Weirton Medical Center

F-F689 the following concern regarding water temperatures:

- Water temperature of 124 degrees Fahrenheit will cause a 3rd degree burn in 3 minutes.

- Water temperature of 120 degrees Fahrenheit will cause a 3rd degree burn in 5 minutes.

- Burns can occur even at water temperatures below those identified, depending on an individual's condition and the length of exposure.

-Third-degree burns penetrate the entire thickness of the skin and permanently destroy tissue. These present as loss of skin layers, often painless (pain may be caused by patches of first- and second-degree burns surrounding third-degree burns), and dry, leathery skin. Skin may appear charred or have patches that appear white, brown, or black.

b) Water Temperatures

On 06/24/24 at 2:30 PM, the water temperature of the sink in room [ROOM NUMBER] was tested by Maintenance Worker #26 under observation of the surveyor. The water temperature was tested by inserting

the stem of the thermometer into the stream of running water, so that the sensor was fully immersed. A water temperature of 120.5 degrees Fahrenheit was reached. Maintenance Worker #26 stated he knew it was undesirable to have a water temperature at or above 120.0 degrees Fahrenheit.

The following areas of the facility were also tested by Maintenance Worker #26 under observation of the surveyor and had temperatures greater than 110 degrees Fahrenheit.

- The shower room sink had a water temperature of 124.0 degrees Fahrenheit.

- The sink in room [ROOM NUMBER] had a water temperature of 123.2 degrees Fahrenheit.

During an interview, on 06/24/24 at 3:55 PM, the Director of Nursing confirmed that plant maintenance staff would ensure all water temperatures were immediately addressed to ensure resident safety.

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 9 of 14 515077 Department of Health & Human Services Printed: 09/22/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 515077 B. Wing 06/26/2024

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Weirton Medical Center 601 Colliers Way Weirton, WV 26062

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 0692 Provide enough food/fluids to maintain a resident's health.

Level of Harm - Minimal harm or 42120 potential for actual harm Based on staff interview and medical record review the facility failed to ensure resident #92 received an Residents Affected - Few adequate amount of nutrition. This was true for one (1) of (1) residents reviewed for nutrition. Resident identifier #92. Facility census 24.

Findings included:

a) Resident #92

An observation on 06/24/24 at 1:14 PM the lunch tray was sitting in front of resident, she was not eating, no assistance was offered or observed during meal.

A second observation on 06/25/24 at 1:32 PM her lunch meal was not consumed and just sitting in front of resident.

A medical record review revealed a physician's order for a diabetic regular diet. No weights or nutritional assessments were documented during her admission to the skilled unit.

A subsequent review of meal intakes revealed the resident's percentages were 0-25 eaten during meals.

During an interview on 06/26/24 at 12:23 PM the Director verified that no weight was obtained on admission or 7 days later. She also verified Resident #92 should have been assessed within the first week of admission for nutritional status.

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 10 of 14 515077 Department of Health & Human Services Printed: 09/22/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 515077 B. Wing 06/26/2024

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Weirton Medical Center 601 Colliers Way Weirton, WV 26062

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 0697 Provide safe, appropriate pain management for a resident who requires such services.

Level of Harm - Minimal harm or **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 43340 potential for actual harm Based on record review and staff interview, the facility failed to ensure that pain management was provided Residents Affected - Few to residents who required such services, consistent with professional standards of practice. Pain medication was not administered appropriately per the physician's order. This was true for one (1) of two (2) residents who were reviewed under the pain pathway in the Long-Term Care Survey Process. Resident #139. Facility census: 24

Findings included:

a) Resident #139

During an interview, on 06/24/24 at 1:33 PM, Resident #139 mentioned he received medication for pain in his back and had arthritis in hand which necessitated pain medication as well. Resident #139 went on the say that he had requested for his doctor visit him today because his pain levels were not always under control.

A record review, completed on 06/26/24 at 8:35 AM, revealed the resident was admitted to the facility on [DATE REDACTED].

The following two (2) orders were for pain management:

-A 06/06/24 Physician Order prescribing: Oxycodone 5 mg oral tablet every 6 hr.,

-A 06/22/24 Physician Order prescribing: Acetaminophen (Tylenol) - 650 mg =2 oral tablets, every 6 hours, PRN, mild - Pain 1-3.

