| 10323 |
GOLDEN LIVINGCENTER - NORFOLK |
285101 |
1900 VICKI LANE |
NORFOLK |
NE |
68701 |
2012-04-04 |
253 |
C |
0 |
1 |
51KT11 |
LICENSURE REFERENCE NUMBER 175 NAC 12-006.18A Based on observations, record review, resident and staff interview; the facility failed to maintain a functional, sanitary and odor free environment as resident room walls and doors were scratched and marred; consistent urine odors were noted in hallways and in resident rooms/bathrooms; bedpans, urine catch pans and personal resident items were lying directly on the floor; the floors of resident rooms and storage areas contained dust and paper residue; resident floor mats were soiled; and counter tops were stained with water deposits. This affected 15 resident rooms/bathrooms (Resident Rooms 1, 9, 16, 18, 21, 26, 27, 28, 29, 31, 32, 34, 35, 39 and 40). The exterior window sills on the entire facility were paint chipped with the bare wood exposed, and the east Dining Room windows were soiled with an accumulation of bird droppings. Facility census was 55. Findings are: A. The following were observed on the Alzheimer's Care Unit (ACU): -Observation on 3/26/12 from 7:55 AM until 9:00 AM revealed the consistent odor of urine in the North hallway of the ACU. The sitting room at the end of the North hallway had 2 cat litter boxes, one with a cover over it and one without a cover, located in a cove behind the entry door. Litter was scattered outside the boxes and there was cat feces accumulated in the uncovered box. There was an odor of cat urine in the room and extending into the hallway outside the room. There were 2 cats observed on the ACU; one in Resident Room 12 and one in Resident Room 8. -Observation on 3/26/12 from 11:19 AM until 12:30 PM revealed the consistent odor of urine in the North hallway of the ACU. Urine odors were also noted in the bathrooms of Resident Room 18 at 11:40 AM and Resident Room 9 at 12:20 AM, located on the ACU. -Observation on 3/26/12 from 2:03 PM until 3:30 PM revealed the consistent odor of urine in the North hallway of the ACU. -Observations on 3/27/12 at 6:25 AM and 7:23 AM revealed the odor of urine in the North hallway of the ACU. 2 cat litter boxes remained in the cove behind the entry door to the sitting room at the end of the North hallway. There was litter scattered outside the boxes and an accumulation of cat feces in the uncovered box. -Observation on 3/27/12 from 9:09 AM until 9:46 AM revealed the consistent odor of urine in the North hallway of the ACU. -Observations on 3/27/12 at 10:25 AM and 10:55 AM revealed the odor of urine in the North hallway of the ACU. (Surveyor ) Observation on 3/27/12 at 11:35 AM in the sitting room at the end of the North hallway in the ACU revealed a deodorizer on the shelf above the cat litter boxes. The room smelled strongly of deodorizer with an underlying odor of urine. (Surveyor ) Observations on 3/27/12 revealed the odor of urine in the North hallway of the ACU at 1:40 PM, at the end of the South hallway of the ACU at 1:59 PM, and at the end of the South hallway and in the North hallway of the ACU at 2:23 PM and 2:45 PM. Observation on 3/28/12 at 6:27 AM revealed a stale odor upon entrance to the ACU. There were large fans running at the ends of both the North and South hallways. The 2 cat litter boxes remained in the cove behind the entry door of the sitting room at the end of the North hallway. The uncovered box had cat feces visible in it. The room smelled of deodorizer. There was a cat sitting in the South hallway. Observations on 3/28/12 revealed stale odors at the end of the South hallway of the ACU at 11:20 AM, in the North hallway of the ACU at 1:37 PM, and at the end of the South hallway at 1:54 PM. At 2:01 PM on 3/28/12, Resident 69 approached the entry door to the dining room in the South hallway of the ACU and urinated on the dining room floor. Interview with Nursing Assistant (NA) - C at this time revealed Resident 69 