Below average — CMS composite of the measures below.
A standard survey is most likely before around October 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Crown Haven Health And Rehabilitation during CMS and state inspections, most recent first.
A resident was not properly assessed or prepared for transfer or discharge, and the facility did not ensure that the process met the resident's needs and preferences, resulting in a deficiency in care planning and transition.
A resident with a history of alcohol dependence and other mental health diagnoses was prescribed Chlordiazepoxide HCl for alcohol withdrawal, but the facility did not obtain or document written informed consent for this medication. Although staff and the Medical Director discussed the treatment plan and side effects with the resident and a family member, no signed consent form was found in the medical record, and the resident did not recall agreeing to the treatment.
The facility did not adequately promote or facilitate resident self-determination, resulting in a failure to support resident choice as required. This was due to actions or omissions by staff that did not encourage or honor the resident's right to make decisions about their care.
A resident with end stage renal disease, encephalopathy, and diabetes, requiring dialysis and insulin, did not have a comprehensive care plan addressing dialysis, ADL functioning, or insulin use. The omission occurred due to an oversight during a transition in MDS nursing staff, resulting in the resident's needs not being fully addressed in the care plan.
Surveyors identified deficiencies in medication management, including failure to transcribe a hospital discharge order for lorazepam gel for a resident with anxiety, improper administration practices when a nurse prepared to give Metoprolol to a resident with a low heart rate without provider notification, and failure to remove a lidocaine patch as ordered for a resident with chronic pain. These lapses involved multiple staff and resulted in noncompliance with professional standards of care.
Two residents who were assessed as safe smokers routinely kept their smoking materials and lighters in their rooms and personal belongings, despite the facility's policy requiring these items to be secured in assigned lockers. Staff and smoking monitors reported ongoing non-compliance and difficulty enforcing the policy, with residents refusing to use the lockers and staff reluctant to confront them. Facility leadership and staff were aware of the persistent issue, which was confirmed through observations and interviews.
A resident reported a suspected sexual assault, but the facility failed to conduct a thorough investigation as per its abuse policy. The investigation lacked signed statements, resident interviews, and skin assessments. No staff members were suspended during the investigation, despite a male nurse aide being on duty during the alleged incident.
A facility failed to ensure staff donned appropriate PPE before entering a resident's room under transmission-based precautions. A nurse aide entered a resident's room, who was under Enhanced Barrier Precautions for a feeding tube and CRE, without wearing a gown, although gloves were worn. The aide admitted to forgetting the gown due to a busy morning, despite knowing the requirement. The DON confirmed staff awareness of PPE requirements.
A resident reported being slapped multiple times by another resident, who had a history of verbal aggression. Despite the incident, the facility did not implement a protection plan, and the aggressor was allowed to return after a hospital evaluation. The incident was reported to law enforcement, but no charges were pressed.
A cognitively intact resident reported being slapped and having her hair pulled by another resident, but the facility failed to report the incident to the state or APS, conduct an investigation, or implement protective measures. The former Administrator did not report the incident, believing it was not reportable since no physical harm occurred. The current Administrator acknowledged the incident should have been reported and investigated per policy.
A resident in a LTC facility experienced a delay in receiving incontinence care, causing her to miss a favorite activity and become emotionally distressed. Despite activating her call light and requesting assistance, the resident waited over an hour and a half before receiving care. The delay was due to the nurse aide's inability to find necessary equipment and being occupied with other tasks. The MDS Nurse eventually provided the care, but the resident was upset and crying due to the prolonged wait.
A facility failed to maintain a clean environment in a resident's room, where dried tube feeding formula was observed on the feeding tube pole and floor. Despite multiple observations, the issue was not reported or addressed by housekeeping staff. Interviews revealed that staff were instructed to report such issues to the Housekeeping Director, but this protocol was not followed.
A resident with a history of incontinence and other medical conditions waited over an hour and a half for incontinence care after activating her call light. Despite the Activity Director's attempt to locate the responsible nurse aide, the resident remained in a soiled brief until the MDS Nurse provided care. The delay prevented the resident from attending a bingo activity, highlighting a deficiency in the facility's care provision.
