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F0584
D

Failure to Maintain Clean and Homelike Environment in Dementia Unit

Philadelphia, Pennsylvania Survey Completed on 05-20-2025

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 maintain a clean and homelike environment in a dementia care unit, as evidenced by observations and staff interviews. During an inspection, the bathroom shared by three residents was found to be dirty, with feces present in the toilet bowl, a strong urine odor, and flies in the bathroom. The facility's policy requires daily cleaning of resident rooms and bathrooms by housekeeping staff, but the Housekeeping Director confirmed that the bathroom had not been cleaned due to a shortage of housekeeping staff. Additionally, a nurse aide reported cleaning a resident after an episode of diarrhea but did not inform housekeeping that the bathroom required cleaning. Staff interviews revealed that when families raised concerns about the cleanliness of resident rooms or environmental issues, nursing staff attributed the problems to resident behaviors and indicated they would address them when time permitted. One resident who used the affected bathroom was hospitalized with a urinary tract infection (UTI) and ESBL (extended-spectrum beta-lactamase producing bacteria) and was receiving antibiotics. The infection control staff confirmed that using a dirty bathroom could result in exposure to such bacteria.

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