Failure to Maintain Safe, Clean, and Homelike Environment
Penalty
Summary
Facility staff failed to maintain a safe, clean, and homelike environment for residents on two of three nursing units. Multiple residents reported that their rooms were dirty and in disrepair, and that shower areas were so unclean that they avoided using them. Direct observations by surveyors confirmed that the shower room was dirty, mildewed, foul-smelling, and littered with trash and debris. The tile was chipped, grout was black in places, and a white crusted substance was present on the floor and walls. Resident rooms were found with broken window blinds, damaged furniture, dirty sinks and toilets, clogged drains, sticky and dirty floors, peeling baseboards, and stained bed divider curtains. Some rooms lacked basic personal items such as televisions, clocks, telephones, or radios, and had holes in the walls with unfinished repairs. Two residents were specifically identified as being affected by these conditions. One resident, with a history of femur fracture, asthma, pneumonia, anxiety, depression, and Hepatitis C, required assistance with activities of daily living and was alert with mild cognitive impairment. Another resident, with a history of stroke, anemia, gout, heart attack, diabetes, asthma, and atrial fibrillation, required extensive assistance and was alert and oriented. Both residents' living environments were found to be unsafe, unclean, and not homelike. Interviews with the new Director of Maintenance revealed that maintenance staffing had been insufficient, with only three employees responsible for repairs and upkeep across two large buildings, contributing to the ongoing issues.