The critical state reports do not focus on cleanliness or abuse at Universal, but they do cite questionable care. The reports cited failure to monitor proper fluids and foods, along with several instances of shoddy medical record keeping.
"It seems one of the central issues was having staff trained and having staff carry out physicians' orders," said Jeff Horton, of the state Division of Facility Services.
The final straw came when investigators determined questions of care put diabetic residents in immediate jeopardy.
"It was very serious. It could have been life-threatening," Horton said.
When Universal failed to meet standards by the set deadline, Medicaid and Medicare residents at the nursing home were told they would have to go.
Claire Pratt and Cynthia Landvater have a close friend, Suzie, caught up in the disruption. They believe the law cares too much about detailed medical records instead of the heart and soul of the facility.
"It is devastating. These patients and their families are in tears. They're heartbroken," Landvater said. "This is where we wanted her to be for the rest of her life. We would put my parents here tomorrow if I had to."
An advocacy group, Friends of Residents in Long Term Care, believes regulators should have considered a compromise like temporary management.
"The state has the ability to regulate and enforce the law to protect the residents," advocate Roger Manus said. "At the same time, not force them to be unneccesarily displaced to other sections."
"The federal nursing home law is pretty unforgiving in this type of instance," Horton said.
The facility is not closing because the private-pay residents will be allowed to stay if they choose.
There are nearly 17,000 nursing homes nationwide with more than 1.8 million beds. Statistics show an 83 percent occupancy rate. As for the aging population in the United States, about 12.5 percent of people are 65 and older. It is about the same in North Carolina.
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