Average — CMS composite of the measures below.
The next survey window likely opens around January 2027
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Harmony Hall Nursing And Rehabilitation Center during CMS and state inspections, most recent first.
A resident with type 2 DM, who was cognitively intact and on insulin therapy, received a dose of glargine insulin from a pen that had been open beyond the manufacturer’s 28‑day discard date. Surveyors found an open glargine pen on the med cart labeled with an opening date that showed it was expired, as well as a second, unopened and undated pen for the same resident. The nurse who administered the insulin reported she did not check the expiration date before giving the dose and acknowledged she should have discarded the expired pen. The Pharmacy Consultant confirmed the 28‑day discard requirement, while the NP, DON, and Administrator each stated that nursing staff were expected to check med carts daily and ensure no expired medications were present or administered.
Surveyors found an open insulin glargine pen on a medication cart that remained in use past the 28-day discard period specified by the manufacturer. The pen was labeled with an opened date and an expiration date that had already passed, yet it was still stored on the cart during the survey. A medication aide assigned to the cart, the covering nurse, the Pharmacy Consultant, the DON, and the Administrator all acknowledged that nursing staff, including medication aides, were expected to check carts daily and remove expired medications, but this did not occur for the insulin pen on Station 2 medication cart #1.
A cognitively intact resident with hemiplegia and documented tobacco use, assessed and care planned as a safe, independent smoker, was found in his room with a pack of cigarettes and a lighter hidden under his shirt, contrary to facility policy requiring all smoking materials to be locked in a medication cart and accessed only with staff assistance. Staff, including a nurse, NA, medication aide, DON, and Administrator, reported that the resident normally obtained smoking materials from staff before going to the designated smoking area and returned them afterward, and that staff were responsible for ensuring the materials were secured. On this occasion, the resident kept his cigarettes and lighter after returning from smoking, reportedly because no staff were present at the medication cart, resulting in unsecured smoking materials in violation of the facility’s smoking policy.
A resident with a g-tube for nutrition and medication was found to have their 60 cc feeding syringe stored with the plunger inside the barrel and visible water droplets present, contrary to facility policy requiring separation of parts to prevent bacterial growth. Staff interviews confirmed the improper storage practice and awareness of the correct procedure.
A resident with dementia was observed with bilateral quarter length side rails in use without evidence of attempted alternatives, a completed side rail assessment, entrapment risk evaluation, or informed consent. Staff interviews revealed confusion about responsibility for assessments, and facility leadership confirmed that required assessments and documentation were not completed.
Two residents were left with medication cups on their bedside tables without being assessed for self-administration. Both residents were cognitively intact and had multiple medications prescribed. Nurse #3 left the medications unattended, leading to a confrontation with one resident and an admission of oversight. The DON confirmed that neither resident had been assessed for self-administration, and medications should not have been left unsupervised.
The facility failed to provide complete SNF ABN forms for two residents prior to their discharge from Medicare Part A skilled services. One resident's form lacked the section for the decision to continue services, while another resident's form was missing both the decision section and the signature. The facility Social Worker and Administrator acknowledged these oversights.
The facility failed to secure smoking materials for two residents identified as safe smokers. One resident was found with cigarettes and lighters in his room, while another had a lighter attached to his bag. Staff interviews revealed a lack of awareness and adherence to the facility's smoking policy, which requires smoking materials to be secured by staff.
Two residents with urinary catheters were observed with their catheter bags resting on the floor, contrary to infection control protocols. Despite the residents' cognitive impairments and dependency on staff, the catheter bags were not properly positioned, as confirmed by staff interviews. The DON expected catheter bags to be attached to the bed frame to prevent floor contact.
Expired Insulin Pen Administered Due to Failure to Check Expiration Date
Penalty
Summary
Surveyors identified a failure to meet professional standards of quality related to insulin administration for one resident with type 2 diabetes mellitus. The resident was cognitively intact, used insulin, and had a care plan directing finger stick blood sugars as ordered, medications as ordered, and monitoring for signs and symptoms of hypoglycemia. Manufacturer instructions for the resident’s glargine insulin pen required it be discarded 28 days after opening. Review of the Medication Administration Record showed the resident received a glargine insulin injection on 2/25/26 at 8:00 p.m. by a nurse. Observation of the medication cart the following day revealed an open glargine insulin pen for this resident dated as opened on 1/20/26 with an expiration date of 2/17/26, indicating it had been used beyond the 28‑day period. A second glargine pen for the same resident was present, unopened and undated. In an interview, the nurse who administered the insulin on 2/25/26 stated she was unaware the pen had expired on 2/17/26 because she did not check the expiration date prior to administration and acknowledged she should have discarded the expired pen. The Pharmacy Consultant confirmed the pen should have been discarded 28 days after opening due to decreased potency after the expiration date. The Nurse Practitioner stated she was unaware the resident had received expired insulin and indicated nursing staff were expected to check medication carts daily for expired medications. The DON and the Administrator both stated that floor nurses were responsible for checking medication carts daily for expired medications, discarding any expired medications, and ensuring no expired medications remained in the carts.