A resident dependent on tube feeding was not administered the prescribed continuous feeding due to an oversight by a nurse. The resident's feeding tube was not restarted after a replacement, leaving the resident without necessary nutrition for most of the day. The Medical Director and Registered Dietitian confirmed the importance of continuous feeding for the resident's condition.
A resident with a PICC line did not have their dressing changed as ordered by the physician, despite documentation indicating otherwise. Observations showed the dressing had not been changed since its insertion, and the responsible nurse admitted to not performing the task. The DON confirmed the oversight, and the Medical Director highlighted the risk of infection due to this failure.
A resident with a tracheostomy in an LTC facility did not receive oxygen at the prescribed rate, and the oxygen concentrator was found dirty with a dusty filter. Staff interviews revealed confusion over cleaning responsibilities, with the nurse unaware of who should clean the equipment. The DON confirmed no cleaning schedule existed, and the resident could not adjust the oxygen settings, indicating a lapse in care.
A facility failed to maintain accurate medical records when a nurse documented changing a PICC line dressing for a resident, despite observations showing the dressing had not been changed as ordered. The nurse admitted to not performing the dressing change and assumed it had been done based on the date on the dressing. The DON confirmed the discrepancy and expressed disappointment in the inaccurate documentation.
Failure to Ensure Safe and Individualized Transfer/Discharge
Penalty
Summary
The facility failed to ensure that the transfer or discharge process met the resident's needs and preferences, and did not adequately prepare the resident for a safe transfer or discharge. The report identifies that the necessary steps to assess and address the resident's individual requirements and preferences during the transfer or discharge process were not followed, resulting in a deficiency related to resident care planning and transition.
Lack of Documented Informed Consent for Psychotropic Medication
Penalty
Summary
The facility failed to document that a resident was informed in advance of the risks and benefits associated with the use of Chlordiazepoxide HCl, a psychotropic medication prescribed for alcohol withdrawal. The resident, who had diagnoses including anxiety, depression, and alcohol dependence, was cognitively intact and had a history of leaving the facility to consume alcohol. Following an incident where the resident left to drink alcohol, the Medical Director, along with the DON and a family member via phone, discussed a treatment plan involving Chlordiazepoxide HCl. The medication was ordered in a tapered dose over five days, and monitoring for alcohol withdrawal symptoms was implemented per physician's orders. Despite evidence of verbal education and discussion about the medication's side effects and treatment plan, there was no written consent form for Chlordiazepoxide HCl in the resident's electronic medical record. Consent forms for other psychotropic medications were present and signed, but not for Chlordiazepoxide HCl. Interviews with the resident, Medical Director, DON, and Administrator confirmed that the resident did not sign any documentation agreeing to the treatment, and the resident did not recall consenting to the medication. This lack of documented informed consent constituted the deficiency identified during the survey.
Failure to Support Resident Self-Determination and Choice
Penalty
Summary
The facility failed to honor the resident's right to self-determination by not promoting and facilitating resident choice. This deficiency was identified based on observations or findings that the facility did not adequately support or encourage residents to make their own choices regarding their care or daily life, as required by regulations. Specific actions or omissions by the facility staff led to a lack of support for resident autonomy and decision-making.
Failure to Develop Comprehensive Care Plan for Resident with Complex Needs
Penalty
Summary
The facility failed to develop an individualized, person-centered comprehensive care plan for a resident with multiple complex medical needs, including end stage renal disease, encephalopathy, and diabetes. The resident required supervision to total assistance with activities of daily living (ADLs), was receiving dialysis three times a week, and had physician orders for insulin administration before meals and at bedtime. Despite these needs being identified in the Minimum Data Set (MDS) and Care Area Assessment (CAA), a review of the resident's electronic medical record and care plan revealed that there were no care plan interventions in place for insulin use, behaviors, dialysis, or ADL functioning as of the review date. Interviews with facility staff indicated that the initial baseline care plan was completed by staff nurses, while the comprehensive care plan was the responsibility of the MDS nurses. Due to a transition in MDS nursing staff, the comprehensive care plan for this resident was overlooked and not completed within the required timeframe. Both the MDS nurse and the Director of Nursing acknowledged that the comprehensive care plan should have addressed all of the resident's needs and been completed appropriately.
