Improper Garbage Disposal and Grounds Maintenance
Summary
The facility failed to properly dispose of garbage and refuse, leading to a potential rodent and pest problem. During a tour of the facility grounds and loading dock area, the surveyor observed construction debris, broken pallets, plastic wrap, Styrofoam panels, and paper litter scattered across the grassy side yard visible from the first-floor residents' windows. Additionally, numerous cigarette butts were found on the ground along the driveway and grassy area, with a cigarette receptacle lying on its side. Behind a short brick wall, more construction debris, metal benches, milk cartons, and tarps were found haphazardly thrown. Further observations behind a large blue storage trailer shed revealed orange milk crates, construction trash, soda cans, and gloves on the ground. Around the facility's three green trash dumpsters, gloves, soda cans, and cigarette butts were also present. The Licensed Nursing Home Administrator (LNHA) acknowledged the concern, stating it was unfair for residents to view such conditions and that the trash could lead to a rodent and pest problem. Interviews with the Maintenance Director (MD) and Housekeeping Director (HD) revealed that both were unaware of their responsibilities for grounds maintenance until recently. The facility's undated policies on grounds maintenance, food-related garbage and refuse disposal, and smoking were reviewed, indicating that maintenance should keep the grounds free of litter and that storage areas should be kept clear at all times.
Penalty
Resources
Below are regulatory guidelines relevant to this citation:
Improper Dumpster Waste Disposal: The dumpster area behind the kitchen had open doors on 2 dumpsters and trash left on the ground behind them, including iron bars and black trash bags. The MM stated anyone using the dumpsters was responsible for placing trash properly and closing the doors, but he had not been trained and had not seen a waste disposal policy. The ADM stated no one was assigned to monitor the issue and staff had not been trained on the task or reviewed the facility's dumpster use and waste disposal policy.
Improper Garbage and Refuse Disposal: Surveyors observed a large lidless dumpster containing exposed facility trash bags and a small dumpster with an open lid exposing its contents to pests and wildlife. The Kitchen Manager acknowledged the conditions, and the Interim Certified Dietary Manager stated the large dumpster was a construction dumpster and should not have contained facility trash.
Uncovered Trash Can in Food Prep Area: A 50-gallon trash can in the food prep area was observed about half full and without a lid while not in use. The Food Service Supervisor stated she was not aware the garbage can required a lid but would get one.
Improper dumpster waste disposal and open dumpster doors were cited after surveyors observed two commercial dumpsters with their doors left open and an improperly trashed recliner chair left on the ground behind them. The HKS, MM, and ADM each described responsibility for keeping the area clean and closing the doors, and the facility policy required waste to be placed fully inside the dumpster and doors or lids to remain closed when not in use.
Improperly Covered Outdoor Trash Receptacle: During a kitchen tour, the outside garbage receptacle was observed with three of eight lids open. Dietary staff, maintenance staff, and administrative staff all stated the dumpster lids should be closed when not in use, and the facility policy documented that outdoor trash receptacles would be kept covered.
Unsanitary Outside Dumpster Area: Surveyors observed two outside dumpsters with litter and debris on the ground beneath them, including a soiled disposable brief, eggshells, an empty hand sanitizer container, and piles of brown debris. The DM stated they did not know which department was responsible for cleaning the dumpster area and acknowledged there should not be litter on the ground. A facility policy stated the area around outside dumpsters should be free from litter.
Improper Dumpster Waste Disposal
Penalty
Summary
The facility failed to dispose of garbage and refuse properly for 2 of 3 dumpsters, specifically dumpsters #1 and #2. During observation on 06/15/2026 at 10:01 a.m., the dumpster area behind the kitchen was found with the doors to both dumpsters open, and improperly trashed iron bars (x5) and black trash bags (x2) were observed on the ground behind the dumpsters. During interviews on 06/17/2026, the MM stated that anyone who used the dumpsters was responsible for making sure trash was placed properly and the dumpster doors were closed, and he stated he had not been trained on the task and had not seen a waste disposal policy. The ADM stated that the dumpster doors should be closed after trashing and garbage should be disposed of properly, but at that time no one was assigned to monitor the identified failures. The ADM also stated staff had not been trained on the task and had not come across the waste disposal policy. The facility policy titled, Dumpster Use and Waste Disposal Policy, stated that all waste shall be disposed of in designated dumpsters, waste should not be left on the ground or beside dumpsters, and dumpster lids and exterior doors leading to dumpster areas shall remain closed and secured when not in use.