Expired Insulin Pen Not Removed From Medication Cart
Penalty
Summary
Surveyors identified a deficiency in medication storage and labeling when they found an expired multi-dose insulin glargine injector pen on one of five medication carts reviewed (Station 2 medication cart #1). The insulin pen had a manufacturer’s instruction to be discarded 28 days after opening, with labeling indicating an opened date of 1/20/26 and a handwritten expiration date of 2/17/26, yet it remained on the cart when observed on 2/26/26. The pen was open and still stored on the cart beyond the 28-day discard date specified by the manufacturer. During interviews, the medication aide assigned to that cart stated she did not administer insulin injections but acknowledged the insulin glargine pen should have been discarded after 28 days. The nurse covering that cart confirmed the expired insulin pen should have been removed and discarded and stated that nursing staff, including medication aides, were expected to check medication carts daily for expired medications. The Pharmacy Consultant also confirmed the pen should have been discarded 28 days after opening. The DON and the Administrator both stated that floor nurses and nursing staff, including medication aides, were responsible for checking medication carts daily and ensuring there were no expired medications, indicating that this expected practice had not been followed for the insulin pen found on Station 2 medication cart #1.
Failure to Secure Resident Smoking Materials per Facility Policy
Penalty
Summary
The deficiency involves the facility’s failure to secure smoking materials in accordance with its smoking policy, which requires all resident smoking materials to be kept in a secure area (medication cart) and accessible only with staff assistance. One resident, who was cognitively intact and assessed and care planned as a safe, independent smoker with a preference to smoke at times of his choice, was found in his room with a pack of cigarettes and a lighter tucked under his shirt against his stomach. The resident reported that he smoked and acknowledged having his smoking materials in his possession in his room. Staff interviews revealed that the resident was expected to turn in his smoking materials to staff after each smoking episode so they could be locked in the medication cart. Nursing staff, including a nurse, a nurse aide, and a medication aide, stated that the resident typically obtained his cigarettes and lighter from staff before going to the designated smoking area and returned them afterward, and that he was aware he was not allowed to keep them. The DON and Administrator both stated that residents deemed safe independent smokers could go to the smoking area whenever they wanted, and that staff were responsible for ensuring smoking materials were returned and secured. However, they acknowledged that the resident likely retained his smoking materials after returning from smoking because no staff member was present at the medication cart, resulting in unsecured smoking materials in the resident’s possession in his room and a failure to follow the facility’s smoking policy.
Improper Storage of Enteral Feeding Syringe
Penalty
Summary
A deficiency was identified when a plastic 60 cc syringe used for enteral feeding, medication, and water flushes for a resident with a gastrostomy tube was observed to be improperly stored. The syringe, after use, was rinsed and placed back into its original bag with the plunger still inside the barrel, and water droplets were visible inside the bag. This method of storage did not follow facility policy, which requires the barrel and plunger to be separated after rinsing to prevent bacterial growth. The resident involved had a history of dysphagia following a stroke and was severely cognitively impaired, requiring a gastrostomy tube for nutrition, hydration, and medication administration. Staff interviews confirmed that the nurse responsible for the syringe did not separate the components after use, despite being aware of the correct procedure. The facility's Infection Preventionist and Administrator both acknowledged that the syringe should have been stored with the barrel and plunger separated to prevent potential bacterial contamination.
Failure to Assess and Document Side Rail Use Prior to Implementation
Penalty
Summary
The facility failed to follow required procedures before the use of bilateral quarter length side rails for a resident with Alzheimer's disease and non-Alzheimer's dementia. The resident, who required partial to moderate assistance with bed mobility and was moderately cognitively impaired, was observed on two occasions with both side rails raised. There was no evidence in the resident's electronic medical record that alternative interventions were attempted prior to the use of side rails, nor was there documentation of a side rail assessment, entrapment risk evaluation, or a review of risks and benefits with the resident or their representative. Informed consent for the use of side rails was also not obtained. Interviews with facility staff revealed a lack of clarity regarding responsibility for completing side rail assessments. The nurse interviewed stated she did not perform side rail assessments and was unsure who was responsible. The DON indicated that assessments were only completed if side rails appeared necessary for positioning and mobility, and was unaware that alternatives needed to be attempted and documented. The Administrator confirmed that side rail assessments were not completed on admission or quarterly for the resident in question.
