Premises Information


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Name

CAROLINAS MEDICAL CENTER

Address

1000 BLYTHE BV

City/State/ZIP

CHARLOTTE

28203

Premise Type

41 - Hospitals

County

Mecklenburg

Inspection Date

6/3/2015

Final Score @ Grade

General Comments

2. 5T storage room with debris on the floor. NSICU-9th, NICU, 11th floor trash room floor with debris. NSICU storage room with debris on the floor. 11T soiled utility room floor in need of cleaning. Play room and team room carpet LCH 4th floor in need of cleaning. 3. OR room 05L177 with a stained ceiling tile. OR hallway wall peeling near Core C. 5T 5912 with peeling paint on ceiling. 5T 5912 and 5901 with missing vent covers. Family room STICU with damaged wall paint. Roof leak observed in hallway at Dickson Heart. Repaint wall in Cath lab room 5. Secure floor molding Electrophysiology room. 10E biohazard room with large hole in the wall. NSICU, NICU, 11th floor trash room walls in need of cleaning. Room 10928 with loose baseboard. 10th floor A/B hallway Women’s restroom with a cracked wall tile. Room 10123 had a stained ceiling tile. 4. Light not functioning in Endo room 17. 5. Dusty vents in 5T EV room, 10E shower area, LCH 9 room 3, LCH 7 room 2. 10. 6T 6924 with an unlabeled bed pan. Handheld urinal in room 9934 in need of cleaning. 11. Observed a hand washing sink being used to process equipment in the PEDS Dialysis soiled utility and 9E soiled utility room. Install or designated an additional sink for processing equipment. 12. Soap dispensers clogged. STICU-11L nourishment area with no paper towels at hand washing sink. Hand sink blocked in 10T ANTE room. LCH floor 10 laundry and LCH 7 family lounge hand washing sinks missing soap. No running water at soiled utility sink in ED diagnostic. 13. Endo hallway sink with low hot water pressure. Hot water less than 100 F at sink in ED major room. 17. ED diagnostics room 31 and hall restroom in the same with hot water at 119 F. 15. Verify the tub in 8B-8208 has backflow prevention. 17. 10th floor AB hallway water fountain with corrosion and residue. 18. Observed a water pitcher in 8A-8106 labeled with the patients initials only. 19. LCH 11 nourishment room, LCH 8 family lounge, LCH 5 family room, PEDS AEC ice machines with residue. 28.Observed nourishment room cabinets in 8D/E, OB Triage, 7A, PEDS ED in need of cleaning. E Hold and Bev area on 3rd floor with cabinets in need of cleaning. 4A-123 with storage on the floor. Gloves next to sink in STICU soiled utility. Observed medicine and water cups not inverted in CATH Lab room 5. IV bags stored next to sink in LCH 10 clean supply room. LCH 10 clean supply room with storage on the floor. Storage within 8 inches of floor in 2nd floor in State/CDC pharmacy room. PEDS ED had toilet paper on the floor in the EVS closet. 30. Observed pill cups stored on top of med cart and not inverted. Observed pill crushers starting to collecting residue on 11L, Cath Lab, CVRU, Dickson Heart, 10D/E, 10A. STICU med cart collecting residue under the clear plastic liners. 33. 4B shower room with a soiled linen container that had no lid. NICU 10614 with unlabeled soiled linen container. 11B clean storage room with soiled linen stored in the room. NICU clean storage room with soiled linen in the room. Soiled linen exposed ED major soiled utility. 34. 6T, 9T linen carts with other personal care items stored touching clean linen. Clean bed in hallway on the 11th floor with nothing covering the clean linen on the bed. 9A, 10A, and 9T clean linen cart covers damaged. Observed OR3 table on 8L damaged. Damaged wheel chair padding in LCH 1. 2nd floor SPD with damaged shower chairs and equipment. 39. Observed some date labels on pre-packaged ready to eat food products from the cafeteria not readable. 40. 6T nourishment with personal food stored above facility food. Observed personal in 8B nourishment room not labeled with patients name. 42. Unwrapped ready to eat apples in 11B nourishment room. 43. Observed refrigerator in 8D-8507 with a door that would not close, observed refrigerator was at 60 F. LCH 4 room 2 missing a thermometer in refrigerator.

Violations

CDI=Corrected During Inspection

R=Repeat Violation

VR=Verification Required

Violation Item	Demerits	Violation Description	CDI	R	VR	Comments
8	1	Facilities conveniently located, clean and in good repair	No	No	No	Observed nourishment refrigerator on 8 L moved down the hallway. Move the refrigerator back to the original location with a hand washing sink. Observed a tub collecting residue around the jets in 8B-8208, 8T hallway restroom toilet soiled. 11th floor waiting room with soiled urinal. NSICU room 9629 toilet in need of cleaning. 10th floor NICU med room sink soiled. 11T soiled utility with a soiled sink. LCU 4th floor hall restroom faucets loose. Room 10123 with a cracked tile in the shower. 10T nourishment room with a damaged backsplash and cracked vanity. 10 A/B hallway restroom with soiled urinal. Room 9508 with hair on the shower bench, room had been cleaned. 4B patient room with low water pressure at hand washing sink. Provide hand washing sinks when required and keep all bathing, toilet, and handwashing equipment clean and in good repair. 15A NCAC 18A .1312.
32	1	Furniture clean and in good repair. Mattresses clean, dry, odor free	No	No	No	Observed chair seams collecting residue in 8T-8934, 8T Nursery, 8L-8606, 8L-8622. Observed beds with rust in 8D-8507, 7A-7110, 7T-7914, 8L-8622, 8T-8934, 11T 119326, 10A 10123, PEDS ED 42. Observed mattress cover on box springs damaged in 8B-8208. Anesthesia room, scan room B, OR with mattresses with tape residue. Diagnostic X-ray room with debris below the bench pad. Damaged chair in CT room F. Damaged mattresses in STICU and with tape residue. STICU waiting room with debris under cushions. Repair damaged handle on sage warmer 10E. 9A clean utility with soiled cart covers. Room 9504 with hole in chair. Couch stained LCH 11 family centers.All furniture shall be kept clean and in good repair. 15A NCAC 18A .1319 (a).
36	1	Approved utensils and equipment, cleaned and sanitized	No	No	No	Observed damaged gasket on nourishment room refrigerators in 8B, 7B. Observed breast milk refrigerator gasket collecting residue on 8D. Observed 8, 10A, LCH 8, ED major refrigerators collecting residue. LCH 4 patient dining room oven with debris. E Hold nourishment with a soiled microwave. PEDS AEC clean utility room frig in need of cleaning. Non-food contact surfaces of equipment shall be cleaned at such intervals as to keep them in a clean and sanitary condition. See rule .1320 (c).