Facility Fails to Maintain Clean and Homelike Environment
Penalty
Summary
The facility failed to maintain a clean and homelike environment in two of its nursing units, as evidenced by several observations made by surveyors. In room 139 bed C, privacy curtains were found to be dirty with brown spots and black streaks. In room 140B, a loose closet door with unsecured hinge screws and cracks in the wall around the heater were noted. Additionally, the shower room on the 1st South nursing unit had 12 ceiling tiles with water damage, including one with a large hole. Room 152 had a broken dresser, a detached baseboard, a loose heater P-Tac unit cover box, holes in the wall near the baseboard, and broken tray tables. Further observations in the 1 North shower room revealed clutter, including three large trash cans in the first shower stall, a large trash can and three tray tables in the second stall, and a mechanical lift stored in the middle of the shower area. There was no privacy curtain between the second and third shower stalls, and the fourth stall contained three mechanical lifts. A regular resident's chair was also placed near the sink, contributing to the cluttered environment. These findings indicate a failure to provide a safe, clean, and comfortable environment as required by regulations.
Plan Of Correction
Step 1 The privacy curtain in room 139C was replaced. Furniture in room 140B was repaired, crack in the wall in room 140 was repaired. Ceiling tiles in 1 south nursing unit replaced. The dresser in room 152 was repaired. The baseboard was repaired and the PTAC cover was repaired, hole in the wall. The bedside tray table replaced room 152B. Clutter in 1 north shower room was immediately removed and the privacy curtain was installed between the second and the third stall. Step 2 A Facility-wide audit will be completed to ensure that furniture, walls, privacy curtains, baseboard, bedside tray tables, and PTAC covers are in good condition and that all shower rooms are clutter-free. Step 3 Facility staff will be educated on the requirements to ensure that residents have a safe, clean, comfortable, and homelike environment. Step 4 NHA/Designee will complete random audit weekly x4 monthly x2. Findings will be reviewed during QAPI meeting.