F0584

E

Failure to Maintain Homelike Environment, Adequate Hot Water, and Cleanliness

Saint Louis, Missouri Survey Completed on 02-04-2026

Penalty

No penalty information released

Summary

The facility failed to provide a safe, clean, comfortable, and homelike environment by allowing excessively loud door alarms to sound repeatedly throughout the building, including during meal service, without timely staff response. During a dining observation with approximately 30 residents present, a fire exit door alarm sounded at a very loud volume and continued intermittently for several minutes before staff silenced it. Residents in the dining room reported that the alarms sounded constantly and were annoying. The Administrator acknowledged that the alarms had been sounding continuously since she began working at the facility months earlier, and that this was not homelike.

The facility also failed to maintain adequate hot water temperatures in multiple resident rooms and bathing areas, affecting residents who were dependent on staff for bathing and personal hygiene. One cognitively intact resident with heart failure and hypertension reported not taking showers lately because the water was cold; observation showed no cold water from the cold tap and hot water measuring only 58.9°F after running for two minutes. Another cognitively intact resident with anxiety, depression, and PTSD stated the facility only had hot water sometimes; observation showed no cold water from the cold tap and hot water at 52.0°F after two minutes. A third cognitively intact resident with renal failure, neurogenic bladder, and paraplegia reported that the water in the room had not worked for several months and that the unit’s shower rooms did not have hot water; observation confirmed the sink water never became warm after several minutes. CNAs reported that some rooms had no hot water since the weather turned cold, that hot water was obtained from an eye wash station for resident care, and that residents on one unit were not receiving regular showers or bed baths due to cold water.

Additionally, the facility failed to thoroughly clean one resident’s room and bathroom. Over multiple observations on different days, the perimeter of the room’s walls contained multiple small, dark pellet-like substances scattered along the floor and within crevices near the walls and furniture bases, along with accumulated dirt and debris. The bathroom toilet had visible brown staining and streaking on the exterior porcelain surface, with accumulated dirt and discoloration around the base where it met the flooring, and darkened residue and debris along the perimeter of the toilet base. The flooring immediately surrounding the toilet base was soiled and discolored. The resident reported that housekeeping staff entered and mopped briefly but did not perform a thorough cleaning.