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

12/13/2017

Final Score @ Grade

93.50

General Comments

CONITNUES FROM PAGE 2: 32) Large tear on bottom surface of mattress in OR1, bedside tables with residue and debris throughout Nursing OPS and 5th floor bays, rust on bed frames in OR 5L core and room 6225, broken bedside table that needed cleaning in 6B, torn pillows in room 9123 and 10401. Observed damaged chair in Maternity nursery, 7215 and 8207 with worn furniture, damaged baby warmer mattress in 8207, damaged potable table (bed table) in 8622 NO POINTS DEDUCTED FOR THE FOLLOWING: 2) Keep all flooring clean. 15A NCAC 18A .1309 (a). Observed floors were dusty and with debris in 11 Tower clean utility and med room; in OR clean equipment room, and 4L Diag clean storage and med room. Observed carpet cleaning needed in PDU family waiting room. 3) Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed touch up paint needed in library, 4067 spa, PACU, and room 6015. Observed wall damage in Bay 5092, and Infusion room 4 of LCH. Observed stained ceiling tile in 4th floor equipment room of LCH, Endo 4KL018, hallway on 4M (near stairs), 7T, 7D hallway, room 04L139, and ICU clean supply (side 1), wall was stained in soiled utility 9B; patch hole under towel rack in room 8207 restroom, 8923 restroom ceiling with microbial growth (shower); repair ceiling in 8106 restroom, and door handle in room 7215 5) Keep all ventilation equipment clean and in good repair. 15A NCAC 18A .1311 (b). Observed vent in restroom on LCH8 with dust build up. 8) Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Observed shower in overnight room in LCH7 with pink and black around base of shower. Observed showerhead in LCH 9 in need of cleaning 8923 shower tile needed cleaning. Keep all handwashing facilities clean and in good repair. 15A NCAC 18A .1312 (b). Observed the sink in room 11124 was slow to drain; clean hand washing in med room in 7T, Observed the hand washing sink was blocked with PPE supplies and monitor in 6T Ante room Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Observed a loose toilet seat in 9205, and 9206, and hoppers were not clean in 8A and 7D. 11) Observed room C18 with a coffee pot that requires filling manually, both sinks used for hand washing. Remove soap/toles from one sink, to obtain clean water for coffee making. 10) Label all disposable bed pans with the residents/patients name and date. 15A NCAC 18A .1312 (c). Observed a bedpan was not labeled in patient room on 3B. 12) Provide liquid soap and disposable towels at all handwashing sinks. 15A NCAC 18A .1312 (d). Observed no soap supplied to the hand sink in the “Fans” food service 11th floor and 6C, no paper towels in the Pre-Op soiled utility, and OR Sterile hand washing areas. Observed the soiled utility room 7T with obstructed paper towel dispenser, and a broken soap dispenser in 7A clean utility.

Violations

CDI=Corrected During Inspection

R=Repeat Violation

VR=Verification Required

Violation Item	Demerits	Violation Description	CDI	R	VR	Comments
13	1	Lavatory and bathing hot water between 100 and 116 F	No	No	No	Maintain the hot water at all resident accessible handwashing sinks and bathing facilities within the temperature range of 100°F to 116°F. 15A NCAC 18A .1312 (e). Observed hot water between 80F and 99F throughout LCH. 4 total sinks in all of LCH had temperatures within required range; 87F hot water in the major patient restroom, 66F in the XRay patient restroom, and 120F in room 45 in Children’s ED, Observed hot water was 91F 4A Lab, 81F at nurses station Nurse OPS, 68F at scrub sink in Nursing OPS, Ultra Sound Unit CT hot water was 85F and 90F in a hallway restroom.
28	0.50	Adequate storage, area clean, items properly stored	No	No	No	All patient care or consumable items shall be stored at least 8 inches above the floor. 15A NCAC 18A .1318 (a). Observed airway cart items stored on floor in 6059, and a box toilet paper and other items were stored on the floor in Helipad storage/office, storage on the floor in room 07G102. Nutrition Area with build-up of residue beneath the coffee maker in Endo Unit. Bagged patient equipment (foam cushions) were stored on the floor in OR 5L core B; storage bins were not clean in central supply 6T, boxes of tubing were stored on the floor in clean utility, and in the equipment room in 9B. Observed storage near hand washing sink 8A and 7A clean utility, storage (paper towels) beneath the hand washing sink in 7D biohazard room
32	2	Furniture clean and in good repair. Mattresses clean, dry, odor free	No	No	No	All furniture, bed springs, mattresses, sleeping mats, draperies, curtains, shades, venetian blinds, or other furnishings in institutions shall be kept clean and in good repair. 15A NCAC 18A .1319 (a). Observed furniture in family waiting areas of 5th and 6th floor in need of replacing. Furniture vinyl is broken down and torn on many pieces. Observed damaged couch in 6015, LCH10 room 11 and room. Observed rusted bed frame in 5th floor, bay7 pre-op; LCH 8 room 24. Observed gym mats in rehab gym on 4th floor with tears. Observed cracked vinyl mat in 4067 spa. Observed laminate on first floor women’s restroom of LCH in disrepair. Observed a tear in the mattress in room 13 Children’s ED, and a severely ripped mattress in room 45 Children’s ED, and build-up of debris in crack/crevices of several beds throughout ED. CONTINUED ON PAGE 5
36	1	Approved utensils and equipment, cleaned and sanitized	No	No	No	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). Observed microwave in 4038 patient dining, 11 Tower, ICU waiting room, 10T nourishment room, and LCH11 in need of detail cleaning. Observed nourishment room cabinets in LCH10 with debris in them. Observed counter top in LCH10 with debris build up; freezer with debris 3T nourishment room, and the cup dispenser lid was missing (clean cups exposed), observed prep sink was not cleaned in 6C “Fans” room.
39	2	Food supply complies with 15A NCAC 18A .2600	No	No	No	All food and food supplies provided by an institution shall be from sources that comply with 15A NCAC 18A. 2600. Observed top refrigeration unit was not working with greek yogurt at 58F, the refrigerator needed cleaning in 6C “Fans”, and staff’s personal belongings (jacket) were stored co-mingled with patient food/supplies in 11 and 6C “Fans” food service room. Observed a turkey sandwich was 50F in 3B patient nourishment room.