Deficiencies (last 3 years)
Deficiencies (over 3 years)
3 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
14% better than South Carolina average
South Carolina average: 3.5 deficiencies/yearDeficiencies per year
8
6
4
2
0
Inspection Report
Annual Inspection
Deficiencies: 6
Date: Dec 20, 2024
Visit Reason
The inspection was conducted as an extended survey in conjunction with the Recertification Survey to assess compliance with quality of care, medication administration, medication storage, food safety, and resident dignity standards.
Findings
The facility was found deficient in multiple areas including failure to maintain resident dignity during insulin administration, inadequate supervision leading to a resident eloping and sustaining injury, medication administration errors including failure to prime insulin pens and delayed medication administration, improper medication storage including expired and discontinued medications stored with active medications, and food safety violations including expired foods, improper labeling, and inadequate sanitation of kitchen equipment. Hand hygiene deficiencies were also observed during meal service.
Deficiencies (6)
Failed to maintain dignity for Resident 39 during insulin injection by not providing privacy or a blanket.
Failed to provide proper supervision resulting in Resident 97 eloping during a fire alarm and sustaining a fractured clavicle.
Medication administration error rate of 15.38% including failure to prime insulin pens and delayed administration of Sertraline for Resident 39.
Failed to ensure proper priming and administration of insulin pens for 3 residents, resulting in uncertainty of correct insulin dosage.
Expired, outdated, and discontinued medications were stored with active medications in 3 of 5 medication carts and 1 of 1 treatment carts; medication cart left unlocked with medications unattended.
Failed to ensure proper hand hygiene by staff during meal service and failed to discard expired foods, label and date open items, and properly sanitize kitchen equipment.
Report Facts
Medication administration error rate: 15.38
Fall risk evaluation score: 16
Expired medications count: 6
Expired medication tablets count: 26
Expired medication tablets count: 20
Frozen rolls count: 95
Ceiling fans with dust buildup: 7
Residents potentially affected: 119
Employees mentioned
| Name | Title | Context |
|---|---|---|
| LPN1 | Licensed Practical Nurse | Failed to provide privacy during insulin injection and failed to prime insulin pen |
| LPN2 | Licensed Practical Nurse | Primed insulin pen incorrectly and could not confirm correct insulin dosage |
| LPN3 | Licensed Practical Nurse | Primed insulin pen incorrectly and failed to hold needle in place for required time |
| LPN6 | Licensed Practical Nurse | Left medication cart unlocked with medications unattended |
| Director of Nursing | Director of Nursing | Confirmed medication administration errors and expectations for kitchen cleanliness |
| Dietary Manager | Dietary Manager | Confirmed food safety and kitchen sanitation deficiencies |
| Maintenance Director | Maintenance Director | Provided information on fire alarm and door security related to resident elopement |
Inspection Report
Complaint Investigation
Deficiencies: 1
Date: Sep 1, 2023
Visit Reason
The inspection was conducted as a complaint investigation triggered by a resident elopement incident on 08/30/2023, involving Resident #1 (R1) who successfully left the facility unsupervised, posing immediate jeopardy to resident health and safety.
Complaint Details
The complaint investigation was triggered by an elopement incident on 08/30/23 involving Resident #1. The facility was found non-compliant with federal regulations causing immediate jeopardy. The resident was found outside the facility unsupervised, posing risk of serious injury or death. The facility's corrective actions were accepted and the immediate jeopardy was removed as of 08/31/23.
Findings
The facility failed to prevent accidents and hazards by not adequately supervising Resident #1, who eloped from the facility and was found outside in the parking lot. The facility was cited for immediate jeopardy due to substandard quality of care related to elopement risk assessment and supervision. The facility implemented corrective actions including increased supervision, staff education, securing the front door, and conducting elopement drills.
Deficiencies (1)
Failure to prevent accidents/hazards for 1 of 3 residents reviewed, specifically a successful elopement placing the resident at risk of serious harm.
Report Facts
Residents affected: 1
BIMS score: 5
Dates: Aug 30, 2023
Dates: Sep 1, 2023
Training frequency: 3
Training duration: 4
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Registered Nurse 1 | Registered Nurse | Reported resident elopement and conducted assessments |
| Certified Nursing Assistant 1 | Certified Nursing Assistant | Reported resident whereabouts during elopement incident |
| Certified Nursing Assistant 2 | Certified Nursing Assistant | Reported resident whereabouts during elopement incident |
| Administrator | Administrator | Provided interviews and acknowledged immediate jeopardy |
| Director of Nursing | Director of Nursing | Provided interviews and oversaw corrective actions |
| Maintenance Director | Maintenance Director | Secured front door and conducted elopement drills |
| Executive Director | Executive Director | Reported incident to authorities and oversaw corrective actions |
Inspection Report
Complaint Investigation
Deficiencies: 2
Date: May 10, 2023
Visit Reason
The inspection was conducted due to a complaint alleging abuse involving a resident (R217), specifically regarding failure to timely report suspected abuse and an incident where a resident's medication was not crushed and their leg was dropped by staff.
Complaint Details
The complaint involved an allegation that on 05/05/23, a nurse refused to crush resident R217's medication and a certified nursing assistant dropped the resident's leg during care, causing pain. The facility did not report the allegation to the state agency within the required two-hour timeframe. Staff involved were suspended, witness statements were obtained, and police were notified.
Findings
The facility failed to timely report an allegation of abuse involving resident R217, with notification to the state agency occurring more than two hours after the facility became aware of the allegation. Additionally, staff involved in the incident were suspended, witness statements were obtained, and the police were notified. Another deficiency was found related to food delivery practices, where food items were not consistently covered during delivery to resident rooms, potentially exposing food to contamination.
Deficiencies (2)
Failed to timely report suspected abuse involving resident R217, with notification to the state agency occurring more than two hours after awareness of the allegation.
Failed to ensure food was covered during delivery to resident rooms on the Morning Star Unit, exposing food to potential contamination.
Report Facts
Residents affected: 1
Residents affected: 31
Employees mentioned
| Name | Title | Context |
|---|---|---|
| LPN10 | Licensed Practical Nurse | Reported resident's concerns about medication and leg incident |
| LPN11 | Licensed Practical Nurse | Alleged to have refused to crush resident's medication |
| CNA8 | Certified Nursing Assistant | Alleged to have dropped resident's leg during care |
| AD | Activities Director / Manager on Duty | Received report of incident and notified DON and ED |
| ED | Executive Director | Interviewed regarding incident and reporting procedures |
| DON | Director of Nursing | Informed about incident and involved in follow-up |
| CNA1 | Certified Nursing Assistant | Observed delivering uncovered food during meal service |
| CNA4 | Certified Nursing Assistant | Observed delivering uncovered food and interviewed about food delivery practices |
| CNA5 | Certified Nursing Assistant | Observed delivering uncovered food and interviewed about food delivery practices |
| CNA6 | Certified Nursing Assistant | Interviewed about food covering practices |
| LPN7 | Licensed Practical Nurse | Observed delivering uncovered food and interviewed about food delivery practices |
| CDM | Certified Dietary Manager | Interviewed about proper food delivery procedures |
| RD | Registered Dietitian | Interviewed about meal delivery observations and expectations |
Inspection Report
Annual Inspection
Deficiencies: 0
Date: Jun 25, 2021
Visit Reason
The inspection was conducted as an annual survey of the Life Care Center of Charleston to assess compliance with health and safety regulations.
Findings
No health deficiencies were found during the inspection.
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