|§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 reviews, observations and staff interviews, it was determined that the facility failed to maintain a sanitary, comfortable, and homelike environment for one of eight residents reviewed (Resident 7).
A quarterly Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs) for Resident 7, dated December 19, 2019, revealed that the resident was cognitively impaired and required extensive assistance from two staff for daily care tasks.
Observations in Resident 7's room on January 29, 2020, at 9:48 a.m. revealed that there were several areas of a dried, brown, smeared substance along the edge and on top of the toilet seat, as well as feces in the toilet.
Observations in Resident 7's room on January 29, 2020, at 2:22 p.m. revealed that the areas of dried, brown, smeared substance remained along the edge and on top of the toilet seat, and there was still feces in the toilet.
Interview with Nurse Aide 1 on January 29, 2020, at 2:25 p.m. confirmed that Resident 7's toilet was soiled and that it should have been cleaned by nursing or housekeeping staff immediately after it was used by the resident.
28 Pa. Code 207.2(a) Administrator's responsibility.
Previously cited 8/2/19.
| ||Plan of Correction - To be completed: 02/13/2020|
Toilet was cleaned in resident 7's room on 1-29-2020 by housekeeping staff.
All toilets and adaptive toileting equipment will be cleaned daily by housekeeping staff and in the event of additional reported cleaning needs by housekeeping to ensure residents homelike environment. Nursing staff are to notify housekeeping staff when toilets need cleaned at any time to ensure residents homelike environment.
Housekeeping staff will be educated to clean the toilets daily as well as how to properly clean the toilets.
Nursing staff, including agency nursing staff and housekeeping staff will be educated on homelike environment by the Administrator/Designee. Nursing staff will also be educated on proper notification to housekeeping staff when toilet cleaning is needed and how to properly clean toilets and / or adaptive toileting equipment when housekeeping is unavailable to ensure residents homelike environment.
An audit ensuring toilets, adaptive toileting equipment are cleaned properly will be done weekly times 4 weeks, monthly times 3 months, and quarterly times three months with results reported to the Quality Assurance monthly meeting for follow-up.