Inspection Reports for The Sanctuary at Stonehaven
6741 Ciscayne Pl, Charlotte, NC 28211, NC, 28211
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Inspection Report
Annual Inspection
Deficiencies: 2
Apr 14, 2021
Visit Reason
The Adult Care Licensure Section conducted an annual survey of the facility on April 14, 2021.
Findings
The facility failed to ensure that at least one staff person on the premises had current cardiopulmonary resuscitation (CPR) certification, as Staff A's CPR certification had expired and no recertification was documented. Additionally, the facility failed to administer medications as ordered by a licensed prescribing practitioner for one resident, as Turmeric capsules ordered for Resident #1 were not administered due to unavailability and awaiting family decision to provide the medication.
Deficiencies (2)
| Description |
|---|
| Facility failed to ensure at least one staff had current CPR certification; Staff A's CPR certification expired on 02/28/21 with no documented recertification. |
| Facility failed to administer Turmeric capsules 400mg twice daily as ordered for Resident #1; medication was not available and not administered for 60 possible doses from 03/16/21 through 04/14/21. |
Report Facts
Medication administration opportunities missed: 60
Staff A CPR certification expiration date: Feb 28, 2021
Staff A hire date: Jun 14, 2020
Survey date: Apr 14, 2021
Inspection Report
Annual Inspection
Deficiencies: 3
Oct 10, 2019
Visit Reason
The Adult Care Licensure Section conducted an annual and follow-up survey on 10/10/2019 to assess compliance with medication labeling, administration, and storage regulations.
Findings
The facility failed to ensure non-prescription medications were labeled with the resident's name, medication administration records (MAR) were accurate and complete, and all medications were stored safely under locked security. Specifically, Resident #1's creams were not labeled or stored securely, and medications such as hydrocodone/acetaminophen and lorazepam were missing from the MAR despite being available for administration.
Deficiencies (3)
| Description |
|---|
| Non-prescription medications were not labeled with the resident's name for 1 of 3 residents (#1). |
| Medication administration records (MAR) were not accurate and complete for 1 of 3 residents (#1), with missing documentation for pain and anti-anxiety medications. |
| Non-prescription medications were not maintained in a safe manner under locked security except when under direct supervision. |
Report Facts
Containers of barrier cream: 3
Containers of antifungal cream: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Resident Care Coordinator | Medication Aide | Responsible for labeling Resident #1's creams and checking eMARs monthly; interviewed regarding medication labeling and administration. |
| Administrator | Interviewed regarding medication labeling, administration, and storage responsibilities. | |
| Pharmacist | Contracted Pharmacy Pharmacist | Interviewed regarding medication orders and labeling for Resident #1. |
Inspection Report
Original Licensing
Deficiencies: 4
Jul 23, 2018
Visit Reason
The Adult Care Licensure Section and the Mecklenburg County Department of Social Services completed an initial survey on 07/23/18 for licensing and regulatory compliance of the facility.
Findings
The facility was found deficient in implementing physician's orders for blood pressure monitoring, respecting residents' privacy regarding video and audio monitoring devices, clarifying medication orders resulting in missed doses, and proper use and documentation of physical restraints such as bed rails.
Deficiencies (4)
| Description |
|---|
| Failed to implement physician's orders for blood pressure checks for Resident #2, with no documented blood pressures from 06/08/18 to 06/30/18. |
| Failed to ensure residents' privacy and dignity related to use of visual and audio monitoring devices accessible in common areas without proper consent or privacy safeguards for Residents #2 and #3. |
| Failed to clarify physician's orders for timolol eye drops for Resident #2, resulting in 14 missed doses from 06/08/18 to 06/21/18. |
| Failed to ensure assessment, care planning, and physician's order for use of bed rails as restraints for Resident #2; bed rails were used without consent or proper documentation. |
Report Facts
Missed medication doses: 14
Dates with no blood pressure documentation: 22
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Resident Care Coordinator | Resident Care Coordinator/Medication Aide | Responsible for blood pressure checks and medication order review; acknowledged missing blood pressure documentation and unclear medication orders. |
| Administrator | Administrator | Interviewed regarding missing blood pressure documentation, monitoring device privacy issues, and lack of physician order for bed rails. |
| Resident #2's Physician's Nurse | Nurse | Provided information on Resident #2's medical orders and bed rail use. |
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