Failure to Maintain Safe, Clean, and Comfortable Environment
Penalty
Summary
The facility failed to maintain a safe, clean, comfortable, and home-like environment for residents, staff, and the public, as evidenced by multiple observations of disrepair and uncleanliness throughout the memory care unit and other areas. Surveyors observed cracked walls with exposed plaster, missing or broken closet doors, broken window blinds, peeling cove base, cracked and stained floors, missing bathroom tiles, and a sink separated from the wall. Additionally, foam was sprayed in a window corner, and a chair/bed rail was missing from a wall. The dining room cabinets were found to contain ground-in dirt, food debris, and trash, with the Director of Housekeeping acknowledging that cleaning had been missed and that such conditions could attract pests. The Administrator confirmed awareness of ongoing pest issues and agreed that the unit required updates. Further observations included a urinal stored on a bathroom handrail without resident identification, a bathroom door missing a doorknob, and a soiled privacy curtain with brown stains. Several rooms had broken or missing blinds and closet doors, with residents reporting that these issues had persisted for months. One resident expressed discomfort due to a bed that was too short, and staff confirmed that maintenance concerns had been reported but not addressed. Documentation showed that while quotes for supplies had been obtained, no orders had been placed for necessary repairs, and work orders were marked as completed despite the issues remaining unresolved. Interviews with staff, including LPNs, the ADON, the Regional Nurse Consultant, and the DON, confirmed awareness of the deficiencies, such as broken blinds and missing closet doors, but also revealed a lack of follow-through in addressing these concerns. Residents reported dissatisfaction with the state of their rooms, including missing closet doors that left their clothing exposed. The facility's own policy required work orders to be completed with priority, but evidence showed that repairs were not made in a timely manner, contributing to an environment that was not safe, clean, or comfortable for residents.