Unclean Shower Rooms and Unlabeled Personal Care Items in Resident Bathing Areas
Penalty
Summary
The deficiency involves the facility’s failure to maintain a safe, clean, comfortable, and homelike environment in two of six shower rooms (3 East and 4 West), contrary to its own housekeeping and infection control procedures. Facility policies required shower rooms and chairs to be cleaned daily, floors to be free of dirt and debris, and walls and doors to be disinfected or spot-cleaned if visibly soiled, as part of an infection control program intended to provide a safe, sanitary environment. Despite these procedures, surveyors observed a brown substance on the floor of the first shower stall in the 3 East shower room on one day, which remained present the following morning before it was later removed. Staff interviews on 3 East showed uncertainty and inconsistency regarding responsibility and frequency for cleaning the shower room. One CNA stated that if the brown substance was a bodily fluid, CNAs were responsible for cleaning it, but they had not provided showers on the days in question and were unsure how often the shower room was cleaned, though they believed it should be disinfected between each resident. Another CNA emphasized the importance of keeping the shower clean between residents and described the shower room as part of the residents’ home. A third CNA reported seeing the brown substance on the 3 East shower stall floors, believed it to be human feces, and cleaned and disinfected the area immediately, noting that shower rooms are “hot spots” for germs and that some residents have open wounds. In the 4 West shower room, repeated observations over several days showed multiple opened, unlabeled personal care items (shaving creams, moisturizing cream, skin guard, shampoo, body wash, antifungal powders) stored on shelves in both shower stalls, and a second stall with standing water, hair, and a bandage covering the drain. During one observation, a resident receiving a shower in the second stall reported that the water was not draining properly and described sitting on a stool in lukewarm water with approximately a half inch of standing water on the floor, stating it was not like showering at home. A CNA reported that the floor did not look clean prior to the shower, with hair and a bandage blocking the drain, and stated that resident care items should be labeled and not used for other residents. An LPN described the stall as not clean and sanitary, citing soap scum, hair over the drain, a gauze bandage, and what appeared to be feces on the floor, and noted that unlabeled personal care items should not be stored in the shower room. The housekeeping/laundry supervisor and a housekeeper both acknowledged that the shower floor was dirty, needed scrubbing, had not been mopped since the prior week, and that the condition was not homelike, despite expectations that shower floors and walls be cleaned daily.
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