Failure to Maintain Effective Pest Control Program Resulting in Ongoing Roach Infestation
Penalty
Summary
The facility failed to maintain an effective pest control program, as evidenced by multiple direct observations and resident and staff interviews confirming the presence of live and dead roaches throughout resident rooms and common areas. Surveyors observed live roaches in resident rooms, on windowsills, walls, dressers, and inside dresser drawers. Accumulations of dead roaches and roach body parts were found in areas such as the pantry and overhead light fixtures. Residents consistently reported seeing roaches frequently in their rooms and stated that they had not witnessed pest control treatments being performed in their rooms. Staff interviews corroborated the residents' accounts, with several CNAs, housekeeping staff, and nursing staff reporting regular sightings of both live and dead roaches in various parts of the facility. Staff described killing roaches themselves and cleaning up the remains, and some reported documenting pest concerns in the pest control log. However, inconsistencies were noted in the use of the pest control log, with the contracted pest control serviceman stating that the log was not always utilized appropriately and that reports of pest activity varied from week to week. The pest control serviceman indicated that he visited the facility weekly, reviewed pest logs, and provided both verbal and written reports to the maintenance assistant. However, there was confusion regarding the receipt and review of these reports, as the maintenance assistant did not receive emailed reports and the newly hired Nursing Home Administrator was unaware of certain facility issues, such as holes in the building exterior that could allow pest entry. The pest control serviceman also noted that some ultraviolet pest control lights were not functioning and had not been repaired for several months. The facility's own pest control policy required maintenance services to assist in pest control when necessary, but observations and interviews indicated ongoing and widespread pest issues.
Plan Of Correction
This plan of correction constitutes this facility's written allegation of compliance for the deficiencies cited. However, submission of this Plan of Correction is not an admission that a deficiency exists or that one was cited correctly. This Plan of Correction is submitted to meet requirements established by state and federal law. What corrective action will be accomplished for those residents found to have been affected by the deficient practice: 1. Resident #4 provided pest control. Housekeeping cleaned Resident #4's windowsill, walls, and dressers. The growth of dark brown/black dusty-like debris behind Resident #4's dresser was cleaned. Resident #4 was interviewed and room observed with no pest control concerns. 2. Resident #7 provided pest control. Resident #7 was interviewed and room observed with no pest control concerns. 3. Resident #3 provided pest control. Housekeeping cleaned Resident #3's floor and under her dresser. Resident #3 was interviewed and room observed with no pest control concerns. 4. Resident #11 provided pest control. Resident #11 was interviewed and room observed with no pest control concerns. 5. Resident #8 provided pest control. Housekeeping cleaned Resident #8's dresser drawer. Resident #8 was interviewed and room observed with no pest control concerns. 6. Housekeeping cleaned the pantry room in the north hallway. Both sides of the refrigerator were cleaned as well as the floor. 7. Shared room for Resident #12 and #13 was provided pest control. Housekeeping cleaned the room and bathrooms. Resident #13's overbed fight fixture was replaced. How you will identify other residents having potential to be affected by the same practice and what corrective actions will be taken: 1. An audit of resident rooms was completed, with no observations of pest concerns. 2. Resident interviews were completed to ensure prompt response for any pest control items reported. 3. An audit of the exterior of the facility was completed to ensure holes identified are repaired to minimize points of entry by 7/12/2025. 4. The facility's lawn service provider cleaned the foliage and trees on the exterior of the facility to minimize points of entry. 5. Two filters, one located on the east nurse's station and one located in the kitchen, were replaced with new bulbs, and filters continue to be cleaned and changed out monthly and as needed. What measures will be put into place or what systematic changes you will make to ensure that the practice does not recur: 1. Staff educated by the administrator/designee on pest control process and use of pest control log of any observed pest control concerns. 2. Housekeeping staff educated on cleaning of resident rooms and other common areas and the use of the pest control log if any observation is made. 3. Residents educated during resident council meetings regarding proper storage of food in the room to minimize pest control concerns and to report any observations to staff. 4. Maintenance staff educated on walking rounds of the exterior of the facility to identify any holes, points of entry, and foliage to minimize pest control concerns. 5. The pest control serviceman was educated by the administrator to provide written reports of each service to the administrator and maintenance staff. 6. The administrator and/or designee will review the pest control service reports to identify any issues or trends and follow up with the pest control company as needed. 7. Pest control service increased from once/week to twice/week and as needed. How the corrective action will be monitored to ensure the practice will not recur, i.e., what quality assurance program will be put in place: The administrator and/or designee will conduct an interview of 5 residents and audit 5 rooms on each unit and common areas to ensure the facility maintains an effective pest control program. This audit will be completed weekly for 4 weeks, then monthly for 3 months. The designee will audit the pest control log for trends. The audit of the pest control log will be completed weekly for 4 weeks, then monthly for 3 months. Identified concerns or trends will be communicated with the pest control company for follow-up as needed. The findings of the audits will be reported to the Quality Assurance Performance Improvement Committee monthly until substantial compliance and sustainability are met. The maintenance director and/or designee will audit the pest control log for trends. The audit of the pest control log will be completed weekly for 4 weeks then monthly for 3 months. Identified concerns or trends will be communicated with the pest control service company for follow-up as needed. The findings of the audits will be reported to the Quality Assurance Performance Improvement committee monthly until the committee determines substantial compliance is maintained. F0925