Non-compliance with Water Temperature Safety Policy
Penalty
Summary
Loyalhanna Care Center was found to be non-compliant with federal and state regulations regarding accident hazards and supervision. The facility failed to maintain a safe environment by not adhering to its policy on water temperature control. The policy, dated January 13, 2025, required water temperatures to be set at no more than 110 degrees Fahrenheit, with weekly checks and documentation of water temperatures in all hot water circuits. However, during a complaint survey, it was observed that water temperatures in several resident rooms exceeded this limit, with temperatures recorded at 125, 121.6, and 119.4 degrees Fahrenheit. Interviews with Maintenance Worker 1 revealed a lack of adherence to the policy, as he admitted to not completing water temperature logs in the past week and was unable to provide documentation of weekly checks. The Nursing Home Administrator confirmed the absence of documented evidence for these checks and acknowledged that the water temperatures should not have been as high as observed. This failure to monitor and document water temperatures as per policy resulted in the facility's non-compliance with the requirements to ensure a safe environment for residents.
Plan Of Correction
Plan of Correction: In preparation and/or execution of this plan of correction does not constitute admission or agreement by the provider of the truth of the facts alleged or conclusions set forth in the statement of deficiencies. The plan of correction is prepared and/or executed solely because it is required by the provisions of federal and state law. IDENTIFIED: Residents identified were not in any immediate harm. Residents have been checked for any skin issues; no skin issues identified. LIKE: No other residents have been identified to have any issues. SYSTEM CORRECTION AND EDUCATION: The Nursing Home Administrator has educated the maintenance staff on the weekly water temp checks to include a sample of resident rooms. Any issues will be reported and handled accordingly. They have also been educated on the Safe Water Temperatures Policy and F689. Water temperature audits will be done weekly x 2 weeks and then monthly x 2 months. Results of audits will be reviewed at the facility's Quality Assurance Performance Improvement (QAPI) meetings. Date of Compliance: 26 March 2025.