration; G.S. 131D-21 (2) Declaration of Residents' Rights | Medications were not administered as ordered. Medications orders were not clarified. Resident assessment was not completed when a significant change in condition occurred. | Paid in Full | $1,000.00 | 3/24/2006 |
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Clare Bridge at High Point | HAL-041-033 | 6/19/2008 | $3,300.00 | Type B Unabated | 10A NCAC 13F .1004 (a) Medication Administration; G.S.131D-21 (2) Declaration of Residents' Rights | Medications were not administered as ordered | |||
| Friendship Care Assisted living | HAL-041-002 | 1/5/2007 | $2,640.00 | Not corrected Type B | 10A NCAC 13F .0403 Qualifications of Medication Staff G.S. 131D-21 (2) Declaration of Residents' Rights | Two Staff administering medications had not completed the clinical skills validation prior to administration of medications. | Paid in Full | $2,899.98 | 12/4/2007 |
| Friendship Care Assisted Living | HAL-041-002 | 11/17/2006 | $12,000.00 | Type A | 10A NCAC 13F .1004(a) Medication Administration; 13F .0505 Training on Care of Diabetic Residents; G.S. 131D-21 (2) Declaration of Residents' Rights | Staff administering insulin were not trained on diabetic care prior to administering insulin. Two residents did not receive insulin as ordered. | Paid in Full | $12,000.00 | 1/23/2007 |
| Friendship Care Assisted Living | HAL-041-002 | 10/24/2006 | $5,120.00 | Not corrected Type B | 10A NCAC 13F.1004 (a) Medication Administration; G.S. 131D-21 (2) Declaration of Residents' Rights | Resident did not receive medications as ordered. | Paid in Full | $5,120.00 | 1/4/2007 |
| Friendship Care Assisted Living | HAL-041-002 | 08/22/2006 | $3,920.00 | Not corrected Type B | 10A NCAC 13F .0703 Tuberculosis Test, Medical Examination and Immunizations; 13F .1004 Medication Administration; G.S. 131D-21 (2) Declaration of Residents' Rights | Residents were not being tested for tuberculosis; medications were not administered as ordered | Paid in Full | $3,920.00 | 1/17/2007 |
| Friendship Care Assisted Living | HAL-041-002 | 07/14/2006 | $12,000.00 | Type A | 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21 (2)(4) Declaration of Residents' Rights | Staff failed to protect residents from physical abuse. | Paid in Full | $12,000.00 | 1/4/2007 |
| Friendship Care Assisted Living | HAL-041-002 | 1/18/2008 | $5,000.00 | Type A | 10A NCAC 13F .0902 (b) Health Care; 10A NCAC 13F .1004 (a) Medication Administration | Due to lack of payment, ordered medications were not obtained nor administered to 4 residents; physican was not notified of failure to obtain/adminster ordered medications | Settlement Agreement 01/17/2008 $5000.00 Paid in Full |
$5000.00 | 2/21/2008 |
| Piedmont Christian Home | HAL-041-010 | 9/6/2006 | $12,000.00 | Type A | 10A NCAC 13F .0901(b) Personal Care and Supervision; 13F .0902(b) Health Care; 13F .0909 Residents Rights; G.S. 131D-21 (2) Declaration of Residents' Rights | Interventions and safety was not provided for a resident with multiple falls when using a Meri-Walker ambulation device | Appealed 10/16/06 Settlement Agreement 6/19/2007 |
$5,000.00 Training Completed 07/11/2007 | 6/19/2007 |
| St. Gales Estates, Inc. | HAL-041-023 | 11/17/2006 | $7,500.00 | Type A | 10A NCAC 13F .0901(b) Personal Care and Supervision; 10A NCAC 13F .0305(h)(4) Physical Environment; 10A NCAC 13F .1212(e) Reporting of Accidents and Incidents; 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21 (2) Declaration of Residents' Rights | Facility failed to keep all door alarms on to alert staff of residents' exiting building. Resident wandered from facility and was struck by automobile. Resident suffered fractures | Paid in Full | $7,500.00 | 12/20/2006 |
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Core Family Care, Inc. | HAL-043-001 | 1/16/2008 | $5,700.00 | Not corrected Type B | 10A NCAC 13F .1004 (a) Medication Administration; G.S. 131D-21 (2)Declaration of Residents' Rights | Medications including insulin were not administered as ordered | Paid in Full | $5,700.00 | 3/19/2008 |
