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F0584
E

Failure to Maintain Odor-Free, Homelike Environment

Mitchell, South Dakota Survey Completed on 04-25-2025

Penalty

Fine: $70,980
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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 maintain a homelike environment free from foul odors in multiple areas, including the physical therapy gym, the nurse's desk outside the therapy gym, the rehab dining room, and the 200-hallway near the nurse's station. Staff and residents reported a persistent sewer odor, particularly near the therapy gym, which was confirmed by both observation and interviews. Maintenance records showed repeated work orders addressing the sewer smell, including smoke tests and plumbing repairs, but the odor continued to be present and noticeable to residents and staff. One resident reported the issue had persisted for years and had communicated concerns to the administrator multiple times, but the problem was not fully resolved. Additionally, a strong urine odor was observed in a resident's room on the 200-hallway and was noticeable down the hall near the nurse's station. The resident was found lying on his bed in wet clothing, with an empty urinal nearby, and did not perceive the odor himself. Staff interviews indicated that the resident often missed the urinal, resulting in urine on the floor and other surfaces, and that he was resistant to having his room cleaned or his linens changed. Housekeeping staff attempted to coordinate cleaning with the resident's bath days, but reported limited cooperation from nursing staff in addressing persistent odor issues. Despite deep cleaning efforts and the use of disinfectant cleaners, the urine odor in the resident's room and the surrounding hallway persisted, sometimes masked by air fresheners. Housekeeping policies required daily damp mopping and thorough cleaning, but the ongoing presence of strong odors indicated that these measures were not effective in eliminating the problem. The facility's failure to address and resolve these odor issues resulted in an environment that was not safe, clean, comfortable, or homelike for residents.

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