Failure to Maintain Boiler and Elevators
Penalty
Summary
The facility failed to maintain essential mechanical systems, specifically the boiler system and three elevator cars, resulting in significant deficiencies. The boiler system malfunction led to the absence of hot water for resident hygiene on the third and fourth floors. This issue was identified when the Plant Operations Manager and a Maintenance Worker discovered a leaking storage holding tank, which necessitated shutting off the water supply, leaving only cold water available for sinks, showers, and toilets. Additionally, all three facility elevators were non-functional, which severely restricted residents' mobility, particularly those on the third and fourth floors. The main elevators had been out of service since repair proposals were received in September, but a payment plan with the vendor had not been finalized, delaying repairs. The service elevator, which was initially operational, also failed due to overuse, leaving the facility without any functioning elevators. This situation forced the facility to carry meals up the stairs and cancel non-essential medical appointments, as residents could only be moved in emergencies using a bed sled.
Plan Of Correction
1. The main elevator was restored on 12/18/24 at 3:19pm. The service elevator generator was submitted to insurance and the facility will receive weekly updates from the insurance company and elevator company on when it can be installed. 2. The elevator inspector reviewed the main elevator on 12/23/24. The elevator and boiler system is in working order. 3. Audits of the elevator's operations and boiler system will be performed weekly x 3 weeks and monthly x 2 months by the Plant Operations Manager or designee. 4. Results of elevator audits will be submitted to the monthly QA process for monitoring and IDT review.