Improper Storage of Garbage and Medical Waste
Summary
The facility failed to properly store garbage and refuse, as evidenced by an observation of the dumpster area that was found to be polluted with garbage and used medical supplies. This issue was confirmed during an interview with the Administrator, who verified the presence of trash and medical supplies on the ground around the dumpster. The deficiency has the potential to affect all residents in the facility, which had a census of 107 at the time of the observation.
Penalty
Resources
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Surveyors found that the dumpster area was not properly maintained or kept free of refuse, with used gloves on the ground, multiple broken and stained recliners, a broken armchair, and a broken chest of drawers left around the dumpster for an extended period. A dietary staff member confirmed the debris and was unaware of how trash and garbage pickup was arranged, noting that maintenance handled disposal. A maintenance staff member stated that maintenance was responsible for cleaning the dumpster area, that he had placed the furniture there months earlier for disposal, and that the person who previously removed trash and debris had stopped doing so without a replacement being found. He acknowledged that the accumulated debris and used gloves created potential for rodent infestation and cross-contamination, contrary to facility policy requiring storage areas to be neat and free of refuse and discarded furniture.
The facility failed to follow its policy requiring outdoor garbage containers to have tight-fitting lids kept closed when not in continuous use. During an observation of the outdoor trash area, two of four dumpsters were found with their lids open. The Dietary Manager confirmed at the time of observation, and later in interview, that the lids on these dumpsters were not closed and that garbage was not properly contained to prevent potential rodent and insect infestation, resulting in a deficiency under facility management regulations.
The facility did not ensure proper disposal of garbage and refuse when surveyors observed both a recycling dumpster and a regular trash dumpster with lids left open, contrary to the facility’s sanitization policy requiring waste to be contained in dumpsters with closed lids. The Dietary Manager reported that wind or trash collection activities sometimes leave lids open, that trash and recycling are collected on scheduled days, and that kitchen staff empty trash daily and are expected to close dumpster lids if they find them open, but this did not consistently occur.
Surveyors found that the trash compactor area, located behind the kitchen entrance, was not properly maintained, with multiple plastic bottles, disposable cups, gloves, and straws scattered in the grassy area beside the compactor. The DM stated that kitchen staff cleaned only the cement platform weekly and that the surrounding grassy areas were not being picked up, despite the compactor being used by all departments. The Administrator acknowledged he did not know why the area had not been cleaned and stated he would want the area free of debris.
The facility failed to ensure proper disposal of garbage and refuse when the outdoor trash bin was observed left open, with one side of the lid broken and unable to close. According to the Dietary Manager, the lid had been broken for several months, allowing the possibility for pests or rodents to access the trash and creating a hazard to staff and residents.
Surveyors found that two outdoor dumpsters were overflowing with bagged garbage stacked above the rim, lids left open, and multiple trash bags and cardboard boxes on the ground. A CNA reported that staff routinely piled trash on top of full dumpsters or left it on the ground and that the dumpsters had not been emptied in weeks, despite concerns being reported to the Administrator. The Maintenance Director stated the dumpsters were not being collected due to nonpayment, acknowledged responsibility for trash on the ground, and admitted he had not recently hauled trash to the landfill. Both the Maintenance Director and Administrator recognized that the overflowing, uncovered dumpsters could attract pests.
Improper Maintenance and Disposal of Garbage and Refuse in Dumpster Area
Penalty
Summary
Failure to properly maintain and dispose of garbage and refuse occurred in the facility’s dumpster area, as identified during an initial kitchen tour when surveyors, accompanied by a dietary staff member, observed multiple items of trash and discarded furniture around the dumpster. Specifically, two used gloves were lying on the ground beside the base of the dumpster, along with one broken metal and upholstered armchair, four cloth recliners with large black stains or substances on the fabric (including one red recliner with the back pulled or broken off), and a broken chest of drawers with broken shelving and top. The dietary staff member confirmed these observations, stated she had not been aware of the trash and garbage accumulation around the dumpster, and reported she did not know what arrangements were in place for trash and garbage pickup, indicating that maintenance was responsible for disposal. Further interview with a maintenance staff member revealed that maintenance staff were responsible for maintaining and cleaning the dumpster area and that he had placed the chairs by the dumpster for disposal several months earlier. He reported that the person who previously picked up and disposed of the garbage and trash around the dumpster had stopped performing this duty and that he had not found a replacement, resulting in the continued accumulation of debris. The maintenance staff member acknowledged that the condition of the dumpster area, with debris, trash, and used gloves, posed potential for rodent infestation and cross-contamination and spread of infection to residents and staff. The facility’s undated policy on Housekeeping, Laundry and Maintenance – Basic Services Provided stated that storage areas must be kept neat and free of extraneous material such as refuse and discarded furniture, which was not followed in this situation.
