|§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 observation, review of facility documentation, review of facility policy and procedure and interviews with residents and staff, it was determined that the facility failed to maintain comfortable water temperatures for residents on one of four nursing units (post acute unit).
A review of the undated facility policy, "Test and log hot water temperatures - Sunday", indicated that water temperatures will be tested to ensure patient room water temperatures do not exceed 110 degrees Fahrenheit, and to check rooms at the end of each wing on a rotating basis, and to let the water run for three minutes before taking the reading.
Interview with Resident R6, who resides in Room 10, on January 13, 2020 at approximately 2:00 p.m., revealed that the water in the shower is cold. The resident reported that it may start out luke-warm but turns cold. He also indicated that when he put the thermometer under the running water it was reading 76 degrees. The resident further stated that he cannot tolerate a cold shower and feels bad for the other residents like his roommate who is older has trouble staying warm without a cold shower.
Observations of the water temperatures in resident rooms taken on January 14, 2020 at approximately 10 a.m. in the presence of Employee E3, Maintenance Director and the Nursing Home Administrator (NHA), using the facility thermometer, revealed the following shower temperatures: Room 10 - 83.6 degrees; Room 25 - 83.6 degrees. During the observation of the shower temperatures the NHA indicated the temperature as being luke-warm and not what he was getting during his audits.
Interview with Employee E3, in the presence of the NHA, on January 14, 2020 at approximately 10:15 a.m. confirmed that the boiler for the post-acute unit (rooms 1- 29) was not functioning properly. Observation of the boiler for the post-acute unit conducted on January 14, 2020, at approximately 10:30 a.m. revealed that the boiler, located in the front of the building, was not operating and that the facility had called a plumber to come in to repair the boiler.
Further interview with Employee E 3 on January 14, 2020, at approximately 1:25 p.m. revealed that the plumber had come and was working on the boiler and that it would need parts, but that it was working. During a follow-up observation of the shower temperatures at approximately 1:30 p.m. in Room 25 the reading was 93.1 degrees after the water had run for a few minutes.
Interview with the NHA on January 14, 2020, at approximately 2:15 p.m. confirmed that the boiler was working intermittently and that the plumber had ordered a new mixing valve which would be installed as soon as it was available. He further stated that the facility was monitoring water temperatures hourly on the post-acute unit and that the nursing staff was in-serviced on using showers on the other units until the boiler was repaired.
A review of shower temperature logs, back to September 2, 2019, revealed that the recorded shower temperatures were between 100 and 110 degrees until January 14, 2020 when the 94.5 degrees was recorded for room 10.
The facility failed to maintain comfortable water temperatures for residents on one of four nursing units.
42 CFR 483.10 Resident Rights
Previously cited 12/06/2018
28 Pa. Code 201.29(j) Resident rights
Previously cited 11/20/19, 12/6/18
28 Pa. Code 205.37(e) Equipment for bathrooms
| ||Plan of Correction - To be completed: 02/17/2020|
Preparation and execution of this plan of correction does not constitute admission or agreement of the facts alleged or conclusion set forth in this statement of deficiencies. The plan of correction is prepared and/or executed solely because it is required by both Federal and State laws.
Resident R6 interviewed and reported water in shower room is warm during shower. Water in shower room temperature is 108.6. Room 10 water temperature is 109.2. Rm 25 water temperature is 108.1. Boiler repaired by plumber on 1/14/2020. Mixing valve repaired on1/29/2020 . Hourly water temps obtained until 1/29/2020 and findings included 108.9 degree Fahrenheit.
Maintenance Director will obtain water temperatures in Post Acute random resident shower rooms and unit shower rooms.
Nursing Home Administrator will in-service facility Maintenance Director on ensuring resident water temperatures range remains between 100-110 degrees.
Maintenance Director will obtain water temps in Post-Acute Unit 5 random rooms 5x a week for four (4) weeks, weekly x 4 weeks then monthly x three (3) months, and as needed. IDT will interview 5 random residents/week for 4 weeks, then monthly x three (3) months, and as needed. Audit findings will be reported at monthly QA and A for further review and recommendations.