Failure to Maintain Clean and Homelike Environment for Residents
Penalty
Summary
The facility failed to maintain a safe, clean, comfortable, and homelike environment for twenty-six sampled residents, as evidenced by multiple observations and interviews. Facility policies required routine cleaning and disinfection of high-touch surfaces and resident-care equipment, as well as adherence to preventative maintenance schedules. However, observations revealed that floors throughout the main corridors were heavily stained with wax buildup and grime, and some resident rooms had a yellowish film on the floors. The bottom of one resident's infusion pole was found coated in a dried brown substance. A grievance form documented concerns about overall cleanliness and stained floors, which the facility attributed to non-fecal stains, but acknowledged the need for deep cleaning. Interviews with staff and a state guardian highlighted ongoing issues with cleanliness and maintenance. The state guardian described the facility as dirty and unsanitary, noting chipped paint, brown smears on walls and privacy curtains, and dirty floors. He reported that while some cleaning and repairs had been attempted, the improvements were insufficient. Staff interviews revealed confusion and inconsistency regarding responsibility for cleaning medical equipment, with LPNs and CNAs providing differing accounts of their roles. Housekeeping staff and the floor technician reported that deep cleaning was infrequent, floors had not been stripped and waxed in a long time, and that there was a lack of enforcement and oversight from management. Further, the former Environmental Services Director stated that inadequate staffing and limited resources hindered the ability to maintain cleanliness, despite requests for additional support. The current Director of Environmental Services, new to the position, was still in the process of revising policies and implementing documentation for cleaning duties. The DON and Administrator expressed differing views on who should be responsible for cleaning medical equipment, with the Administrator stating that CNAs should not handle medical equipment and that nurses should address any visible dirt. The Administrator also noted that staff had been instructed to stop waxing floors over dirt, as this practice contributed to the facility's unclean appearance.