Piedmont Hills Center For Nursing And Rehab
Inspection Findings
F-Tag F0580
F 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
(DON) on 10/23/25 at 12:10 PM. The DON indicated she recalled being summoned to Resident #5's room by Nurse #4 around 6:40 PM on 9/3/25. The DON revealed when she entered Resident #5's room she observed a bump over Resident #5's left eye and spoke to the RP for about 10 minutes. The DON indicated that during the conversation they discussed hospice and hospitalization. The DON also indicated she would have wanted Nurse #3 to notify the provider at the time when Resident #5's pulse dropped below 60 bpm and would have wanted Nurse #4 to notify the On-Call NP immediately when Nurse #4 observed the injury to Resident #5's head.An interview was conducted with the Administrator 10/23/25 12:55 PM. The Administrator indicated Nurse #3 and Nurse #4 should have notified the provider immediately of any change in condition.
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Printed: 04/13/2026 Form Approved OMB No. 0938-0391
Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
10/23/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Piedmont Hills Center for Nursing and Rehab
109 S Holden Road Greensboro, NC 27407
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F-Tag F0684
F 0684 Level of Harm - Actual harm Residents Affected - Few
11:30 AM and it was unwitnessed. Nurse #3 recalled observing Resident #5 on the floor on the side of his bed. Nurse #3 indicated Resident #5 was fully assessed , had no injuries and the Director of Nursing , NP and the RP were notified. She also indicated that the NP was in the facility at the time of the first fall and was able to assess Resident #5 between the 1st and 2nd falls. The 2nd fall occurred on 9/3/25 at 1:00 PM and was witnessed either by Nurse #4 or the Staff Development Coordinator (SDC) who was the unit manager at that time and Nurse #3 recalled Nurse #4 reporting the incident to her. Nurse #3 indicated that
she thought Nurse #4 completed the post fall assessment and Resident #5 was already assisted to the wheelchair when she was notified of the 2nd fall. Nurse #3 revealed she noted on the incident report that
the 2nd fall was unwitnessed in error and that she did not obtain witness statements and did not report a low pulse rate of 56 at 12:00 PM and again at 12:15 PM to the medical provider at that time. Nurse #3 could not explain why she did not notify the NP of the low pulse rate, but it should have been reported to the provider at that time.
A telephone interview was conducted with the SDC on 10/23/25 at 12:30 PM and she did not recall witnessing Resident #5's falls on 9/3/35 or completing any documentation related to a fall.
An interview was conducted with the RP on10/21/25 at 5:00 PM. The RP revealed she was notified of both Resident #5's falls that occurred on 9/3/25 and came to the facility at approximately 3:00 PM on 9/3/25 to check on the resident. The RP indicated upon her arrival Resident #5 was observed seated in his wheelchair at the nurse's station for monitoring and she did not observe any head injury at that time. The RP further explained that she assisted Resident #5 back to the room and did not recall any staff members that came to Resident #5's room to check on him between the hours of 3:00 PM and 5:00 PM and neither Nurse #3 or Nurse #4 had not come into the room to complete any neurological or vital sign checks from 3:00 PM until Resident #5 was sent to the hospital. The RP indicated that around 5:00 PM she had observed a large bump that had formed over Resident #5's left eye and slightly swollen lip and notified Nurse #4 when he entered Resident #5's room. The RP indicated that around 5:00 PM she requested Nurse #4 notify someone in charge that she wanted to speak to them as she felt that the staff had not been monitoring Resident #5 and may require hospitalization. The RP revealed the Director of Nursing (DON) came to Resident #5's room around 6:30 PM to discuss h
FORM CMS-2567 (02/99) Previous Versions Obsolete
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Piedmont Hills Center for Nursing and Rehab in Greensboro, NC inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
Frequently Asked Questions
- What is an F-tag violation?
- F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
- Were these violations corrected?
- Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
- How often do nursing home inspections happen?
- CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
- What should families do about these violations?
- Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in Greensboro, NC, (5) Report new concerns to state authorities.
- Where can I see the full inspection report?
- Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from Piedmont Hills Center for Nursing and Rehab or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.