Failure to Maintain Safe and Accessible Restroom Facilities
Penalty
Summary
The facility failed to provide a safe, clean, comfortable, and homelike environment for six residents, as evidenced by multiple nonfunctional toilets and inadequate access to alternative restroom facilities. Several residents, including those with intact cognition and those with cognitive impairments, experienced prolonged periods without access to a working toilet in their rooms. In one instance, a resident was unable to use her bathroom for two months due to a nonfunctional toilet and damaged tiles, and was directed to use a shower room or a bedside commode. However, the shower room required a code that only staff knew, and the alternative common area restroom was labeled for visitors only, further restricting access. The resident reported episodes of incontinence as a result of these barriers. Other residents also faced similar issues, with reports of toilets that would not flush and required maintenance intervention. In some cases, residents had to wait for staff to unlock alternative restrooms, and in one instance, a toilet in a shared bathroom was found to be nonfunctional and contained unflushed fecal matter. Staff interviews confirmed awareness of the plumbing issues, but repairs were delayed due to the unavailability of maintenance personnel. Some residents expressed distress and frustration over the lack of access to functional restroom facilities, and staff verified that these issues had persisted for days or even since admission for certain individuals. Facility policy review indicated that residents have the right to a safe and clean living environment, including general maintenance of sanitary interiors. Despite this, observations and interviews revealed ongoing problems with restroom accessibility and cleanliness, affecting residents' dignity and comfort. The deficiency was identified through record review, observation, and interviews, and was determined to have the potential to impact all residents in the facility.