§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 observations, review facility policies and staff interview, it was determined that the facility failed to maintain a clean and homelike environment in resident care areas and dining experience for one of five nursing units observed (Anthony dementia Unit).
Findings Include:
Review of facility policy "Housekeeping Safe and Sanitary Living Arrangements" dated on June 1, 1996, revealed, "St. John Neumann Nursing Home shall provide a safe and hygienic living arrangement for residents as designated by governmental agencies for licensure and certification purposes. In order to comply with this mandate, we require that employee within the Housekeeping Department clean resident rooms including bathrooms daily."
On May 20, 2025, at 11:12 a.m. an observation was conducted on the nursing unit Anthony in room 411 revealed Resident's R1, R2 and R3 bathroom was dirty. The toilet bowl had spot feces all over with urine smell, bathroom was not clean and had files in the bathroom when opening the door.
On May 20, 2025, at 11:14 a.m.., an interview was conducted with Registered Nurse, Employee E5 revealed that when families have concerns about the resident's rooms or environment issues nursing staff reply that it's dementia residents with behaviors and will get to it when they have time.
Interview with Housekeeping Director, Employee E4 on May 20, 2025 at 11:15 a.m. confirmed the bathroom in Room 411 was dirty, the toilet had spot of feces all over and housekeeping didn't clean the bathroom because of shortage of housekeeping staff.
Interview with the Nurse aide, Employee E6 on May 20, 2025 at 11:28 a.m. revealed that at 9:14 am in the resident R2 task she helped and clean resident R2 after he was in the toilet and had a loose/ diarrhea. Never informed the housekeeping that Resident's R2's bathroom was dirty.
Resident R1 was send out to the hospital on May 7, 2025, with the Diagnosis with UTI and ESBL (extended-spectrum beta-lactamase producing bacteria) and still is getting antibiotics.
On May 20, 2025, at 12:25 p.m. an interview was conducted with the infection control staff, Employee E7 confirmed that Resident R1was in the hospital and treated for UTI and ESBL (extended-spectrum beta-lactamase producing bacteria). The infection control also confirmed that a person using a dirty bathroom can get the bacteria.
28 Pa. Code 201.14 (a) Responsibility of licensee.
| | Plan of Correction - To be completed: 05/20/2025
1.R1, R2, and R3 residents', room 411, bathroom was cleaned immediately during the complaint visit.
2.An audit was completed on 5/20/25 of Anthony Unit's resident bathrooms by the Housekeeping Supervisor to assure resident bathrooms were clean.
3.Education was completed with nursing and environment service staff to assure that resident bathrooms are cleaned on a routine and as needed basis.
4.The Housekeeping Supervisor or Designee will Audit the resident bathrooms on the Anthony Unit for cleanliness weekly x 4 weeks and then monthly x 2 months to assure substantial compliance is achieved.
5.All audit findings will be reported at QAPI X 3.
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