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F0584
E

Failure to Maintain a Safe, Clean, and Odor-Free Environment

Evansville, Indiana Survey Completed on 04-09-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to provide a safe, clean, and odor-free environment for residents, staff, and the public, as evidenced by multiple observations of offensive odors and unsanitary conditions over a five-day period. Strong smells of urine were repeatedly detected in public hallways, alcoves, stairwells, and near the chapel, as well as outside specific resident rooms and the Holy Family Nurses Station. Additionally, the smell of feces was noted in alcoves on the second floor. These conditions were observed on several occasions, indicating a persistent issue rather than isolated incidents. Further, interviews and direct observations revealed that resident rooms and bathrooms were not being cleaned adequately. One resident reported that her room was not cleaned daily, and brown dried mud and dirty shower floors were observed in her room on separate days. Another resident's family member reported finding food crumbs behind drawers, and subsequent inspection confirmed the presence of food crumbs, a sticky bathroom floor, and a dirty shower floor. A housekeeper stated there was no daily cleaning list and described inconsistent cleaning practices. The DON confirmed that there should be no offensive smells in the building and provided a policy stating the facility's intent to maintain a clean, odor-free environment, which was not being met.

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