Failure to Maintain Comfortable Temperatures and Provide Bed Linens
Penalty
Summary
The deficiency involves the facility’s failure to provide a safe, comfortable, and homelike environment by not maintaining appropriate room temperatures for several residents and not providing bed linens for one resident. Surveyors observed that one resident was sleeping in a room that was noticeably colder than the common area, with the room thermostat set to 59°F and a wall furnace present but not functioning when the thermostat was adjusted. Another resident reported that his room was often cold despite the thermostat being set to 78°F. A third resident, sharing the cold room, was heard moaning in discomfort; a CNA stated this resident was moaning because she was cold and did not like being cold. Staff interviews revealed that CNAs and the Maintenance Supervisor believed the room thermostats did not work and that the 300-unit was often colder than other areas. The Maintenance Supervisor confirmed that room temperatures on the 300-unit were controlled by a thermostat at the nurse’s station, that he was aware of recent complaints, and that he did not keep logs of temperature readings. The RN and DON both acknowledged ongoing complaints about cold temperatures on the 300-unit, with the RN noting the nursing station vent constantly blew cold air and that residents had recently complained about cold rooms. The deficiency also includes the facility’s failure to provide bed linens for a resident with multiple chronic conditions, including atopic dermatitis, type 2 diabetes mellitus with diabetic neuropathy, varicose veins with inflammation, and unspecified dementia. This resident was repeatedly observed lying directly on a bare mattress without linens at multiple times throughout the same day. CNA staff reported that all CNAs are responsible for making resident beds and that beds should be re-made immediately after linens are removed. The RN stated that resident beds should be made without unnecessary delay, that residents should not lie directly on the plastic mattress surface because prolonged contact could disrupt the skin, and that residents can be cold without a blanket. The DON stated it was her expectation that all residents’ beds be made immediately after linens are removed and acknowledged that residents cannot rest comfortably without linens and that delays in making beds could contribute to worsening skin issues.
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