F0923

E

Failure to Maintain Operational Bathroom Ventilation Systems in Multiple Resident Rooms

Tekamah, Nebraska Survey Completed on 02-12-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to ensure that resident bathroom ventilation systems were operational as required by licensure regulation 175 NAC 12-007.04D. Facility documentation titled “Exhaust Fans” dated as completed on 1/28/26 instructed staff to check all exhaust fans in bathrooms and other specified areas and to verify that airflow was sufficient to hold a piece of paper to the vent when operating. However, during an observation conducted with the Maintenance Director (MD) and the Administrator, the ventilation systems in resident bathrooms in rooms 1, 5, 10, 11, 15, 16, 17, and 18 on the East hall and rooms 1, 2, 3, and 4 on the South hall did not draw a 1‑ply square of toilet paper to the surface of the ventilation cover, indicating that the systems were not working properly at that time.

During interview, the MD confirmed that the ventilation systems in these 12 resident bathrooms were not functioning properly, as evidenced by the failure to draw the toilet paper to the vent surface. The MD also confirmed that monthly checks of the ventilation system had been marked as completed in the electronic Exhaust Fan documentation on 1/28/26, but there was no record specifying which rooms had been tested or how many rooms had been completed. The MD acknowledged that the last documented check of the ventilation systems was on 1/28/26 and that the documentation did not identify the specific rooms where exhaust fans had been checked. The facility census at the time was 33, and 12 of 27 occupied resident rooms were found to have non-functioning or insufficient bathroom ventilation.