Failure to Maintain Clean, Odor-Free Environment on Resident Hall
Penalty
Summary
The deficiency involves the facility’s failure to provide a clean, sanitary, and homelike environment on one hall, particularly in the room of Resident #3. Resident #3, who was cognitively intact and admitted with diagnoses including acute and chronic respiratory failure with hypoxia, type 2 diabetes mellitus with hyperglycemia, and stage 3 chronic kidney disease, required set-up/clean-up assistance with toileting, showering, and personal hygiene and had mixed bladder incontinence. Her care plan directed staff to check frequently for incontinence, cleanse the perineum, apply barrier cream, change clothing as needed, and encourage the use of a chux pad and open brief in the chair during the day, with the resident notifying staff when she needed changing. Surveyors observed a strong, pervasive urine odor on the 600 hall during the initial tour and again on a later date, and staff confirmed the odor was coming from Resident #3’s room. Upon entering Resident #3’s room, surveyors observed a pile of laundry near the door. The resident reported that she places soiled laundry on the floor near the door every day for an aide to collect, and that the pile present had been there since earlier that morning; she also stated that when housekeeping came to clean, additional soiled laundry was added to the pile. CNAs confirmed the hall was malodorous, verified the presence of soiled clothing, and reported there was a bagged soiled down comforter in the room that the resident would not allow the facility to launder and was awaiting family pick-up. One CNA stated the odor on the hall was always a problem and that some residents had requested their doors be shut due to the odor; she also stated she had not known the soiled linen was on the floor until the survey and later verified that the collected laundry was saturated. Another resident on the hall confirmed preferring her door shut at times because of the odor. Fourteen other residents lived on the same hall, and the facility’s Homelike Environment policy required a safe, clean, comfortable environment with pleasant, neutral scents.
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