| Pinecrest Gardens | HAL-043-022 | 6/19/2008 | $3,500.00 | Type B Unabated | 10A NCAC 13F .0904 (e)(4) Nutrition and Food Service; G.S. 131D-21 (2) Declaration of Residents' Rights | Facility failed to serve residents ordered therapeutic diets | |||
| Oak Hill Living Center | HAL-043-015 | 3/20/2008 | $4,000.00 | Type A | 10A NCAC 13F .0904 (e)(4) Nutrition and Food Service; G.S. 131D-21 (2) Declaration of Residents' Rights | Facility failed to serve 5 of 8 residents therapeutic diets and thickened liquids as ordered | |||
| Oak Hill Living Center | HAL-043-015 | 5/15/2008 | $7,000.00 | Type A | 10A NCAC 13F .0902 (b) Health Care; G.S. 131D-21 (2) Declaration of Residents' Rights | Facility failed to provide residents with follow-up and referrals for routine and acute health care needs including high blood sugars, weight loss, and pain | Paid in Full | $7,000.00 | 6/25/2008 |
| Oak Hill Living Center | HAL-043-015 | 5/15/2008 | $3,350.00 | Type B Unabated | 10A NCAC 13F .1004 (a) Medication Administration; G.S. 131D-21 (2) Declaration of Residents' Rights | Medications were not administered as ordered including insulin | Paid in Full | $3,350.00 | 6/25/2008 |
| Primrose Villa Retirement IV | HAL-043-019 | 3/20/2008 | $1,080.00 | Type B Unabated | 10A NCAC 13F .0311 (d) Other Requirements; G.S. 131D-21 (2) Declaration of Residents' Rights | Hot water temperatures were not maintained in safe range for use in resident and community baths | Paid in Full | $1,080.00 | 6/30/2008 |
| Pinecrest Gardens of Lillington | HAL-043-012 | 8/27/2007 | Staff Training | Type A | 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21 (2) Declaration of Resident's Rights | Facility failed to supervise smoking activities of resident with dementia residing in the facility's locked unit. Resident had previously had a fire in her bathroom. | Training Completed | 10/10/2007 | |
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Cherry Springs Village | HAL-045-099 | 6/19/2008 | $4,000.00 | Type A | 10A NCAC 13F .1004 (a) Medication Administration; G.S. 131D-21 (2) Declaration of Residents' Rights | Medications were not administered as ordered; resident did not receive coumadin as ordered | |||
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Twin Oaks Rest Home | HAL-046-002 Proposal #1 | 4/5/2007 | $810.00 | Not corrected Type B | 10A NCAC 13F .0407 (a) (5) Other Staff Qualifications; G.S. 131D-21 (2) Declaration of Residents' Rights | Healthcare registry verifications were not conducted for six staff | Paid in Full | $810.00 | 8/30/2007 |
| Twin Oaks Rest Home | HAL-046-002 Proposal #2 | 4/5/2007 | $810.00 | Not corrected Type B | 10A NCAC 13F .0407 (a) (7) Other Staff Qualifications; G.S. 131D-21 (2) Declaration of Residents' Rights | Criminal background checks were not conducted for five staff | Paid in Full | $810.00 | 8/30/2007 |
| Twin Oaks Rest Home | HAL-046-002 Proposal #3 | 4/5/2007 | $810.00 | Not corrected Type B | 10A NCAC 13F .0406 (a) Test for Tuberculosis; G.S. 131D-21 (2) Declaration of Residents' Rights | Five of seven staff did not have tuberculois tests | Paid in Full | $810.00 | 8/30/2007 |
| Twin Oaks Rest Home | HAL-046-002 Proposal #4 | 4/5/2007 | $1,080.00 | Not corrected Type B | 10A NCAC 13F .1004 (a) Medication Administration; G.S. 131D-21 (2) Declaration of Residents' Rights | Medications were not administered as ordered for 7 of 8 residents | Paid in Full | $1,080.00 | 8/30/2007 |
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Open Arms Retirement Center | HAL-047-003 | 1/30/2007 | $5,250.00 | Not corrected Type B | 10A NCAC 13F .0406 (a) Test for Tuberculosis; 10A NCAC 13F .0504 (a) Competency Validation for Licensed Health Professional Support Task; G.S. 131D-21 (2) Declaration of Residents' Rights | Three of 13 staff did not have tuberculosis test; ten of 13 staff were not competency validated before providing licensed health professional tasks such as oxygen administration, changing dressings, catheter care, using hoyer lift, and other services | Settlement Agreement 3/13/08; Appealed 3/2/07 | ||
