Deficiency Records for Universal Health Care/fuquay-Varina
Updated as of March 01, 2022
This is not the most recent data for Universal Health Care/fuquay-Varina. For the most recent information, click here.
A list of the most recent deficiencies for Universal Health Care/fuquay-Varina. The list is based on the information provided by CMS from both standard inspections and from complaints filed by residents.
| Deficiency | Type of Deficiency | Deficiency Date | Date Corrected | Resulted from a Complaint? |
|---|---|---|---|---|
| Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2021-09-20 | 2021-10-01 | Y |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2021-09-20 | 2021-10-01 | Y |
| Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | Health | 2021-06-11 | 2021-09-20 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2021-09-20 | 2021-09-01 | Y |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2021-06-11 | 2021-08-06 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2021-06-11 | 2021-08-06 | Y |
| Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | Health | 2021-06-11 | 2021-08-06 | Y |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2021-06-11 | 2021-08-06 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2021-06-11 | 2021-08-06 | Y |
| Provide enough food/fluids to maintain a resident's health. | Health | 2021-06-11 | 2021-08-06 | Y |
| Allow residents to self-administer drugs if determined clinically appropriate. | Health | 2021-06-11 | 2021-08-06 | N |
| Reasonably accommodate the needs and preferences of each resident. | Health | 2021-06-11 | 2021-08-06 | N |
| Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | Health | 2021-06-11 | 2021-08-06 | N |
| Assess the resident when there is a significant change in condition | Health | 2021-06-11 | 2021-08-06 | N |
| Assure that each resident?s assessment is updated at least once every 3 months. | Health | 2021-06-11 | 2021-08-06 | N |
| Ensure each resident receives an accurate assessment. | Health | 2021-06-11 | 2021-08-06 | N |
| Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | Health | 2021-06-11 | 2021-08-06 | N |
| Notify the appropriate authorities when residents with MD or ID services has a significant change in condition. | Health | 2021-06-11 | 2021-08-06 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2021-06-11 | 2021-08-06 | N |
| Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | Health | 2021-06-11 | 2021-08-06 | N |
| Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | Health | 2021-06-11 | 2021-08-06 | N |
| Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | Health | 2021-06-11 | 2021-08-06 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2021-06-11 | 2021-08-06 | N |
| Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | Health | 2021-06-11 | 2021-08-06 | Y |
| Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Health | 2021-06-11 | 2021-08-06 | Y |
| Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | Health | 2021-04-05 | 2021-06-11 | Y |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2020-08-10 | 2020-08-31 | Y |
| Have exits that are accessible at all times. | Fire Safety | 2019-12-17 | 2019-12-18 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2019-12-17 | 2019-12-18 | N |
| Keep residents' personal and medical records private and confidential. | Health | 2019-11-16 | 2019-12-07 | N |
| Ensure each resident receives an accurate assessment. | Health | 2019-11-16 | 2019-12-07 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2019-11-16 | 2019-12-07 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2019-11-16 | 2019-12-07 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2019-11-16 | 2019-12-07 | N |
| Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | Health | 2019-11-16 | 2019-12-07 | N |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2019-02-15 | 2019-03-19 | N |
| PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2019-02-15 | 2019-03-19 | N |
| Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Health | 2019-02-15 | 2019-03-19 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2019-02-15 | 2019-03-19 | N |
| Provide and implement an infection prevention and control program. | Health | 2019-02-15 | 2019-03-19 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2019-02-15 | 2018-08-27 | N |
