Facility Fails to Maintain Sanitary and Comfortable Environment
Penalty
Summary
The facility failed to maintain a sanitary and comfortable environment for two residents. For Resident R220, an observation on January 15, 2024, revealed that the IV pole used for administering an antibiotic intravenously was soiled at its base with what appeared to be old tube feeding formula. This observation was made in the presence of the Director of Nursing, indicating a lapse in maintaining cleanliness of medical equipment. Resident R164 experienced discomfort due to a malfunctioning over-the-head light that could not be turned off. The resident, who was admitted on January 2, 2025, with a progressive neurological condition, cerebrovascular accident, and Parkinson's disease, reported that the light had been broken since admission. Despite attempts by facility staff to fix the light, it remained inoperable, forcing the resident to sleep with the lights on. The administrator confirmed the issue with the light on January 12, 2025.
Plan Of Correction
1) Overhead light for resident R164 was fixed. IV pole for Resident R220 was cleaned. 2) Facility wide audit of current residents who are ordered IV medication were checked for cleanliness; variances were addressed. A facility wide audit was also completed of all resident rooms to ensure that all overhead lights had strings that were appropriate in length to meet the needs of the residents. Variances were addressed. 3) Maintenance director/designee will educate maintenance department staff members on ensuring broken overhead lights are fixed timely. Housekeeping director/designee will educate housekeeping department staff members on ensuring proper cleanliness of IV poles. 4) Random room audits will be conducted weekly x 3, then monthly x 2 or until compliance is met to ensure cleanliness of IV poles and that overhead lights are in proper working order. Variances will be addressed and reported to the QAA committee.