Failure to Adhere to Professional Standards in Medication Management
Penalty
Summary
The facility failed to ensure that services provided met professional standards of quality in three separate cases involving medication management and adherence to physician orders. In the first case, a resident with end stage renal disease, depression, and diabetes was admitted with a hospital discharge summary that included an order for lorazepam gel to be applied topically every 24 hours as needed for anxiety. Despite this, the lorazepam gel was not transcribed into the electronic medical record (EMR) or the medication administration record (MAR) from the time of admission until over two months later. Interviews revealed that both the admitting nurse and the Director of Nursing expected the medication to be processed and clarified with the provider if there were questions, but this did not occur, resulting in the omission of the medication from the resident's regimen. In the second case, a resident with hypertension and a history of cerebral infarction had an active order for Metoprolol, a medication that lowers heart rate and blood pressure. During medication administration, a nurse prepared to give Metoprolol to the resident despite a recorded heart rate of 46 beats per minute, which is below the normal range. The nurse did not have parameters to hold the medication and was unaware that Metoprolol should not be administered with a low heart rate unless directed by a provider. The nurse practitioner intervened before administration, instructed the nurse to hold the medication, and subsequently wrote an order to clarify the parameters for holding Metoprolol. In the third case, a resident with severe pain and a left knee contracture had a physician's order for a lidocaine patch to be applied in the morning and removed at bedtime. Observation revealed that the patch was not removed at bedtime as ordered, and the nurse responsible had documented its removal without actually performing the task. The nurse later could not recall if the patch had been removed, and the Director of Nursing confirmed that the order was not followed. These incidents demonstrate failures in medication transcription, administration, and adherence to physician orders for multiple residents.
Failure to Enforce Smoking Materials Storage Policy
Penalty
Summary
The facility failed to implement its smoking policy regarding the storage of smoking supplies for two residents who were assessed as safe smokers. The facility's policy required that all smoking materials and incendiary devices, such as lighters and cigarettes, be secured by the facility and not stored in residents' rooms. Despite this, both residents kept their smoking supplies in their personal spaces, such as bedside drawers and backpacks, and routinely carried them into and out of the facility without staff intervention. One resident, who was cognitively intact and independent in most activities of daily living, was observed keeping his cigarettes and lighter in his shirt pocket and bedside dresser, contrary to the facility's policy. Staff interviews revealed that although the resident was aware of the smoking agreement, he had never been told he could not keep supplies in his room. The staff responsible for monitoring smoking compliance reported difficulty enforcing the policy, as residents resisted using the assigned lockers for their smoking materials and staff were reluctant to confront them due to fear of negative reactions. Another resident, who had incomplete paraplegia and required maximum assistance with most activities of daily living, also kept his cigars and lighter in his room and in his backpack attached to his power wheelchair. Multiple staff members confirmed that this resident did not comply with the policy and managed his own smoking supplies. The facility had attempted to enforce the policy but was unsuccessful, as the resident refused to relinquish his smoking materials and declined to sign the smoking agreement. Facility leadership and staff acknowledged ongoing non-compliance with the smoking policy among residents, with several interviews indicating that the issue was persistent and difficult to manage.
Failure to Implement Abuse Policy Following Allegation
Penalty
Summary
The facility failed to implement its abuse policy effectively following an allegation of sexual assault involving a resident. The policy required a thorough investigation and protective measures, including interviewing all potential witnesses, securing physical evidence, and providing emotional support to the resident. However, the investigation was incomplete, lacking signed statements from staff, resident interviews, and skin assessments. The facility did not suspend any suspect staff members during the investigation, as required by their policy. The incident involved a resident who was cognitively intact and reported feeling pain in her lower abdomen and upper thigh area, suspecting sexual assault while she was asleep. The resident mentioned the incident during a pre-operation appointment, leading to her being sent to the emergency room for a sexual assault exam. The facility was informed of the allegation by the hospital staff, not by the resident directly, and began their investigation afterward. Interviews with staff, including the Unit Manager, Social Worker, and Director of Nursing, revealed inconsistencies and a lack of documentation in the investigation process. The staff did not recall specific details of the investigation, and no male staff members were suspended, despite the presence of a male nurse aide on duty during the alleged incident. The investigation folder lacked comprehensive documentation, and the facility's response did not align with their established abuse policy.
