|§483.10(i) Safe Environment. |
The resident has a right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
The facility must provide-
§483.10(i)(1) A safe, clean, comfortable, and homelike environment, allowing the resident to use his or her personal belongings to the extent possible.
(i) This includes ensuring that the resident can receive care and services safely and that the physical layout of the facility maximizes resident independence and does not pose a safety risk.
(ii) The facility shall exercise reasonable care for the protection of the resident's property from loss or theft.
§483.10(i)(2) Housekeeping and maintenance services necessary to maintain a sanitary, orderly, and comfortable interior;
§483.10(i)(3) Clean bed and bath linens that are in good condition;
§483.10(i)(4) Private closet space in each resident room, as specified in §483.90 (e)(2)(iv);
§483.10(i)(5) Adequate and comfortable lighting levels in all areas;
§483.10(i)(6) Comfortable and safe temperature levels. Facilities initially certified after October 1, 1990 must maintain a temperature range of 71 to 81°F; and
§483.10(i)(7) For the maintenance of comfortable sound levels.
Based on clinical record review, observation, and resident and staff interview, it was determined that the facility failed to provide a clean, comfortable environment on two of two nursing units (first floor nursing unit and second floor nursing unit, Residents 30, 39, 17, 63, 83, 16, 34, 64, 74, 7, 40, 4, 82, 20, and 25).Findings include:The initial tour of the nursing facility started at 9:40 AM on the first-floor nursing unit. The surveyor then toured the second-floor nursing unit. Observation of Resident 30 and 39's room revealed their bathroom was shared with two residents of the adjoining room. A dirty washcloth and hospital gown were on the bathroom floor. Observation of Resident 39's room revealed dried spills on the floor, to the left of the bed, away from the window side. There were two plastic medication cups and paper debris on the floor under the bed.Observation of Resident 17 and 63's room revealed their bathroom was shared with two residents of the adjoining room. A basin was on the floor in the bathroom next to a toilet plunger. An unlabeled urinal was on the back of the toilet. Dust was observed under the base board heater in the room. Observation of Resident 83 revealed the resident was in bed covered with a white bedspread. The bedspread had dried brown stains on the top of it near the bottom half of the bedspread. On the floor, was a fall prevention mat that was torn exposing the foam interior.Observation of the second-floor hallway floor underneath the mechanical lift were clumps of dust. The mechanical lift was under a bulletin board entitled "Resident Reviews." The mechanical lift had a build up of dust and dried stains on the frame closest to the floor. This was confirmed with Employee 1, social worker, on March 30, 2019, at 10:15 AM.Observation of Resident 16 and 34's room revealed dust under the base board heater. This was confirmed with Employee 1 on March 30, 2019, at 10:20 AM.Observation of Resident 64 and 74's room revealed the bathroom was shared with two residents of the adjoining room. Stacked on the back of the toilet were a wash basin, a bedpan, and then three wash basins. A plastic graduated collection container was also on the back of the toilet.Observation of Resident 7 and 40's room revealed they shared a bathroom with two residents in the adjoining room. Four basins were stacked together on the back of the toilet.Observation of Resident 4 and 82's room revealed they shared a bathroom with two residents in the adjoining room. A basin was on the floor of the bathroom. A used cake of soap and dentures were inside a denture cup without a lid on the shelf in the bathroom. The denture cup had Resident 4's name on it. A clothes hanger and a bedpan were hanging together off the back of the toilet. Observation of Resident 20 and 25's room revealed they shared a bathroom with two residents in the adjoining room. Seven basins were stacked together on the back of the toilet. Periwash and ProCare Cream were on the bathroom floor. The above findings were reviewed with the Nursing Home Administrator on March 30, 2019, at 11:00 AM.28 Pa. Code 207.2(a) Administrator's responsibility
| ||Plan of Correction - To be completed: 05/14/2019|
1. All areas identified: Rooms 30 and 39 dirty washcloth and hospital gown were removed off BR floor; Room 39 dried spills on floor cleaned and debris from floor removed; Room 17 and 63 basins removed from common bathroom, urinal placed at resident bedside and dust under baseboard cleaned; Room 83 stained bedspread removed and replaced with alternative clean bedspread, torn floor mat replaced; mechanical lifts cleaned of dust and stains; Room 16 and 34 baseboard heater cleaned of dust; Room 64 and 74 wash basins, bedpan removed from common bathroom and placed at resident bedside, graduated container labeled per resident; Room 7 and 40 basins removed from common bathroom; Rooms 4 and 82 basins and bedpan from common bathroom removed, Resident 4 dentures and cup cleaned, bathroom cleared of hangers; Room 20 and 25 basins and toiletries removed from common bathroom and floor.
2. All resident bathrooms and mechanical lifts were cleaned of any stains and debris. Resident basins, urinal and toiletries were placed in resident specific areas. Resident bedspreads were checked to assure that no stains were noted.
3. Each room will be on schedule for detail cleaning each month. Laundry will continue to check for stained bedspreads and replace as needed. Housekeeping will clean all mechanical lifts routinely. Nursing will continue to check resident bathrooms daily to assure resident specific items are properly stored and not in common bathrooms and soiled linen will be disposed of in proper container.
4. Staff will be in serviced by-Administrator/designee on creating a safe, clean, comfortable environment. Audits on safe sanitary environment will be completed weekly x 4, monthly x 3 then quarterly or until compliance is achieved. Findings will be reviewed at monthly QAPI committee by Administrator/designee.
5. Date of Compliance is 5/14/2019