Peak Resources-Shelby: Infection Control Gaps - NC
The resident, identified in inspection records only as Resident #75, was admitted to the facility with type 2 diabetes. On November 25, 2025, a physician assistant ordered semaglutide, a drug prescribed to help regulate her blood sugars and assist with weight loss. The order called for a subcutaneous injection once a week, every Monday.
The pharmacy never filled it. The facility sent the order on November 25, but left out the dosage. The pharmacist, reached by phone during the February inspection, said he received the original order without dosage information and could not dispense the drug. A corrected order was eventually sent, and the medication was delivered sometime later, though the inspection report does not specify the exact date. Resident #75 told inspectors she did not receive her first dose until January 2026, roughly six weeks after it was prescribed.
What the medical record showed during those six weeks was something different entirely.
The Medication Administration Record for December 1 indicated that Nurse #2, working the 7:00 AM to 7:00 PM shift, had administered semaglutide to Resident #75 at 8:00 AM. For December 8, the same nurse documented that the resident refused the medication. For December 15, she noted the dose was not given because the facility was awaiting delivery from the pharmacy.
When inspectors interviewed Nurse #2 on February 9, she told them the medication was not available on any of those three dates. It was not available December 1, not available December 8, not available December 15. She said she documented the December 1 administration in error and that the December 8 refusal notation was also wrong. She said she should have written that the medication was unavailable on both dates.
The December 15 entry, at least, came closer to the truth, though the medication had been unavailable since the start, not just that week.
Resident #75 is cognitively intact, according to her quarterly assessment. She told inspectors directly what had happened: the drug was ordered in November, and she didn't get it until January.
The administrator, interviewed on February 11, said she had no idea Resident #75 had gone without the medication because it was never delivered. She said that when a medication is not administered, staff are expected to document the real reason accurately in the resident record.
That did not happen here. For two of the three missed doses, the nurse recorded something other than what occurred, once logging an administration that never took place, once attributing the missed dose to the resident's own refusal when the resident had never been offered the medication at all.
Inspectors attempted to reach the former Director of Nursing multiple times. They were unsuccessful.
The deficiency was cited at a level of minimal harm or potential for actual harm. Whether six weeks without a prescribed diabetes medication constitutes minimal harm to the resident who went without it is a question the inspection report does not answer. Semaglutide, sold under brand names including Ozempic and Wegovy, is used to lower blood sugar in people with type 2 diabetes and carries FDA approval for that purpose. Resident #75's physician assistant prescribed it specifically because her blood sugars needed regulating.
She waited six weeks. The record, for most of that time, said otherwise.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Peak Resources- Shelby from 2026-02-11 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: August 5, 2026 · Our methodology
Peak Resources- Shelby in Grover, NC was cited for violations during a health inspection on February 11, 2026.
The resident, identified in inspection records only as Resident #75, was admitted to the facility with type 2 diabetes.
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.