Failure to Maintain Clean and Homelike Environment Due to Inadequate Linen and Carpet Care
Penalty
Summary
A deficiency was identified regarding the facility's failure to maintain a safe, clean, comfortable, and homelike environment for its residents. One resident with chronic kidney disease, anxiety disorder, and mobility issues was observed lying on a bed with a fitted sheet that was visibly stained over half its surface. The resident reported that staff did not change the sheets frequently. This observation was confirmed by an activity coordinator, who stated the sheets were unacceptable and needed immediate changing. Further investigation revealed widespread issues with the facility's carpeting. Multiple areas throughout resident rooms and common spaces had sticky carpets, strong urine odors, and visible stains. Staff interviews confirmed that the carpets had not been thoroughly cleaned in several years, and there was no established schedule for carpet cleaning. Housekeeping staff reported that the carpets were persistently sticky and that a new carpet cleaning machine had only recently been acquired. Prior to this, only spot cleaning was performed, and the equipment used was inadequate for deep cleaning. Several residents and family members also reported concerns about dirty carpets and persistent odors, particularly from urine, which was attributed to spills from bedside commodes and leaking catheters. Documentation showed that the facility had professional carpet cleaning performed only a few times over the course of a year, and that the choice of carpet was influenced by concerns about moisture in the building's foundation. However, there was no evidence that a comprehensive moisture test had been completed to determine if alternative flooring could be installed. The lack of a systematic cleaning schedule and the use of inappropriate cleaning equipment contributed to the ongoing environmental deficiencies affecting a significant number of residents.