Improper Garbage and Refuse Disposal
Penalty
Summary
The facility failed to ensure garbage and refuse were disposed of properly. On 6/8/2026 at 9:51 AM, surveyors observed a large dumpster with no lid containing exposed filled household-style plastic garbage bags, and the bags were not secured from pests or wildlife. In the same area, a small dumpster had its left side top lid open, exposing the contents of the dumpster to pests and wildlife. During interviews, the Kitchen Manager acknowledged that the large dumpster with no lid should not contain garbage and confirmed the small dumpster lid was open. On 6/9/2026 at 9:09 AM, the Interim Certified Dietary Manager stated the large dumpster was a construction dumpster and should not contain facility trash. The facility policy titled Sanitization, last reviewed 1/22/2026, stated that kitchens, kitchen areas, and dining areas are to be kept clean, free from garbage and debris, and protected from rodents and insects, and that garbage and refuse containers are to be in good condition with waste properly contained in dumpsters/compactors with lids or otherwise covered.
Uncovered Trash Can in Food Prep Area
Penalty
Summary
The facility failed to ensure garbage cans were properly covered in the food prep area to minimize attracting pests and rodents. Based on observation, interview, and review of the U.S. Food and Drug Administration 2022 Food Code, a 50-gallon trash can in the food prep area that was not being used was observed about half full and had no lid. The FDA Food Code Section 5-501.113 requires receptacles and waste handling units to be kept covered when inside the food establishment if they contain food residue and are not in continuous use or after they are filled. The Food Service Supervisor stated she was not aware the garbage can required a lid but would get one.
Improper Dumpster Waste Disposal and Open Dumpster Doors
Penalty
Summary
Dispose of garbage and refuse properly was cited after surveyors observed the facility’s dumpster area next to the loading dock with commercial-size dumpsters #1 and #2 left with their doors open. Surveyors also observed an improperly trashed recliner chair on the ground behind both dumpsters. The observation was made during the survey visit, and the report identified the condition in 2 of 2 dumpsters reviewed. During interviews, the HKS stated that the MM was responsible for keeping the dumpster area clean and closing the doors, and that she helped sometimes, while the MM was responsible for monitoring those tasks. The HKS said the doors may have been left open because the MM forgot to close them or because the dumpsters may have been full, and she stated she had not received training on the task and had not come across the waste disposal policy. The MM stated he was responsible for properly disposing of the recliner chair and closing both dumpster doors, and that he was also responsible for monitoring the task. The ADM stated that anyone who throws away trash is responsible for keeping the dumpster area clean and closing the door, while the MM monitors the task, and he was not sure why the recliner was left on the ground or why the dumpster doors were left open. Record review showed the facility policy required waste to be placed fully inside the dumpster, doors or lids to remain closed when not in active use, and maintenance or environmental services to inspect dumpster areas routinely for cleanliness and compliance.
Improperly Covered Outdoor Trash Receptacle
Penalty
Summary
The facility failed to maintain and dispose of kitchen garbage and refuse properly. During a kitchen tour, the outside garbage receptacle was observed with three of the eight lids open. Dietary Staff E stated that all of the lids were supposed to be closed. Maintenance Staff B later stated that all lids on the outside trash dumpster should always be closed, and Administrative Staff A stated she expected all trash dumpster lids to be closed when not being used. The facility's 2020 policy, Garbage and Rubbish Disposal, documented that outdoor trash receptacles would be kept covered.
Unsanitary Outside Dumpster Area
Penalty
Summary
The facility failed to ensure sanitation of the outside trash storage area for 2 of 2 outside dumpsters. During a tour of the kitchen with the Dietary Manager, two dumpsters were observed outside the facility. Under the left dumpster, surveyors observed a wet, soiled disposable brief, eggshells too numerous to count, and piles of brown, dry debris too numerous to count. Under the right dumpster, surveyors observed an empty hand sanitizer container and piles of brown, dry debris too numerous to count. In interview, the Dietary Manager stated they were unaware of which department was responsible for cleaning the outside dumpster area and acknowledged there should not be litter on the ground. A current facility policy dated 2001 stated the area surrounding outside dumpsters should be free from litter.
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