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F0585
D

Failure to File Grievance for Missing Resident Belongings

Greenville, North Carolina Survey Completed on 06-11-2025

Penalty

Fine: $81,485
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to file a grievance on behalf of a resident who verbally reported missing personal belongings to the Social Worker (SW) after returning from a hospital stay. The resident, who was moderately cognitively impaired and diagnosed with non-Alzheimer's dementia, reported on multiple occasions that a small suitcase, a pair of shoes, and two cotton nightgowns were missing. The SW acknowledged receiving these verbal reports but did not inform other staff, initiate a grievance, or attempt to locate the items, instead waiting for the resident to provide a written list with sizes. The missing items were never found. Facility policy required staff to immediately respond to concerns and allow residents to file grievances orally, in writing, or anonymously without fear of reprisal. The SW admitted responsibility for following up on the missing items and recognized that a grievance should have been filed, especially given the resident's cognitive status. The Administrator was unaware of the missing items and stated that a list should have been made for the resident, but did not believe a grievance was necessary until after a period of unsuccessful searching. No grievance was filed, and the resident's concerns were not formally addressed.

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