Failure to Maintain Clean and Homelike Environment for Residents
Penalty
Summary
The facility failed to maintain a clean and homelike environment for two residents. One resident was observed multiple times in her room with fall mats on both sides of her bed that were dirty with black marks. Despite repeated observations over several days, the condition of the mats did not change, and a housekeeper was unable to confirm when the mats were last cleaned, acknowledging their dirty state. Another resident was consistently observed sitting in a hallway area directly beneath a ceiling tile with a large black spot. Nursing staff were unaware of the dirty ceiling tile and had not reported it to maintenance. The issue was only addressed after it was pointed out by a surveyor. The maintenance supervisor later indicated the damage might have been from an old leak, but could not determine the source, and the tile was found to be dry.