Third Avenue Health & Rehab: Insulin Delay - Kingston, PA
A resident at Third Avenue Health & Rehab Center on 702 Third Avenue had been prescribed degludec, a long-acting insulin, to control his blood sugar. He had diabetes. He was cognitively intact, scoring a 14 out of 15 on a standardized mental status assessment. He knew exactly what was happening.
The facility had sent two notifications to the pharmacy requesting the medication: one on March 16 at 10:27 PM, and another on March 17 at 6:25 PM, hours before the supply ran out entirely. Neither notification produced the medication in time. Nobody documented that staff followed up to confirm the insulin had actually been obtained and was ready for administration.
Nine o'clock came and went. The insulin wasn't there.
At 3:00 AM on March 18, staff woke the resident to give him the injection, six hours after it was due. His blood sugar measured 346 milligrams per deciliter at that point. Normal fasting levels run between 70 and 120. His was nearly three times the upper limit of that range.
The resident confirmed it himself during an interview with inspectors on March 26. The ordered insulin was not available at the scheduled time, he told them. Staff had woken him in the middle of the night to administer it.
The Director of Nursing, interviewed on March 27, confirmed the sequence: two pharmacy notifications sent before the supply depleted, no documented evidence the facility verified the medication was actually on hand before the scheduled dose time.
The inspection report, completed March 27, 2026, cited the facility for failing to ensure timely acquisition and availability of prescribed medications. The violation was tagged at a level of minimal harm or potential for actual harm, affecting one of 20 residents reviewed.
What the report describes is a gap that ran for at least six hours, across a medication that exists specifically to prevent blood sugar from going uncontrolled overnight. Degludec is a long-acting insulin, meaning it is designed to provide a steady baseline of glucose control through the night and into the next day. Missing a dose by six hours doesn't just delay relief — it leaves that baseline absent during the hours the body is fasting and not receiving any food to moderate the effect.
A blood glucose reading of 346 is in the range associated with symptoms including fatigue, increased thirst, blurred vision, and in more serious cases, the beginning of diabetic ketoacidosis, a condition that can become life-threatening if untreated. The inspection report does not document whether the resident experienced any of those symptoms. It records the number, and the number is stark on its own.
The facility's own emergency delivery policy, dated February 24, 2026, less than a month before this incident, required staff to immediately notify the pharmacy when a physician order requires emergency medication delivery. Notifications were sent. What wasn't done was making sure those notifications worked.
The resident was awake at 3:00 in the morning, being given an injection he should have received six hours earlier, with a blood sugar reading that told its own story about what those six hours had cost him.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Third Avenue Health & Rehab Center from 2026-03-27 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 18, 2026 · Our methodology
THIRD AVENUE HEALTH & REHAB CENTER in KINGSTON, PA was cited for violations during a health inspection on March 27, 2026.
A resident at Third Avenue Health & Rehab Center on 702 Third Avenue had been prescribed degludec, a long-acting insulin, to control his blood sugar.
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.