Failure to Follow Enhanced Barrier Precautions
Penalty
Summary
The facility failed to ensure that appropriate Personal Protective Equipment (PPE) was donned by staff before entering a resident's room under transmission-based precautions. Specifically, Nurse Aide #1 entered the room of a resident who was under Enhanced Barrier Precautions (EBP) due to a feeding tube and carbapenem-resistant enterobacterales (CRE) without wearing a gown, although gloves were worn. The facility's policy required both gown and glove use during high resident care activities, which were not adhered to in this instance. During an interview, Nurse Aide #1 acknowledged the requirement to wear a gown and gloves under EBP but admitted to forgetting to don a gown due to a busy morning. The Director of Nursing (DON) confirmed that all staff were aware of the precautions and PPE requirements posted on residents' doors, despite the recent departure of the Assistant Director of Nursing who previously oversaw infection control education.
Failure to Protect Resident from Abuse
Penalty
Summary
The facility failed to protect a resident's right to be free from abuse, as evidenced by an incident involving two residents. Resident #8, who was cognitively intact and required assistance for daily activities, reported being slapped multiple times by Resident #7, who also exhibited verbal aggression. Resident #7, diagnosed with schizophrenia and diabetes, had a history of verbal behavioral symptoms. The incident occurred when Resident #7 exited the smoking courtyard and encountered Resident #8, leading to physical aggression. Following the incident, Resident #8 reported the assault to Nurse #1, who noted that Resident #8 was in stable condition with no injuries. The Unit Manager was informed, and law enforcement was called, although Resident #8 declined to press charges. Resident #7 was sent to the hospital for evaluation and returned the same night. Despite the incident, the former Administrator did not consider it a reportable event or one requiring a protection plan, as no physical harm was observed. Interviews with staff, including the Social Worker and Activity Director, confirmed that Resident #8 was upset but did not wish to press charges. Attempts to interview Resident #7 and the Director of Nursing were unsuccessful. The facility's response to the incident, including the lack of a protection plan and the decision to allow Resident #7 to return, highlights the deficiency in safeguarding residents from abuse.
Failure to Implement Abuse Policy Following Resident-to-Resident Incident
Penalty
Summary
The facility failed to implement its abuse policy in the areas of reporting, investigating, and protection following an allegation of resident-to-resident abuse. The incident involved a cognitively intact resident who reported being slapped and having her hair pulled by another resident. Despite the report, the facility did not notify the state agency or Adult Protective Services (APS), and no investigation was conducted. The facility's policy required the Abuse Coordinator or designee to investigate all allegations, take statements, secure evidence, and prepare a detailed report, none of which were completed in this case. Additionally, the facility did not implement any protective measures to prevent further potential abuse. The resident who reported the abuse was not injured, and the perpetrator was temporarily removed for a hospital evaluation but returned the same day. Staff interviews revealed a lack of communication and action from management, with no instructions given for increased supervision or protection. The former Administrator did not report the incident, believing it did not qualify as reportable since no physical harm occurred. The current Administrator, unaware of the incident, acknowledged that it should have been reported and investigated per the facility's policy.
