Unsafe and unsanitary resident rooms were observed with clutter, uncovered food, and rodent activity. A resident with schizophrenia and depression had food crumbs and meat under the bed, while another resident reported mouse droppings and hoarded food in a crowded room. Other rooms had overflowing bins, bags of belongings, and uncovered food, and staff reported that some residents refused housekeeping access and that pest control service in resident rooms was inconsistent.
Failure to maintain bedroom ceiling lights for two residents. One resident had impaired cognition, dementia, and was enrolled in hospice, while the other had intact cognition and diagnoses including fibromyalgia, anxiety, depression, and chronic pain. The second resident reported a flickering ceiling light that had not worked for a long time, caused headaches, and left the room dark unless she used the pull-string light. Staff said maintenance requests were supposed to be entered in TELS, but the DON and MT-D confirmed no request had been submitted for the issue.
Failure to maintain building and grounds in good repair: A resident’s room had a damaged closet door jamb, gaps around a window AC unit, and a dirty fan, while other areas of the facility showed rotted and peeling window casings, a hanging piece of exterior trim above the smoking patio, and a hole in the patio sidewalk. The DON described the hanging wood as dangerous and the administrator stated there was no system to track or follow up on environmental concerns and no maintenance staff to monitor or audit these issues.
Dusty room fans were found in multiple resident rooms, including rooms of residents with trachs, vents, and tube feedings. Surveyors observed dust on fan grids and blades while residents were in bed or sleeping, and one resident said the fan was dirty and did not know when it was cleaned. Staff confirmed the fans were dusty and said they should be cleaned, especially in rooms with respiratory problems.
A resident with severe cognitive impairment and a G-tube had an IV pole and tube feeding pump in the room that were observed with dried tan-colored residue on the pole, all five legs, and the floor below. The same residue remained on repeated observations, and an RN and NM stated the pole and pump should be cleaned when spills are seen and during feeding changes for infection control purposes; facility policy called for daily wiping with disinfectant.
A ceiling tile in a second-floor east wing common area had a large yellow water stain and grey mold growth, and the condition remained unchanged on re-observation. The area was used by residents, families, and physicians for activities, visits, charting, and dictation. An LPN manager, the activities director, and the director of maintenance all observed the area, and maintenance identified the issue as likely related to a water leak and confirmed the grey growth was mold.
A resident with impaired cognition, oxygen use, hospice services, and multiple serious diagnoses was observed with a cracked, splintered headboard and footboard and a personal fan covered with visible dust and matter while blowing air across the resident’s head. The resident and SO stated the bed had been broken for months and the fan had not been cleaned, and multiple staff members acknowledged the dirty fan and damaged bed parts, but no maintenance request had been submitted for the repairs.
Shower Room Not Maintained in a Clean, Sanitary Condition: Surveyors observed unidentified pink matter covering part of the D1 unit shower walls, with additional deposits on the shower brushes, handheld shower bag, and plumbing fixtures. An NA stated she used one of the brushes after giving a resident a shower, and the housekeeper confirmed the pink matter was present and said she had not cleaned the shower the day before. The IP stated the shower needed to be cleaned, and the administrator said the shower should be cleaned to provide a clean environment for residents.
Persistent urine and bowel odors were observed in a resident hallway and in a resident room, with staff, residents, and a family member reporting the odors were ongoing and strong. A cognitively intact resident with BPH, obstructive uropathy, rheumatoid arthritis, and bladder incontinence had urine-soaked clothing, blankets, linens, and a wheelchair cushion in the room, and staff acknowledged the odor was a known issue. Surveyors also found gray dust and debris on vents in two hallways and a day room, and staff stated common area vents were not on a scheduled cleaning routine.
Soiled Wheelchair Not Kept Clean: A resident with Parkinson’s disease, depression, and moderate cognitive impairment was observed in an adaptive WC with yellow and white food debris, chunks of food, and dried liquid on the seat area and cushion. The same debris remained on later observations, including during breakfast when the resident was feeding himself with his mouth over the soiled area. An RN stated WCs are supposed to be cleaned at least weekly and when noted to be soiled.
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