often urinated in inappropriate places on the ACU. Observations on 3/28/12 at 2:15 PM and 3:08 PM revealed the odor of urine at the end of the South hallway of the ACU, and at 3:15 PM the cat feces noted in the uncovered cat litter box in the sitting room at the end of the North hallway remained positioned as noted earlier in the day. Observation on 3/29/12 at 6:15 AM revealed a stale odor with underlying odors of urine at the end of the South hallway and in the North hallway of the ACU. Fans were running at the ends of both hallways. Observation on 3/29/12 at 6:30 AM revealed an odor of urine in the sitting room at the end of the North hallway. A puddle of urine was observed on the floor in front of the exit door in this room. Observation on 3/29/12 from 7:13 AM until 7:50 AM, and at 8:05 AM, revealed a consistent odor of urine in the North hallway of the ACU. The puddle of urine in the sitting room at the end of the North hallway was drying but remained damp. The room smelled of urine. Observation on 3/28/12 at 9:45 AM revealed urine odors upon entry to the ACU and throughout the North hallway of the ACU. The puddle of urine on the floor in the sitting room at the end of the North hallway remained damp. Observations on 3/29/12 revealed the odor of urine in the South hallway of the ACU at 10:13 AM and in the North hallway of the ACU at 11:26 AM. Observation on 3/29/12 at 1:14 PM revealed stale odors in both hallways of the ACU. There was a housekeeper on the unit cleaning and there were wet floor signs up in different areas of the unit. The puddle of urine on the floor in the sitting room at the end of the North hallway of the ACU had been cleaned; however, the room continued to smell of urine. Observation on 3/29/12 at 2:38 PM revealed odors in the North hallway of the ACU. Observations on 4/2/12 at 6:30 AM and 9:26 AM revealed stale odors upon entrance to the ACU, and throughout the North hallway of the ACU. During interview on 4/2/12 from 9:54 AM until 10:00 AM, Licensed Practical Nurse (LPN) - I verified there were consistent odors on the ACU. LPN - I stated the cat litter boxes were cleaned weekly by the night shift. LPN - I further verified Resident 69 and Resident 54 urinated in inappropriate areas on the ACU. Observation on 4/2/12 at 11:24 AM revealed urine odors in the North hallway of the ACU. The 2 cat litter boxes in the sitting room at the end of the North hallway were clean. Observation on 4/2/12 at 2:15 PM revealed stale odors upon entrance to the ACU. Observations on 4/3/12 revealed an odor of deodorizer with under lying odors of urine upon entrance to the ACU at 7:52 AM and 1:15 PM. Observation on 4/4/12 at 6:30 AM revealed stale odors in the North hallway of the ACU. The 2 cat litter boxes in the sitting room at the end of the North hallway were clean. Review of the Cat Policy (undated) revealed the cat litter boxes and the area around them was to be cleaned every Thursday night and signed off on the calendar to indicate that it was done. Review of the calendar for 2/12 and 3/12 revealed the cat litter boxes were cleaned 2/2/12, 2/9/12, 2/16/12, 2/23/12, 3/1/12, 3/8/12, 3/15/12, 3/22/12, 3/26/12, 3/27/12 and 3/28/12. B. The following odors were observed in the traditional unit of the facility: There was a urine odor in Resident 14 and Resident 21's bathroom on 3/26/12 at 12:12 PM and 12:22 PM. (Surveyor ) There was a urine odor in Resident Room 21 on 3/27/12 at 11:31 AM. (Surveyor ) There was a urine odor in the corridor by the East Nurses Station on 3/27/12 at 2:45 PM and 3:00 PM. There was a sour unpleasant odor in the Soiled Utility Room adjacent to the East Nurses station during this time. (Surveyor ) On 3/28/12 from 2:00 PM until 2:28 PM there was a fecal odor in the corridor by the East Nurses Station. The fecal odor intensified when the door to the adjacent Soiled Utility Room was opened. During this time Nursing Assistant A stated, It smells out here and