Failure to Provide Timely Incontinence Care
Penalty
Summary
The facility failed to provide timely incontinence care to a resident, resulting in the resident missing a favorite activity and experiencing emotional distress. The resident, who was admitted to the facility in 2015, had a care plan indicating bowel and bladder incontinence and depressive episodes. On the day of the incident, the resident activated the call light at 1:47 PM, requesting assistance from a nurse aide for incontinence care before attending a bingo activity scheduled for 2 PM. However, the nurse aide did not return to provide the necessary care, leaving the resident in a soiled and wet brief. The Activity Director, upon noticing the resident's call light, attempted to locate the nurse aide but was unsuccessful. The Director of Nursing was informed of the situation, but the resident continued to wait for over an hour and a half before receiving care from the MDS Nurse. During this time, the resident remained in her room, missing the bingo activity and becoming upset and crying due to the delay in care. The resident expressed frustration over the inability to care for herself and the necessity of relying on staff for assistance. Interviews with staff revealed that the nurse aide was unable to find the necessary equipment to assist the resident and was occupied with other call lights. The nurse aide later apologized to the resident for the delay. The MDS Nurse confirmed that the resident's call light was on when she arrived and provided the needed incontinence care. The facility's Director of Nursing acknowledged that the delay in care was not dignified and that the resident's call light had been on for an extended period, causing distress to the resident.
Failure to Maintain Clean Environment in Resident Room
Penalty
Summary
The facility failed to maintain a clean and homelike environment in one of the resident rooms, specifically room [ROOM NUMBER], where tube feeding formula was observed dried on the feeding tube pole and the floor. Observations were made at multiple times throughout the day, revealing that the dried formula covered the pole, the base of the pole, and the floor beneath it. Despite the presence of the dried formula, it was not reported or cleaned by the housekeeping staff, leading to a deficiency in maintaining a clean environment for the resident. Interviews with the Housekeeping Director and Housekeeper #1 revealed that the housekeeping staff were instructed to report such issues to the Housekeeping Director, who would then clean the area using a specific method involving a cleaner and a scraper. However, Housekeeper #1, who was responsible for cleaning the room, stated that she did not notice any dirt during her cleaning shift and did not return to the room afterward. The Director of Nursing and the Administrator both indicated that staff members were expected to either clean such spills or report them to someone who could, but this protocol was not followed in this instance.
Failure to Provide Timely Incontinence Care
Penalty
Summary
The facility failed to provide timely incontinence care to a resident, leading to a deficiency in the care provided. The resident, who had a history of major depressive disorder, anxiety disorder, overactive bladder, urgency of urination, and urgency incontinence, was admitted to the facility in 2015. The resident required substantial to maximum assistance with toileting hygiene and was frequently incontinent of bladder and always incontinent of bowel. On the day of the incident, the resident turned on her call light at 1:47 PM, requesting assistance from a nurse aide for incontinence care before attending a bingo activity. Despite the resident's request, the nurse aide did not provide the necessary care in a timely manner. The Activity Director, who was informed of the resident's need, attempted to locate the nurse aide but was unsuccessful. The Director of Nursing was informed of the situation, but the resident remained in a soiled and wet brief until the MDS Nurse, who was not responsible for direct care, provided the necessary incontinence care much later. The resident expressed dissatisfaction with the delay, stating that she had to wait approximately an hour and a half for assistance, which prevented her from attending the bingo activity she enjoyed. Interviews with staff revealed that the nurse aide responsible for the resident's care was unable to find the mechanical lift needed for assistance and was occupied with other residents' needs. The nurse aide left the facility at the end of her shift without providing care to the resident, assuming the next shift would address the issue. The MDS Nurse confirmed that the resident's brief was soiled with feces and moderately wet with urine when she finally provided care. The facility acknowledged that it was unreasonable for a resident to wait over an hour and a half for incontinence care.
Failure to Administer Continuous Tube Feeding as Ordered
Penalty
Summary
The facility failed to administer tube feedings as ordered by the physician for a resident with a gastrostomy tube. The resident, who was dependent on tube feeding to meet nutritional needs due to a tracheostomy and other medical conditions, was observed multiple times throughout the day without the prescribed continuous tube feeding formula being administered. The feeding tube pump was present, but the formula was not hung, and an unopened bottle of formula was noted in the resident's room. Nurse #1 acknowledged the oversight, stating that the tube feeding was mistakenly not restarted after replacing a leaking gastrostomy tube earlier in the shift. Interviews with the Medical Director, Director of Nursing, and Registered Dietitian confirmed that the resident's tube feeding should have been immediately restarted once the tube was replaced and functioning. The Medical Director and Registered Dietitian emphasized the importance of continuous feeding for the resident's specific medical needs, highlighting that the resident was 100% dependent on the feeding tube for nutrition. The oversight resulted in the resident going without the necessary tube feeding for the majority of the day, contrary to the physician's orders.