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Clayton House | HAL-051-028 | 6/27/2007 | $5,360.00 | Not corrected Type B | 10A NCAC 13F .1004 Medication Administration; G.S. 131D-21 (2) Declaration of Resident's Rights | Medications were not administered as ordered for 7 of 16 residents | Settlement Agreement 4/4/08; Appealed 7/27/07 |
||
| Cardinal Care Assisted Living | HAL-051-030 | 9/26/2007 | Staff Training | Type A | 10A NCAC 13F .0902 (b) Health Care; 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21 (2) Declaration of Residents' Rights | Staff failed to clarify orders with physician which resulted in resident not receiving insulin as ordered | Training Completed | 12/23/2007 | |
| Cardinal Care Assisted Living Village #2 | HAL-051-032 | 11/19/2007 | $3,600.00 | Not corrected Type B | 10A NCAC 13F .0901 (b) Personal Care and Supervision; G.S. 131D-21 (2) Declaration of Residents' Rights | Facility failed to supervise resident's smoking behavior. Resident smoked in his room | Paid in Full | $3,600.00 | 1/17/2008 |
| Four Oaks Assisted Living | HAL-051-026 | 9/26/2007 | $7,000.00 | Type A | 10A NCAC 13F .0901 (b) Personal Care and Supervision; G.S. 131D-21 (2) Declaration of Residents' Rights | Staff failed to supervise the smoking activities of residents whose behavior demonstrated the need for increased supervision | Paid in Full | $7,000.00 | 11/28/2007 |
| Front Street Family Care Home | FCL-051-017 | 02/14/2006 | $2,000.00 | Type A | 10A NCAC 13G .1004(a) Medication Administration; G.S. 131D-21 Declaration of Residents' Rights | Medication not administered as ordered for one resident | Paid in Full | $2,000.00 | 4/28/2006 |
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Leaks Family Care | FCL-053-013 | 8/29/2006 | Staff Training | Not corrected Type B | 10A NCAC 13G .1004(a) Medication Administration; G.S. 131D-21 (2) Declaration of Residents Rights | Medications not administered as ordered | Training Completed | 10/30/2006 | |
| Ashewood Estates Retirement | HAL-053-011 | 5/14/2008 | $16,000.00 | Type A | 10A NCAC 13F .0901 (b) Personal Care & Supervision; 10A NCAC 13F .0902 (b) Health Care G.S. 131D-21 (2) Declaration of Residents' Rights | Facility failed to implement measures to prevent falls; physician notification and medical assessment/treatment was not obtained for resident who fell and those who had acute and routine healthcare needs | |||
| Facility Name | License Number | Penalty Issued Date | Penalty Amount | Penalty Type | Reason for Issuance | Current Status | Amount Paid | Date of Payment | |
|---|---|---|---|---|---|---|---|---|---|
| Rule Cited | Nature of Violation | ||||||||
| Oakdale Heights Senior Living | HAL-060-062 | 04/06/2006 | $1,000.00 | Not corrected Type B | 10A NCAC 13F .1004(a) Medication Administration; 13F .0909 Residents Rights; GS 131D-4.4 Adult Care Home Minimum Safety Requirements Rights | Medication for one resident not administered as ordered | Paid in Full | $1,000.00 | 5/12/2006 |
| Slay's Rest Home | HAL-060-038 | 8/27/2007 | $9,120.00 | Not corrected Type B | 10A NCAC 13F .0507 Training On Cardio-Pulmonary Resuscitation; G.S. 131D-21 (2) Declaration of Residents' Rights | Facility failed to to ensure at least one staff on duty at all times who had CPR course. Facility failed to correct noncompliance for 98 days past date given for correction | Paid in Full | $10,090.00 | 12/21/2007 |
| Slay's Rest Home | HAL-060-038 | 8/27/2007 | $7,840.00 | Not corrected Type B | 10A NCAC 13F .0407 (a)(7) Other Staff Qualifications; G.S. 131D-21 (2) Declaration of Residents' Rights | Criminal background checks for 4 of 5 staff were not conducted. Facility failed to correct noncompliance for 98 days past date given for correction | Paid in Full | $8,676/00 | 12/13/2007 |
| Willow Ridge Assisted Living | HAL-060-070 | 6/2/2006 | $2,500.00 | Type A | |||||