Improper Containment of Garbage in Outdoor Dumpsters
Penalty
Summary
The facility failed to properly contain garbage in two of four outside dumpsters, contrary to its own policy and state regulations. The facility’s policy on food-related garbage and refuse disposal, dated 10/29/25, required that all garbage and refuse containers be provided with tight-fitting lids or covers and be kept covered when stored or not in continuous use. During an observation of the outdoor trash receptacles on 3/23/26 at 9:30 a.m., dumpster one and dumpster three were noted to have lids/covers that were not closed. The Dietary Manager (Employee E21), present during the observation, confirmed that the lids on dumpsters one and three were not closed. In a subsequent interview on 3/24/26 at 12:30 p.m., the Dietary Manager further confirmed that the facility failed to properly contain garbage in the outside trash receptacles to prevent the potential for rodent and insect infestation, constituting noncompliance with 28 Pa. Code 201.18(b)(3) Management. No residents or specific patient conditions were mentioned in the report, and the deficiency centered solely on the improper handling and containment of garbage in the facility’s outdoor dumpsters as observed and confirmed by staff.
Improper Securing of Dumpster Lids and Refuse Disposal
Penalty
Summary
The facility failed to dispose of garbage and refuse properly by not ensuring that dumpster lids were shut and secured, potentially affecting all 54 residents. Facility policy on sanitization requires that garbage and refuse containers be in good condition, without leaks, and that waste be properly contained in dumpsters with lids. During observation on 3/26/26 at 10:25 AM, the surveyor noted one lid open on the recycling dumpster and one lid open on the regular trash dumpster. In an interview at 11:10 AM the same day, the Dietary Manager stated that sometimes the wind or the trash truck leaves the lids open, that regular trash is picked up three times a week and recycling once a week, and that kitchen staff are responsible for emptying trash daily and are expected to close dumpster lids if they see them open. No specific residents were individually identified in the report, and no additional clinical details or medical histories were provided regarding the residents who could be affected by this deficiency.
Failure to Maintain Clean Trash Compactor Area
Penalty
Summary
Surveyors observed that the facility failed to keep the area around the trash compactor free of accumulated trash and debris. During an observation of the dumpster area with the Dietary Manager, the trash compactor was seen in a fenced area behind the kitchen entrance, with a cement platform in front and grassy areas to the left and back. In the grassy area on the left side of the compactor, surveyors noted four plastic bottles, six disposable cups, four disposable gloves, and seven straws that had not been removed. The Dietary Manager reported that a member of the kitchen staff cleaned only the cement platform on a weekly basis and confirmed that the trash and debris on the left side and back of the trash compactor were not being picked up. The Dietary Manager stated she did not know why those areas were not attended to and noted that all departments in the facility used the same trash compactor. In a separate interview, the Administrator stated he did not know why the trash compactor area had not been cleaned and indicated he would want the area free of debris.
Failure to Maintain Covered Outdoor Trash Bin
Penalty
Summary
The facility failed to properly dispose of garbage and refuse by not maintaining the outdoor trash bin in a covered condition. On 03/12/26 at 11:37 a.m., surveyors observed the outdoor trash bin left open, with only one side of the lid able to be closed and the other side broken. During an interview at 11:50 a.m. the same day, the Dietary Manager stated that the outdoor trash bin lid was broken and that they had been trying to fix the lid for the last six months. She also stated that pests or rodents can get into the trash and that it is a hazard to staff and residents. The report notes that if staff fail to keep outdoor trash bins closed, the environment may become unsanitary, increasing the risk of pest infestation and disease transmission to residents.
Improper Disposal and Overflow of Facility Garbage Dumpsters
Penalty
Summary
The facility failed to dispose of garbage and refuse properly for two outdoor dumpsters located at the back of the property. During an observation, both dumpsters were seen with lids open and unable to close because bagged garbage was stacked above the rim. Additionally, 11 bags of trash and 5 cardboard boxes were observed on the ground outside the dumpsters. The facility did not provide an Environmental Policy when requested by surveyors. In interviews, a CNA reported that staff had to pile trash bags on top of already full dumpsters and sometimes leave trash bags on the ground beside them, and stated that the dumpsters had not been emptied in weeks. The CNA also stated she had voiced concerns to the Administrator but nothing had been done. The Maintenance Director acknowledged responsibility for the trash on the ground and stated the dumpsters were overflowing because sanitation had not collected them due to lack of payment, and that he had not recently hauled trash to the landfill as he sometimes did. Both the Maintenance Director and the Administrator acknowledged that overflowing dumpsters and open lids could attract pests to the facility grounds and possibly into the facility.
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