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F0921
D

Failure to Maintain Clean and Odor-Free Environment

Big Rapids, Michigan Survey Completed on 07-18-2025

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 odor-free environment for two residents with environmental concerns. Observations revealed a persistent and strong smell of urine in the hallways and specific resident rooms, particularly around the Nurse's Station and in the rooms of two residents. One resident, who was occasionally incontinent and had vision problems, frequently urinated on and around the toilet, resulting in wet floors. Staff reported that it was common for the bathroom floor to be wet with urine and that housekeeping was often called to clean up. Another resident, who used urinals at the bedside due to medical conditions, was observed to have multiple urinals, some full and some empty, left on the floor and on a wastebasket in the room. The smell of urine was consistently noted in this resident's room during multiple observations. Resident Council Meeting Minutes further documented ongoing concerns from residents about inadequate cleaning of toilets and careless dumping of bedpans and urinals, leading to messy and unclean conditions. These findings were corroborated by both staff interviews and direct observations, indicating a pattern of insufficient cleaning and maintenance of resident areas, particularly in relation to the management of incontinence and urinal disposal.

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