Elevate Health And Rehabilitation

#98 and her lacosamide. He said he thought the missed lacosamide doses were a mistake and that it

jeopardy to resident health or would be hard to say a particular number of missed doses exactly that would lead to a seizure safety because she had seizures even on her medications. He was unable to recall the date of Resident #98's last seizure prior to 1/14/25.

Medical Director #3 said Resident #98's infection likely

complications the resident had.

Medical Director #3 stated he thought the missed doses of lacosamide may have contributed to her possibly having a seizure but that she was on other seizure medications.

He agreed Resident #98's nine (9) missed doses of lacosamide would lower her seizure thresh hold making her more likely to have a seizure. He said he did not think Resident #98 not getting her lacosamide was alright by any means. An interview was conducted with the Administrator, the Administrator in Training (AIT), and the Director of Nursing (DON) on 08/28/2025 at 4:30 PM.

The DON stated she had not been the DON in January.

The Administrator primarily spoke during the interview.

The Administrator reported Resident #98 had been hospitalized and returned to the facility on 1/4/25.

She could not recall the reason for that hospitalization.

She explained she believed the hospital had given a prescription for a 3-day supply of lacosamide.

The Administrator said the pharmacy did not have a prescription to refill the lacosamide, but the nursing department had thought the pharmacy had the prescription.

The Administrator stated the nurse, she said she did not know which one specifically, had called the pharmacy about the medication and had been told the medication would arrive.

The Administrator stated when the medication did not arrive the nurse notified the physician and got an order to hold the medication until it came from the pharmacy.

She reported during the hold process of the medication; she thought it was Nurse #1 who had called the pharmacy to check on the medication and had been told it was coming.

The Administrator explained that on the morning of 1/14/25, Resident #98's lacosamide was not available and Medical Director #1 was in the building so Nurse #1 had gone to him about the lacosamide, and Medical Director #1 sent a prescription to the pharmacy that morning.

The Administrator reported then later that same morning Resident #98 had a seizure.

She stated Medical Director #1 was in the building at the time and had gone to see Resident #98.

She reported that the Medical Director had tried to do things at the facility to stop the seizure, but it was not effective, and Resident #98 was sent out to the hospital by EMS.

The Administrator explained the assigned nurse was responsible for contacting the provider for a prescription when needed and that the nurse should have gotten the prescription.

She said when the medication did not arrive from pharmacy the nurse should have escalated that by letting the DON or management know the medication had not come.

The Administrator reported it should have been identified in the morning clinical meeting by the DON, Unit Manager, or Staff Development Coordinator that typically attended the morning clinical meeting that Resident #98's lacosamide was not available.

The Administrator said she thought it had been mentioned in the clinical morning meeting about the lacosamide not being there, but it was assumed that since there was a hold order obtained from the physician the physician was aware, and the medication was in the process of being delivered.

The Administrator said at the time, nursing was not following processes.

The Administrator indicated nurses were to contact the pharmacy before a medication ran out and were to notify the provider a new prescription was needed before a medication ran out.

She said there was not good oversight by the former DON and there had not been thorough clinical meetings at the time.

She explained that was why changes in management were made and why corporate management had been in the building to make changes.

The Administrator said lacosamide was not an available medication in the facility's back up medication system.

She stated the nurse should have been persistent in obtaining the controlled prescription for the lacosamide and said it was their duty as a nurse to obtain it.

The Administrator said Resident #98's missed doses of lacosamide was a significant medication error.

The Administrator was notified of immediate jeopardy on 8/27/25 at 5:40 PM.

The facility provided the following Corrective Action Plan with a correction date of 1/22/25: 1.

How will corrective action be accomplished f

Federal health inspectors cited Elevate Health and Rehabilitation in Asheville, NC for a deficiency under regulatory tag F-F0812 during a standard health inspection conducted on 2025-09-02.

Category: Nutrition and Dietary Deficiencies

The facility was found deficient in the following area: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Scope/Severity Level E: pattern, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 3 deficiencies cited during this inspection of Elevate Health and Rehabilitation.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-09-17.