|§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 review of facility policy, observation, and resident and staff interviews, it was determined that the facility failed to provide a comfortable water temperature for showering for six of 12 residents (Resident R301, R302, R303, R306, R307 and R309), comfortable noise levels for eight of 12 residents (Resident R301, R303, R304, R305, R306, R307, R309 and R310) and safe environment for laundry chute in one of one bathrooms (A Wing).
A review of the facility policy "Shower/Tub Bath" indicated that the bath area should be a comfortable temperature for the resident. The policy indicated that a tub should be filled with water that is 105
During a group interview on 3/13/19, at 1:00 pm, six of 12 residents (Resident R301, R302,R303, R306, R307, R309) indicated that the water temperature for showering is too cold and is uncomfortable.
During an observation in the B Wing shower room on 3/12/19, at 1:57 p.m. the water temperature in the front shower was measured at 50 (degrees Fahrenheit) and the back shower water temperature was measured at 96
During an observation on 3/12/19, at 2:06 p.m. the first floor shower water temperature was measured at 97.7
A review of resident council meeting minutes indicated that residents had complained of cold water temperature on January 29, 2019, and again on March 7, 2019.
A review of maintenance weekly water temperatures documentation indicated that the water temperature fluctuated between 98 and 104
During an interview on 3/12/19, at 2:15 pm the Nursing Home Administrator was informed that the facility failed to make certain that water temperatures and sound levels were comfortable for residents.
During a group interview on 3/13/19, at 1:00 p.m., eight of 12 residents (Resident R301, R303, R304, R305, R306, R307, R309 and R310) indicated that the noise level at the facility is too loud and that staff members yell down the hallway to each other on a regular basis.
During an observation on 3/14/19, at 2:55 p.m. staff person was observed yelling down the hallway to other staff member, saying "are these anyone's keys" very loudly.
During an interview on 3/14/19, at 2:58 p.m. Licensed Practical Nurse Employee E4 confirmed that staff was yelling down the hall which created a noisey environment.
During an observation on 3/12/19, at 2:10 p.m. of the A Wing resident bathroom, an approximately 12" x 18" laundry chute was unlocked and accessible to residents.
During an interview on 3/12/19, at 2:15 p.m. Certified Nurse Aide Employee E5 confirmed that the laundry chute was unlocked and could create an unsafe environment for residents.
28 Pa Code: 201.14(a) Responsibility of licensee.
Previously cited 3/30/18, 2/9/17 and 8/30/16.
| ||Plan of Correction - To be completed: 05/02/2019|
1. The mixing valve on the hot water tank servicing the B and C wing shower room was changed by maintenance. A lock was immediately placed on the laundry chute. The staff member identified was educated on using a loud tone when speaking.
2. Resident council held 3/25/2019. No further concerns regarding water temperature of showers. No concerns regarding staff speaking in loud tones. No residents affected by unlocked laundry chute.
3. Education will be provided to nursing staff by DON/designee to check water temperature prior to showers and to communicate with resident regarding comfort level of water temperature. Education to be provided to staff by DON/designee regarding lock placed on laundry chute. Education to be provided to staff by DON/designee regarding appropriate noise levels when speaking amongst one another.
4. Audits of water temperatures to be completed 5 times a week for 2 weeks, then 3 times a week for 2 weeks, then weekly at random times for 2 weeks. Audit of lock in place on laundry chute will occur 3 times a week for 4 weeks, then at weekly at random times for 2 weeks. Audit of noise levels in facility will occur 3 times a week for 4 weeks, then weekly at random times for 2 weeks. Findings will be summarized and reported to the Quality Assurance Performance Improvement Meeting. Quality Assurance Performance Committee will determine the need for further audits and/or recommendation