F0921

D

Failure to Maintain Safe and Comfortable Resident Room Temperatures

Rock Island, Illinois Survey Completed on 01-26-2026

Penalty

No penalty information released

Summary

The facility failed to maintain resident room temperatures at a comfortable, safe level for multiple residents during a period of substandard indoor temperatures. Surveyors measured room temperatures for three residents on the second floor, finding readings between 59.9 and 62.4 degrees using an infrared thermometer. One resident was observed in a wheelchair wearing multiple layers of clothing and a knitted hat and stated he was cold and that his room had been cold for the past week. Another resident was seated in an easy chair wearing multiple layers of clothing, a coat, and a hat and also stated he was cold. A third resident was seated on his bed in multiple layers of clothing and stated it was cool in his room. Facility temperature logs for occupied rooms over several days documented random room temperatures ranging from 54 to 68 degrees.

The facility’s heating system consisted of two steam boilers, with only one boiler functioning at the time of the survey. The Administrator stated that the working boiler had the capacity to heat the entire building but acknowledged the facility had been having trouble maintaining air temperatures inside the building for about a week due to sub-zero wind chills. The Maintenance Director reported that the building is over 100 years old, with high ceilings, large old windows, and multiple elevators that allow cold air to enter without restriction, and that one boiler was shut down due to the need for major repairs. He stated that he had taken temperatures in all resident rooms twice daily and that resident room temperatures had ranged from 54 to 68 degrees. These conditions occurred despite the facility’s policy on emergency procedures for heat loss, which directs staff to quickly assess loss of heating and determine if remediation is possible or if partial or full evacuation is necessary.