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F0880
E

Failure to Provide Hand Soap in Resident Bathrooms for Infection Control

Zion, Illinois Survey Completed on 11-14-2025

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 ensure that residents' bathrooms were stocked with antiseptic hand soap for four out of eight residents reviewed for infection control. Observations revealed that multiple residents' bathrooms lacked hand soap, and residents reported that this had been an ongoing issue. Residents stated that they had repeatedly requested hand soap from staff but were ignored, and some mentioned that the soap had been removed due to a recall and was not replaced for an extended period. Residents affected were assessed as having no cognitive impairment and were able to articulate their concerns clearly. Staff interviews confirmed the absence of hand soap in the bathrooms, and it was acknowledged by both the Director of Nursing and the Maintenance Director that a soap recall had occurred months prior, but soap had not been replenished in a timely manner. The facility's own hand hygiene policy, which aligns with CDC guidelines, requires handwashing with soap and water, especially before eating and after using the toilet. The lack of hand soap in resident bathrooms directly contravened this policy and compromised infection control practices.

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