§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.
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Observations:
Based on observation and staff interview, it was determined that the facility failed to provide adequate housekeeping and maintenance services to ensure a clean, comfortable, and homelike environment on two of four nursing units (Nursing Units C, and F; Residents 1, 2, 3, 4, 5, and 6).
Findings include:
Observation of Nursing Unit C (second floor) on March 26, 2025, at 10:33 AM revealed the following findings:
A wheelchair in the hallway with no resident identifier had a significant accumulation of crumbs and debris under the seat cushion on the chair. There was also an unidentified piece of metal on the seat of the chair. A concurrent interview with Employee 1, nurse aide, revealed the wheelchair belonged to Resident 1.
Resident 2's wheelchair had an accumulation of crumbs and debris under the seat cushion on the wheelchair.
Resident 3's wheelchair had an accumulation of crumbs and debris under the seat cushion on the wheelchair.
Another wheelchair with no resident identifier had an accumulation of crumbs and debris under the seat cushion on the wheelchair. A concurrent interview with Employee 1 revealed it was unclear who the wheelchair belonged to.
Observation of the Nursing Unit C shower room on March 26, 2025, at 10:53 AM revealed the following:
There were multiple tears in the padding on the shower gurney exposing the underlying foam padding. One of the tears was six inches in length.
A shower chair had five resident lift slings of various sizes piled on the seat. Another sling was draped over the backrest of the chair. There was a blue-colored padded foam heel boot amongst the slings.
A pink colored basin held various shower supplies that included skin moisturizer and soap. At least two different resident initials were noted on two of the items. One of the items had leaked. There was an unused, folded brief in the basin. The item had leaked onto several of the other items including the brief and the bottom of the basin.
Observation of the Nursing Unit F (third floor) shower room on March 26, 2025, at 11:04 AM revealed the following:
A bucket used for a bedside commode was on the floor in the shower stall partially full of a brownish-tinged liquid. The bucket contained a brown colored object that appeared to be from a bowel movement floating in the water.
A black colored hair comb was located on a shelf above the sink. The teeth of the comb had a significant accumulation of white flakes and several strands of hair in it. The comb was placed with multiple other combs that appeared to be unused.
Observation of Nursing Unit F on March 26, 2025, at 11:11 AM revealed the following:
Resident 4's wheelchair was wet with an unidentified liquid under the seat cushion of the wheelchair. A concurrent interview with Employee 3, nurse aide, revealed that the wheelchair would be cleaned immediately.
Resident 5's Geri-chair had plastic collapsible trays on bilateral sides of the chair. The edges of both trays were broken exposing jagged edges of plastic.
Observation of Resident 6's wheelchair on March 26, 2025, at 2:58 PM revealed debris in the cupholder. There was a missing protective cap on the metal frame on the front left side of the wheelchair. There was an accumulation of dirt and debris in the missing cap. There was rust on the frame of the wheelchair.
The above information was reviewed in a meeting with the Nursing Home Administrator and the Director of Nursing on March 26, 2025, at 3:20 PM.
28 Pa. Code 201.18(b)(3)(e)(2.1) Management
| | Plan of Correction - To be completed: 04/29/2025
The wheelchairs identified in the survey belonging to residents 1, 2, 3, 4, 5, and 6 were cleaned of debris. The cracked trays on the wheelchair belonging to resident 5 were removed from the chair. The foam cushion on the shower gurney was replaced and the shower slings were organized appropriately. Clutter in the shower room was organized, and the bucket for the bedside commode was emptied.
An audit was conducted of resident wheelchairs to identify chairs that needed a deep cleaning. All chairs in circulation will be cleaned in accordance with the facility cleaning schedule. All shower rooms will be checked for cleanliness.
Facility nursing and housekeeping staff received education on the wheelchair cleaning schedule and shower room sanitation.
The Administrator or designee will audit the wheelchairs in accordance with the cleaning schedule 5x a week x 8 weeks to ensure they are appropriately cleaned. Shower rooms will be audited weekly x 8 weeks for clutter.
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