Failure to Prevent Pest Infestation in Resident Wound and Living Space
Penalty
Summary
A deficiency was identified when a resident with multiple complex medical conditions, including malignant neoplasm of the head and face, diabetes, peripheral vascular disease, and a chronic ulcer, was found to have a wound on the left foot containing maggots. The wound was discovered by CNAs during care, who immediately reported it to nursing staff. The resident was noted to be cognitively intact, dependent on staff for most activities of daily living, and receiving hospice services. Medical record review and staff interviews confirmed that maggots were present in the wound bed upon initial assessment, though the wound was clean the following day. Multiple observations revealed the persistent presence of flies in the resident's room and the hallway outside, including during wound care and dressing changes. Staff interviews indicated that the resident often hoarded food and trash, contributing to the fly problem, and that staff had to regularly clean the room. The presence of flies and maggots in the wound, as well as in the resident's living space, demonstrated a failure to maintain an effective pest control program to prevent and address infestations, directly impacting the resident's environment and wound care.