Haven of Sedona

In the surveyor’s words

From the most serious findings on record at Haven of Sedona, in the surveyor’s own words.

• Immediate jeopardy, patternF880Feb 10, 2022

  Based on observations, interviews, facility documentation, policy review, COVID-19 rapid test card instructions, the Center for Disease Control (CDC) guidelines, and the Centers for Medicare & Medicaid Services (CMS) guidance, the facility failed to maintain an effective infection control program by using improper infection control techniques while performing COVID-19 testing for 6 residents (#53, #8, #11, #27, #17, and #16). As a result, the Condition of Immediate Jeopardy (IJ) was identified. The facility also failed to ensure that residents performed hand hygiene prior to meals. The census was 65 and 4 residents were positive for COVID-19. Findings include: On February 8, 2022 at 2:53 p.m., the Condition of IJ was identified. […]

• No harm, potential for more than minimal, widespreadF727Apr 22, 2026

  Based on review of facility documentation, staff interviews, and facility policy, the facility failed to ensure that the Director of Nursing did not work as Charge nurse when facility census was more than 60 residents. The census was 87. This deficient practice could result in potential harm to residents due to insufficient staffing to adequately meet resident needs. Findings include: The Facility Assessment with completed date of March 21, 2022 included an intent to evaluate its resident population and identify resources needed to provide the necessary person-centered care and services the residents require. The number of residents the facility were licensed to provide care for was 112. Average daily census ranged 85-95 with 20-30+ being short term stays. […]

• No harm, potential for more than minimal, widespreadF851Apr 9, 2025

  Based on resident and staff interviews, facility documentation and policy review, the facility failed to ensure ensure staffing information submitted was accurate. The deficient practice could result in residents receiving inadequate care due to potential lack of staffing. Findings include: The PBJ (Payroll-Based Journal) Staffing Data Report revealed that the facility consistently triggered for excessively low weekend staffing for all four quarters in 2024 and, the 1st quarter of 2025. […]

• No harm, potential for more than minimal, patternF584Apr 22, 2026

  Based on observations, resident and staff interviews, and policy reviews, the facility failed to ensure maintenance, clean, safe and comfortable interior for 7 out of 7 rooms sampled. The census was 87. The deficient practice could result in resident rooms not having a safe, clean, and homelike environment.Findings include:During a walk-through of the 100-Hall conducted on January 19, 2026 at 2:18 p.m. the following was observed:room [ROOM NUMBER]: entryway flooring was uneven, broken, missing the transition strip, and appeared to be dirty with brownish/black grime with the crack embedded with dirt/debris. […]

• No harm, potential for more than minimal, patternF628Apr 22, 2026

  Based on closed record review, staff interviews, and the review of facility process and policy, the facility failed to ensure that a copy of the transfer/discharge notification was sent to the ombudsman for five of five sampled residents (#12, #100, #102, #8, and #107) for discharge. The census was 87. The deficient practice could leave residents without protection against inappropriate transfers or discharges and without access to an advocate to explain their rights and options. […]