Failure to Assess Self-Administration of Medications
Penalty
Summary
The facility failed to assess the ability of two residents to self-administer medications before leaving their medications on the bedside table. Resident #25, who was cognitively intact, had several medications prescribed, including atorvastatin, gabapentin, metoprolol, sertraline, amoxicillin, and doxycycline. There was no documentation in the Electronic Medical Record (EMR) indicating that Resident #25 had been assessed for self-administration, nor was there a physician's order or care plan addressing this. On the morning of the observation, Nurse #3 left a medication cup with several pills on Resident #25's bedside table without supervision, leading to a confrontation when she attempted to retrieve the cup. Similarly, Resident #62, also cognitively intact, had multiple medications prescribed, such as amlodipine, aspirin, oxybutynin, empagliflozin, meloxicam, a multivitamin, omega-3, and metformin. Like Resident #25, there was no assessment, physician's order, or care plan for self-administration documented in the EMR. During an observation, a medication cup was found on Resident #62's bedside table, and Nurse #3 admitted to leaving it there due to being called away to another resident's room. Resident #62 mentioned that she preferred to take her medications with milk and that the medications were often left for her to take with breakfast. Interviews with the Director of Nursing (DON) confirmed that neither resident had been assessed for self-administration of medications, and it was acknowledged that medications should not have been left on the bedside tables. Nurse #3 admitted to the oversight in both cases, recognizing that she should have supervised the residents taking their medications instead of leaving them unattended.
Incomplete SNF ABN Forms for Two Residents
Penalty
Summary
The facility failed to provide a complete Centers for Medicare and Medicaid Services (CMS) Skilled Nursing Facility Advanced Beneficiary Notice (SNF ABN) for two residents prior to their discharge from Medicare Part A skilled services. For Resident #170, the SNF ABN was missing the section indicating the resident's decision to continue Medicare Part A services, although the resident's name, the date services were to end, the estimated cost of the services, and the resident's signature were present. The facility Social Worker acknowledged that Resident #170 did not choose an option and that this was not documented. Attempts to contact Resident #170 were unsuccessful, and the facility Administrator confirmed that the SNF ABN should have included the resident's decision. For Resident #7, the SNF ABN was incomplete as it lacked both the section for the decision about continuing Medicare Part A services and the resident's signature. The facility Social Worker admitted it was an oversight that Resident #7 did not choose an option or sign the form, and it was typically signed alongside the Notice of Medicare Non-Coverage. Resident #7 did not recall being presented with the ABN form. The facility Administrator confirmed that the SNF ABN should have been completed with the resident's decision and signature.
Failure to Secure Smoking Materials for Residents
Penalty
Summary
The facility failed to secure smoking materials for two residents who were identified as safe and independent smokers. Resident #23 was observed with a pack of cigarettes and two lighters on his bedside table, despite the facility's policy requiring smoking materials to be kept in a secure area accessible only by staff. Although Resident #23 was noted to be cognitively intact and had a care plan indicating he was a safe smoker, the presence of an oxygen concentrator in his room posed a potential hazard. Interviews with staff revealed that smoking materials should be locked in the medication cart, but Resident #23 admitted to keeping his lighters at his bedside, and staff were unaware of this practice. Similarly, Resident #106 was observed with a cigarette lighter attached to his bag during a Resident Council meeting, contrary to the facility's smoking policy. Although Resident #106 was also assessed as a safe and independent smoker, staff interviews indicated a lack of awareness regarding the lighter in his possession. The facility's policy required residents to return all smoking materials to staff after use, but Resident #106 stated he kept his lighter with him. The Director of Nursing confirmed that residents were not supposed to keep lighters, and the Administrator acknowledged the challenge of residents being resourceful in keeping smoking materials.
Failure to Prevent Catheter Bags from Touching the Floor
Penalty
Summary
The facility failed to prevent urinary catheter bags from touching the floor, which is a critical measure to reduce the risk of infection. This deficiency was observed in two residents, both of whom had urinary catheters. Resident #87, who was admitted with chronic kidney disease, benign prostatic hyperplasia, and urinary retention, was found with his catheter bag resting on the floor on multiple occasions. Despite being dependent on staff for all activities of daily living due to severely impaired cognition, the catheter bag was consistently observed touching the floor, indicating a lapse in proper catheter care. Similarly, Resident #91, who was admitted with chronic kidney disease, a urinary tract infection, and urinary retention, also had her catheter bag resting on the floor. Observations confirmed that the catheter bag was not properly positioned, and interviews with Nurse #3 revealed an acknowledgment that the bags should not touch the floor. The Director of Nursing also confirmed the expectation that catheter bags should be attached to the bed frame in a manner that prevents them from touching the floor, highlighting a failure in adherence to infection control protocols.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Kinston
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Signature Healthcare Of Kinston | 1.9 mi | ★★★★★ | 8 | 0 |
| Nc State Veterans Home-kinston | 2.4 mi | ★★★★★ | 0 | 0 |
| Greendale Forest Nursing And Rehabilitation Center | 12.1 mi | ★★★★★ | 0 | 0 |
| Ayden Court Nursing And Rehabilitation Center | 15.8 mi | ★★★★★ | 6 | 1 |
| Pruitthealth-farmville | 21.2 mi | ★★★★★ | 5 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.