Hagerstown Healthcare Center
Hagerstown Healthcare Center in HAGERSTOWN, MD — inspection on October 23, 2025.
Found 2 citations. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
During the interview on 10/23/25 at 10:00 AM, Staff #2 reviewed Resident #1's behavior monitoring.
She acknowledged that it did not identify the non-pharmacological interventions staff should implement when resident #1 was exhibiting behaviors.
When asked what she would do, she stated I would talk to him/her, redirect him/her, or offer something to read.
When asked how she would know what Resident #1's individualized interventions were, she stated, Well, I know the resident I know what [he/she] likes.
You gotta know your residents.
When asked how someone who isn't familiar with the resident would know what to attempt, she stated I don't know, it should be written in the behavior monitoring record.
On 10/23/25 at 11:08 AM the above concerns were reviewed with the Administrator, the Mobile Director of Nursing, and Staff #1 the Infection Prevention Nurse.
Facility ID:
IDENTIFICATION NUMBER:
A.
Building
COMPLETED
10/23/2025
STREET ADDRESS, CITY, STATE, ZIP CODE
Hagerstown Healthcare Center
750 Dual Highway Hagerstown, MD 21740
SUMMARY STATEMENT OF DEFICIENCIES
Based on medical record review and staff interview, it was determined that the facility staff failed to keep complete and accurate medical records by failing to ensure a resident had only one unvoided MOLST in the medical record.
This was evident for 1 (#3) of 4 residents reviewed during a complaint survey.The findings include: Maryland MOLST (Maryland Orders for Life Sustaining Treatment) is a portable and enduring medical order form covering options for cardiopulmonary resuscitation and other life-sustaining treatments.
The medical orders are based on a patient's wishes about medical treatments.
Per the MOLST instructions: Updating the Form: The MOLST form shall be voided and a new MOLST form prepared when there is a change to any of the orders. If modified, the physician, NP, or PA shall void the old form and complete, sign, and date a new MOLST form.
Voiding the Form: To void this medical order form, the physician, NP, or PA shall draw a diagonal line through the sheet, write VOID in large letters across the page, and sign and date below the line. A nurse may take a verbal order from a physician, NP, or PA to void the MOLST order form.
Keep the voided order form in the patient's active or archived medical record.On 10/22/25 at 1:30 PM, a review of Resident #3's electronic medical record (EMR) was conducted. In the Miscellaneous section of the EMR, a review of the documents scanned into the EMR revealed voided MOLST forms and copies of the corresponding original, unvoided MOLST form:- There was a scanned copy of an unvoided MOLST dated 7/7/25 and a copy of the 7/7/25 MOLST that was voided on 7/17/25- There was a scanned copy of an unvoided MOLST dated 7/17/25 and a copy of the 7/17/25 MOLST that was voided on 9/22/25.- There was a scanned copy of an unvoided MOLST dated 9/22/25 and a copy of the 9/22/25 MOLST that was voided on 10/14/25.- There was a scanned copy of an unvoided MOLST dated 10/14/25 and a copy of the 10/14/25 that was voided on 10/15/25.On 10/23/25 at 11:00 AM, during an interview, Staff #5, Social Worker (SW) stated that resident MOLST forms were uploaded in the EMR.
The SW stated that when a new MOLST was created, the old MOLST would be voided; a copy of the new MOLST and a copy of the voided MOLST would then be uploaded into the EMR.
The SW stated that a copy of the original, unvoided MOLST that corresponded with the voided MOLST would be kept in the resident's EMR because medical records were not to be deleted, and having voided and unvoided MOLST forms in the EMR showed a trail.Following the interview, the concerns with Resident #3 having more than one unvoided MOLST in the EMR and the guidance that a resident have only one active MOLST in his/her medical record were discussed with the Nursing Home Administrator (NHA) and the SW, who acknowledged the concerns, and offered no further comments at that time
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