Clayton Rehab: Nurses Deployed Without Competency Checks - NC
The facility's staff development coordinator couldn't find the records. The former Director of Nursing said she thought someone else had handled it. The interim Director of Nursing said the nurses should have known how to do their jobs. On the afternoon of October 30, 2025, the Administrator, Regional Clinical Director, and Regional Director of Operations searched together and confirmed what everyone else had already discovered: no completed licensed nurse competency checklist existed for Nurse 5 or Nurse 6.
Both nurses had completed a medication administration evaluation, a separate form. That was it.
The staff development coordinator, referred to in the inspection report as the SDC Nurse, described what the facility's competency process was supposed to cover. Newly hired nurses were taught where crash carts were located, how to check a resident's code status, what to do when a resident was found unresponsive, how to access the treatment cart and supply room, and when to call a provider. There was a column on the competency form specifically for noting whether a nurse needed additional training.
None of that documentation existed for Nurse 5 or Nurse 6.
The SDC Nurse told inspectors she had only been working part time for portions of the year and believed that Unit Managers and the former DON had been picking up competency validations during her reduced hours. She did not know who specifically was doing them. She was not sure what, if anything, had been completed.
She did know there had been some kind of medication competency concern involving Nurse 5. She thought the former DON was supposed to follow up. She did not know whether the issue had ever been resolved.
The former DON, interviewed separately, said she was aware of one isolated incident involving Nurse 5: he had failed to watch a resident take medication to confirm the resident actually swallowed it. She did not know whether any follow-up had occurred. She thought the SDC Nurse would have that information.
The SDC Nurse thought the former DON had it.
The interim DON, who had been the Unit Manager at the time a resident identified in the report as Resident 1 was admitted, described what Nurse 5 should have known on that admission date. The other Unit Manager and the former DON had helped enter orders into the electronic record. Nurse 5 had been told the resident had arrived and that the resident was his responsibility. He had access to the electronic medical record and the orders within it. He should have known not to text the nurse practitioner. If communication with the NP was necessary, he should have called her.
The inspection report does not detail what Nurse 5 did or did not do in caring for Resident 1 beyond that reference. What it documents is the absence of any formal verification that he had the skills to handle what he encountered.
The SDC Nurse had completed a competency checklist for one nurse, Nurse 2. That form was signed by both the SDC Nurse and Nurse 2. Under the category of medical emergencies, Nurse 2 had given herself a self-evaluation score of 4, indicating she felt confident. The SDC Nurse signed off that the competency was validated.
For Nurse 5 and Nurse 6, there was no form at all. No self-evaluation. No validator signature. No record of what either nurse knew or didn't know when they began caring for residents at Clayton Rehabilitation.
The deficiency was cited at a level of minimal harm or potential for actual harm.
Whether Nurse 5's unresolved medication issue was ever addressed, and what he did in the hours after Resident 1 arrived under his care, the inspection report leaves unanswered.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Clayton Rehabilitation and Healthcare Center from 2025-10-30 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: June 23, 2026 · Our methodology
Clayton Rehabilitation and Healthcare Center in Clayton, NC was cited for violations during a health inspection on October 30, 2025.
The facility's staff development coordinator couldn't find the records.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.