Failure to Change PICC Line Dressing as Ordered
Penalty
Summary
The facility failed to change the dressing on a peripherally inserted central catheter (PICC) line for a resident as ordered by the physician. The resident, who was admitted with osteomyelitis of a pressure ulcer and an abscess, had a PICC line inserted at the hospital prior to admission. The physician's order required the PICC line dressing to be inspected, cleaned, and changed every Thursday during the day shift. However, observations on July 1st revealed that the dressing had not been changed since June 13th, despite documentation on the Medication Administration Record (MAR) indicating that it had been changed on June 20th and June 27th. Nurse #2, who was responsible for the dressing changes, admitted during an interview that she had not changed the dressing in the last month and could not explain the discrepancy in the MAR. The Director of Nursing confirmed the oversight and acknowledged that the facility had limited experience with PICC lines. The Medical Director expressed concern about the increased risk of infection due to the failure to change the dressing as scheduled.
Deficiency in Respiratory Care for Tracheostomy Resident
Penalty
Summary
The facility failed to provide safe and appropriate respiratory care for a resident with a tracheostomy by not delivering oxygen at the prescribed rate and not maintaining the cleanliness of the oxygen concentrator and its filter. The resident, who was severely cognitively impaired and dependent on a tracheostomy for oxygen, was observed multiple times with the oxygen concentrator set to 3.5 liters instead of the prescribed 4 liters. Additionally, the oxygen concentrator was found to be dirty with dried substances and dust on the filter. Interviews with staff revealed a lack of clarity regarding responsibilities for cleaning the oxygen concentrator and its filter. Nurse #1, who was responsible for the resident, confirmed the incorrect oxygen setting and acknowledged the need for cleaning the concentrator and filter. However, she was unaware of who was tasked with this cleaning duty. The Housekeeping Director and Housekeeper #1 also provided conflicting information about the cleaning responsibilities, with the Housekeeping Director stating that both nursing and housekeeping were responsible, while Housekeeper #1 indicated she was not supposed to clean the concentrator unless it was a quick wipe down. The Director of Nursing (DON) further confirmed the absence of a cleaning schedule for the oxygen concentrator and filters, and stated that night shift staff were responsible for changing the tubing. The DON also emphasized that the resident could not change the oxygen settings themselves, indicating a lapse in monitoring and maintenance of the equipment. This deficiency highlights a breakdown in communication and responsibility assignment among the staff, leading to inadequate respiratory care for the resident.
Inaccurate Documentation of PICC Line Dressing Change
Penalty
Summary
The facility failed to maintain a complete and accurate medical record for a resident requiring intravenous medications. Nurse #2 documented on the Medication Administration Record (MAR) that she had changed the peripherally inserted central catheter (PICC) line dressing on two occasions, as per the physician's order, which required the dressing to be changed every Thursday on the day shift. However, observations made on July 1, 2024, revealed that the dressing had not been changed since June 13, 2024, as it was noted to be rolled up at the edges with dirt particles, indicating it had not been replaced as documented. During an interview, Nurse #2 admitted that she had not changed the dressing in the last month and could not explain why she documented otherwise on the MAR. She mentioned that she assumed the dressing had been changed because it was dated for the same day she checked it. The Director of Nursing confirmed the discrepancy and expressed disappointment that Nurse #2 documented an action that was not performed, acknowledging that the dressing should have been changed according to the physician's order.
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Illustrative
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
Illustrative
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Illustrative
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Nursing homes near Charlotte
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Rockwell Park Rehabilitation And Healthcare Center | 1.4 mi | — | 11 | 1 |
| Shamrock Nursing Center | 2.8 mi | ★★★★★ | 0 | 0 |
| University Place Nursing And Rehabilitation Center | 3 mi | ★★★★★ | 2 | 0 |
| Asbury Health And Rehabilitation Center | 3.2 mi | ★★★★★ | 5 | 0 |
| Peak Resources - Charlotte | 4.4 mi | ★★★★★ | 0 | 0 |
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