| 1138 |
RIVERSIDE HEALTH CARE CENTER |
115375 |
5100 WEST ST NW |
COVINGTON |
GA |
30014 |
2017-08-17 |
469 |
E |
0 |
1 |
I6YR11 |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, record review, and interview, the facility failed to ensure adequate pest control services were provided to address the presence of cockroaches, flies, spiders and gnats for residents residing on three out of four wings (100 unit, 300 unit, and 400 unit) and in the kitchen. Staff failed to report the presence of bugs/insects to the maintenance department; interventions to eradicate insects were not timely. The census was 147. Findings include: 1. Environmental Observations/Tour a. 100 Unit -Room 115 - On 8/14/17 at 2:08 p.m., several gnats were observed flying above Resident (R)#218's bedside tray. -Room 115 - On 8/14/17 at 2:35 p.m. a gnat was flying between R#219 and the surveyor during the resident interview. b. 300 Unit -Observations were conducted in the Unit 3 dining room beginning at 12:50 p.m. on 8/14/17. R#17 received her lunch tray at 1:04 p.m. CNA ZZZ assisted R#17 by removing the plate cover and by opening the drinks on R#17's tray, then walked away. At 1:06 p.m., three flies were observed to land on R#17's food. During the next five minutes, flies landed and re-landed on R#17's food six times. R#17 did not respond to the presence of the flies and did not receive staff assistance or support to address the flies. The Dietary Manager (DM) was interviewed at 10:30 a.m. on 8/16/17 and confirmed flies were a problem in the kitchen. The DM confirmed, with food deliveries and dietary personnel coming in and out of the back door to perform tasks such as taking out trash, it was very difficult to keep the flies out of the kitchen, especially in the summer. -During the environmental tour with the Maintenance Director (MD) on 8/17/17 between 9:45 a.m. and 11:06 a.m. a fly was observed flying in the 300 Hallway, halfway down the hall. c. 400 Unit -During the environmental tour with the MD on 8/17/17 between 9:45 a.m. - 11:06 a.m., a gnat was observed flying in the hallway adjacent to the dining room. -400 Hall near the dining room and the emergency exit door - on 8/14/17 at 12:50 p.m. and again, during the tour with the MD on 8/17/17 between 9:45 a.m. - 11:06 a.m., multiple spider webs containing numerous dead gnats were observed surrounding the exit door (above the door and vertically down on both sides of the door), located near the dining area. Additionally, there were large spider webs (approximately 8 inches in diameter) with dead gnats located in both corners of ceiling in the hallway near the exit door and fluorescent light. Debris was observed on the floor in the corner on the hallway near the emergency exit door. The debris included seven small dead bugs. -400 Unit Nurses' Station - on 8/17/17 during the tour with the MD between 9:45 a.m. - 11:06 a.m. a fly was buzzing around the nurses' station. -Room 419 - on 8/15/17 at 10:18 a.m. a squashed dead bug was observed on the floor by bed B. 2. Family interview An interview was conducted with the family member of R#61 on 8/14/17 at 2:27 p.m. The family member stated flies were problematic. 3. Staff Interview The Maintenance Staff AA was interviewed on 8/16/17 at 11:34 a.m. and stated the facility was short one maintenance staff member. He stated the MD had been going back and forth between two sister facilities due to a staff shortage and he too had been going back and forth as well, but spent most of his time at this facility. Maintenance Staff AA stated he was primarily located at this facility and reported there should be two full-time maintenance staff, plus a third staff that did nothing but painting due to the large size and age of the building (census was 147 residents). The MD was interviewed on 8/17/17 during an environmental tour conducted between 9:45 a.m. and 11:06 a.m. The MD stated the facility had a pest control contract and monthly visits were made by the pest control contractor. The MD stated, He comes monthly for pest control and sprays (insecticide), or he comes (more often) as needed. There is a pest control log at each of the three nurses' station. The MD stated staff were to document in the log the presence of insects so the maintenance staff would be aware of problems; extra visits could be conducted by the pest control contractor or facility specific interventions could be implemented if pests were problematic. The MD stated gnats were an issue throughout the geographic region in the state and there was an effective solution he implemented. He stated he set traps with apple cider vinegar that drew in fruit flies/gnats when he was aware of problematic areas within the facility. The MD showed the surveyor a small, apple-shaped with an open top, plastic gnat trap from the 400 hall nurses' station that did not contain any vinegar and would have therefore been ineffective. The MD stated he had been going back and forth to provide services between two sister facilities due to being short one maintenance staff between the two buildings. 4. Pest Control Records and Facility Logs a. The Pest Control Policy (undated) indicated the goal was to ensure that, as far as possible, pests (rats, mice, roaches, ants, fruit flies, silver fish, etc.) within the premises are kept to an absolute minimum with the ideal being eradication but due to the resilience and persistence of some species this ideal is impossible to achieve. Steps and action included: 1. The Pest Control Contractor attends site (sic) takes appropriate action, complete (sic) a service report which is then filed in the NHA (Nursing Home Administrator) office . 2. The contractor will also respond to unscheduled request to effectively rid the premises of further pests . 4. Common areas, dietary units, nursing stations, rest rooms, break rooms, dining rooms, etc. will be services (sic) monthly and as needed . 5. After every site visit the Contractor shall provide a service report detailing time and date of visit, type of visit i.e. routine, call out or follow up. Location inspected or visited, Evidence of pests. Any proofing, housekeeping or hygiene recommendations to eliminate causes of infestation. Any precautions to be observed by staff as a result of action by the Contractor. b. All Commercial Pest Solutions records were reviewed for the previous three months. The pest control contractor made monthly regular visits to the facility on [DATE], 6/28/17 and on 7/24/17. At each visit the contractor sprayed in the dietary department. Records showed he sprayed one resident room (208) on the 7/24/17 visit. Records showed he sprayed the perimeter on the 6/28/17 visit. There was no documentation showing the contractor sprayed any other areas. c. Facility Logs - Each nursing station contained a note book in which staff was to document the presence of pests for purposes of notifying maintenance staff. The Service Request Logs included minimal documentation of staff identifying pests from 3/1/17 - 8/17/17: -Unit 1: There were no entries documented. -Unit 2: There was a total of two entries (7/28/17 - spiders were documented in the hallway and in room 216 and on 8/7/17 ants and bugs were noted in room 206 near the window). -Unit 3: There was a total of one entry over the past 6 months (3/17/17 - roaches were documented at the nursing cart). d. The facility's Kitchen Sanitation and Storage report, dated 5/26/17-5/30/17, identified 13 areas of concern including, Several roaches were observed today in (sic) kitchen and were killed. However, (Name of Dietary Manager) asked that we have the pest company to come again. 5. Resident council and/or grievances Review of the Resident Council Minutes dated 3/14/17 documented a concern of c/o (complaint of) gnats in facility, consensus. |
2020-09-01 |