Failure to Maintain Resident Room Window in Safe and Homelike Condition
Summary
A deficiency was identified when a resident's room window was found to have a hole, allowing flies to enter the room. The resident's daughter reported the issue and took temporary measures by taping the hole and using a fly swatter. The Maintenance Director was unaware of the problem, stating that he typically addresses work orders the same day they are submitted, but no work order had been received for this issue. Upon inspection, the window was found to be inadequately covered with a piece of plexiglass that was not properly secured, leaving visible gaps and allowing outside air to enter the room. The plexiglass was attached with only one screw and loose duct tape, which was no longer effective, resulting in the wind blowing the plexiglass inward. Staff interviews revealed that the process for reporting maintenance issues involves filling out a work order and notifying maintenance, but in this case, the process was not followed, and the deficiency went unaddressed until it was observed during the survey. The facility's policy emphasizes the importance of maintaining a safe, clean, and homelike environment, but the failure to promptly identify and repair the window compromised these standards for the resident involved.
Penalty
Resources
Below are regulatory guidelines relevant to this citation:
Trusted data from CMS and state health departments
Every citation, penalty and Plan of Correction is sourced from public CMS records (latest release July 29, 2026) and official state health department websites — never guesswork.
In your survey window? See what surveyors are citing.
The Survey-Prep Report maps your facility's risk from 12 months of CMS and state citation data — what's being cited around you and what to check first. $129 one-time.