Autumn Care Of Waynesville
Inspection Findings
F-Tag F0880
F 0880
Provide and implement an infection prevention and control program.
Level of Harm - Minimal harm or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
observations, record review, and staff interviews, the facility failed to implement their policy for Enhanced Barrier Precautions (EBP) for a resident (Resident #3) when Nurse #1 performed wound care without donning a gown. The deficient practice occurred for 1 of 1 staff member (Nurse #1) observed for infection control practices during wound care.Findings included:The facility's Enhanced Barriers policy last revised 5/19/2025 revealed EBP are indicated for high contact care activities for high-risk residents. High-risk residents are those with chronic wounds and indwelling devices. Staff engaging in high-contact activities will don (put on) both gloves and gown before initiating the activity and remove before exiting the room.
Review of Resident #3's 5-day Minimum Data Set, dated [DATE REDACTED] revealed he had an unstageable pressure injury. An observation was conducted on 9/09/25 at 10:38 AM while Resident #3 received wound care to his left heel. Nurse #1 was observed to enter Resident #3's room without a gown. Nurse #3 performed hand hygiene and donned gloves. She removed the soiled dressing, removed her gloves and performed hand hygiene. She donned gloves and washed and dried the wound and removed her gloves. She performed hand hygiene, donned gloves, applied skin prep, applied clean gauze, covered wound with pad and clean gauze which was secured with tape. She removed her gloves and performed hand hygiene. She did not wear a gown during the process. An interview on 9/09/25 at 10:50 AM with Nurse #1 revealed she had forgotten to wear her gown during wound care. She stated she had received infection prevention education
on EBP and knew she was supposed to follow EPB during wound care, but her nerves had gotten the better of her. An interview on 9/09/25 at 12:05 PM with the Director of Nursing and the Administrator revealed Nurse #1 had received Infection Prevention training and should have worn a gown during wound care. They stated Nurse #1 was nervous and had made a human mistake.
Residents Affected - Few
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date
these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE
TITLE
(X6) DATE
FORM CMS-2567 (02/99) Previous Versions Obsolete
Facility ID:
If continuation sheet
Event ID:
Autumn Care of Waynesville in Waynesville, 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 Waynesville, 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 Autumn Care of Waynesville or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.