Review of the Medication Administration Record revealed the following dates that Acetaminophen/Tylenol was given to resident despite his pain being higher than three (3):

-Acetaminophen/Tylenol was given on 06/22/24 at 11:14 AM for a pain of ten (10)

-Acetaminophen/Tylenol was given on 06/24/24 at 5:43 PM for a pain of four (4)

-Acetaminophen/Tylenol was given on 06/25/24 at 8:12 AM for a pain of six (6)

During an interview on 06/26/24 at 11:34 AM, the Director of Nursing acknowledged the above-mentioned dates where pain levels where at the level that Oxycodone should have been administered instead of Acetaminophen/Tylenol.

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 11 of 14 515077 Department of Health & Human Services Printed: 09/22/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 515077 B. Wing 06/26/2024

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Weirton Medical Center 601 Colliers Way Weirton, WV 26062

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 0756 Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. Level of Harm - Minimal harm or potential for actual harm 50795

Residents Affected - Few Based on record review and staff interview, the facility failed to ensure the attending physician documented

in the resident's medical record, that the pharmacist's monthly medication review with recommendations had been reviewed and what, if any, action has been taken to address it. This was true for one (1) of five (5) unnecessary medication reviews throughout the long-term care survey process. Resident identifier: #2. Facility census: 24.

Findings include:

a) Resident #2

Record review on 06/25/24 at 3:38 PM for Unnecessary Meds, and Med Regimen Review, revealed that drug regimen reviews were performed by the pharmacist on 05/29/24 at 8:57AM, and on 06/25/24 at 9:53 AM.

The pharmacist had notified physician that there were no depression, anxiety, or other mental health diagnoses for the prescribed drugs Duloxetine, Mirtazapine, and Lorazepam.

Record review 0n 06/26/24 at 10:17 AM revealed that physician had not acknowledged or responded to the consultant pharmacist's recommendation.

Record review on 06/26/24 at 10:23 AM revealed the facility's Drug review policy stated:

Recommendations of the consulting pharmacist are acted upon and documented by the attending physician.

The attending physician must document in the resident's chart that the identified irregularity has been reviewed and what, if any, action has been taken to address it within seven (7) days (48 hours if urgent action is required)

During an interview with the DON, on 06/26/24 at 10:50 AM, she confirmed the physician had not acted upon

the pharmacist's recommendations dated 05/29/24.

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 12 of 14 515077 Department of Health & Human Services Printed: 09/22/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 515077 B. Wing 06/26/2024

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Weirton Medical Center 601 Colliers Way Weirton, WV 26062

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 0761 Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately Level of Harm - Minimal harm or locked, compartments for controlled drugs. potential for actual harm 50795 Residents Affected - Some Based on observation, and staff interview, the facility failed to ensure the safe storage of medications in the medication room. The facility had made no provision to install the appropriate environmental controls, and monitoring devices, to preserve the integrity of the medications stored in the medication room. This was a random opportunity for discovery. This failed practice had the potential for more than minimal harm. Facility census: 24.

Findings included:

a) Medication Room

During an inspection of the medication room on 06/25/24 at 08:11 AM, this surveyor noted that there was no temperature monitoring device in the medication room. Interview of LPN #12 at 08:14 AM revealed that the medication room temperature was not monitored or documented.

The Director of Nursing (DON) # 23, on 06/26/24 at 11:38 AM, confirmed that the medication room temperature was not monitored. She stated she would have to consult with the pharmacy. The DON acknowledged that she did not have any knowledge of the need for the medication room to be temperature monitored.

Manufacturers' recommendations specify the storage temperature range for medications, because many medications can be altered by exposure to improper temperature, light, or humidity, it is important the facility implement procedures that address and monitor the safe storage and handling of medications in accordance

these recommendations.

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 13 of 14 515077 Department of Health & Human Services Printed: 09/22/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 515077 B. Wing 06/26/2024

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Weirton Medical Center 601 Colliers Way Weirton, WV 26062

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 0868 Have the Quality Assessment and Assurance group have the required members and meet at least quarterly

Level of Harm - Minimal harm or 42120 potential for actual harm Based on facility documentation and staff interview the facility failed to have required members sign in at the Residents Affected - Few Quality Assessment and Assurance (QAA) meetings. This failed practice had the potential to affect all residents residing at the facility. Facility Census: 24.

Findings included:

a) QAA

Record review of the facility's documentation of QAA Meeting Agenda and Minutes revealed no meeting was conducted in the first quarter of 2024.

During an Interview 06/26/24, at 2:23 PM the Director verified the first quarter required quarterly QAA meeting was not conducted. No other information was provided prior to the end of the survey on 06/26/24.

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 14 of 14 515077