Failure to Maintain Clean, Safe, and Homelike Resident Environment
Penalty
Summary
Surveyors observed multiple deficiencies related to the facility's failure to maintain a clean, safe, and homelike environment for residents across all units and over several days. Resident rooms and bathrooms were found with significant cleanliness and maintenance issues, including waterlogged towels used to address leaks, bio growth on shower tiles and grouting, stained and oxidized bathroom fixtures, and non-cleanable surfaces such as torn fall mats and over-bed tables. Equipment such as shower chairs and fabric chairs were also found to be in poor condition, with visible bio growth and surfaces that could not be adequately cleaned. In several instances, resident areas were cluttered with unused wheelchairs and mechanical lifts, blocking access to common spaces. Interviews with staff revealed a lack of clarity and accountability regarding the reporting and resolution of maintenance and cleanliness issues. The unit manager confirmed that all staff are responsible for observing and reporting such concerns, but was unaware of the specific deficiencies identified by surveyors. The maintenance director stated that work orders are addressed by priority but acknowledged that neither he nor his staff conduct daily room checks, relying instead on reports from other staff. There was also confusion regarding departmental responsibilities for equipment maintenance, such as wheelchairs and fall mats, and no maintenance logs were kept for certain items. Additional observations included malfunctioning air conditioning units that were loud and disruptive to residents, water leaks resulting in stained ceiling tiles and puddles in hallways, and privacy curtains and assist rails with visible brownish substances. Facility records showed that some maintenance issues, such as water leaks, were documented in work orders, but there was no documentation regarding the loud air conditioning unit. Facility policies required regular cleaning and maintenance of resident rooms and HVAC systems, but these procedures were not consistently followed, as evidenced by the ongoing issues observed during the survey.