Failure to Maintain Safe Hot Water Temperatures in Resident Rooms
Penalty
Summary
The facility failed to ensure residents' right to a safe, clean, comfortable, and homelike environment by not maintaining hot water temperatures in resident room sinks at or below 110°F. During observations on 02/24/2026, surveyors measured hot water temperatures of 122°F in the bathroom sink of Resident #46, 120°F in the bathroom sink of Resident #31, and 118°F in the bathroom sink of Resident #20. Resident #46, admitted on 02/10/2026 with muscle weakness and muscle spasms, stated she had not noticed if the water in her restroom was too hot. Resident #31, admitted on 01/05/2023 with Alzheimer's disease and muscle weakness and assessed as cognitively intact with a BIMS score of 15, reported that the hot water at his faucet had been "pretty hot" about a week prior but that he adjusted the temperature himself. Resident #20, admitted on 08/12/2021 with heart failure and muscle weakness and also cognitively intact with a BIMS score of 15, similarly reported that the hot water had been hot a couple of weeks earlier but that he adjusted the faucet to avoid burning his hands. The deficiency was further supported by staff interviews and facility practices. The Maintenance Assistant Director, when informed of the elevated water temperatures, stated that he believed the normal hot water temperature should be about 120°F and explained that temperatures were controlled at mixing valves, but that staff did not check water temperatures in resident rooms. He acknowledged he was still learning about safe water temperature levels. The Administrator stated that the expectation was for maintenance staff to spot check water temperatures and monitor them via the mixing valves, but also confirmed that the facility did not have a policy on monitoring hot water and that they operated based on regulations. The Administrator acknowledged that excessively hot water could possibly lead to a resident getting burned and reported that no residents had been burned due to hot water at the time of the interview.
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