Failure to Maintain Clean and Homelike Environment
Penalty
Summary
The facility failed to maintain a clean, comfortable, and homelike environment for its residents, as evidenced by multiple observations, interviews, and record reviews. Housekeeping practices were inconsistent and insufficient, resulting in unsanitary conditions throughout the facility. Specific issues included unswept and unmopped dining room floors, uncleaned carpets in common areas, dirty resident rooms and bathrooms, and persistent urine odors. Observations revealed dust, debris, and grime in resident rooms, bathrooms, and hallways, as well as food, trash, and spills left unaddressed in the dining room. The courtyard and smoking area were also littered with cigarette butts, and several areas had visible build-up and stains that were not being regularly cleaned. Interviews with staff and residents confirmed these deficiencies. Family members and residents reported that rooms were not being cleaned regularly, with some unable to recall the last time their rooms had been cleaned. Staff interviews revealed that the housekeeping team was understaffed, with recent reductions in personnel and the elimination of the floor technician position. Housekeepers reported being unable to keep up with daily cleaning tasks, often prioritizing trash removal and smoke breaks over thorough cleaning. Deep cleaning was only performed when residents moved out, and some rooms were never deep cleaned. The Housekeeping Supervisor admitted to a lack of written cleaning schedules and infrequent monitoring of cleaning activities. The facility's own policies and job descriptions outlined clear expectations for daily and deep cleaning, including specific procedures for cleaning resident rooms, bathrooms, common areas, and carpets. However, these procedures were not being followed, and documentation of cleaning activities was lacking. The Environmental Services Director and Administrator acknowledged the unsanitary conditions, the absence of job descriptions in employee files, and the need for more thorough cleaning throughout the facility. Residents with medical conditions such as muscle weakness, chronic pain, and urinary retention were living in these unclean environments, with some rooms containing blood stains, urine, and feces that were not promptly addressed.