proceeded to spray deodorizer in the hallway which did not alleviate the odor. ( ) A fecal odor was noted in the corridor outside Resident 38's room on 3/29/12 from 10:08 AM until 10:15 AM. (Surveyor ) A urine odor was noted in Resident Bathrooms/Rooms 18 and 21 during environmental tour of facility on 4/3/12 from 8:55 AM until 11:30 AM (Surveyor ) There was a urine odor in Resident 8's room on 4/3/12 at 6:10 AM. An incontinence brief which was saturated with urine was in the wastebasket. The wastebasket was on the floor next to the head of the resident's bed. The urine odor remained present in the room at 8:20 AM. The soiled incontinence brief had not been removed from the wastebasket. (Surveyor ) C. The following areas were observed to be in need of more frequent cleaning: The light switch and the wall next to the toilet were smeared with feces in Resident 16's bathroom on 3/26/12 at 11:47 AM. The toilet seat was soiled with feces in the bathroom of Room 31 on 3/26/12 at 12:12 PM. The stool riser on the toilet in the shared bathroom of Room 26 and Room 27 was soiled with feces on 3/26/12 at 2:25 PM and 3/27/12 at 7:53 AM. D. On 3/27/12 at 1:25 PM, 3/28/12 at 11:00 AM and 3/29/12 at 8:00 AM, an accumulation of bird droppings was noted on the exterior window sills adjacent to the patio/smoking area used by residents. The painted surface of the window sills was worn off exposing the bare wood. (Surveyor ) An accumulation of bird droppings on the exterior window sills adjacent to the patio/smoking area was noted on 4/3/12 during environmental tour from 8:55 AM until 11:30 AM. E. During the environmental tour of the facility with the Administrator, and the Maintenance Supervisor on 4/3/12 from 8:55 AM until 11:30 AM the following issues were identified. -Room 1-A bottle of perineal wash was lying directly on the floor next to the toilet. In addition, this was also observed on the Stage 1 room observation. -Room 16-Bathroom floor contained a sticky residue. The inside of the toilet bowl contained a dark brown stain. -Room 21-The sink faucets were reversed and the sink did not drain when filled with water. -Room 30-2 floor mats were soiled with dust and floor debris. -Room 31-The closet door contained a 4 inch gouged and wood splintered hole. The closet doors for bed 2 did not shut as hangers, clothing and personal items protruded out of the closet. A package of disposable briefs was lying on the floor in front of the closet doors. The walls of the room were paint chipped and marred. The 2 floor mats were soiled and contained 3 holes in the mats which did not provide an easily cleanable surface. -Room 32- The patched wall next to the sink was not painted in a 4 foot area. The bathroom floor was soiled with dust and debris. -Room 34-A bedpan and commode container were stored on the floor in the bathroom. A soiled glove was lying inside the commode container. The bathroom floor was soiled with dust and paper. The floor mat lying on the floor next to the resident's bed was soiled. Soiled paper tape was stuck to the mat. -Room 35-A 2 foot area of the wall behind the bed was scratched and marred. -Room 39-A bedpan and a stool riser were stored directly on the floor next to the toilet in the bathroom. The bathroom door was scuffed on the inside and outside surface of the door in a 3 foot by 2 foot area. The room wall next to the foot of the bed was marred in a 2 foot by 1 foot area. -Room 40-Resident clothing and multiple personal items were stored directly on the floor. Dust was noted on the floor between the items. Snack items of chips and crackers were sitting directly on the floor. Crushed chips were noted on the floor before and after housekeeping had performed the daily cleaning duties. 3 basins/bedpans were stored directly on the bathroom floor. The bathroom sink stopper was lying on the floor under the sink. Resident 11 who resides in this room stated on 4/3/12 from 10:30AM until 10:33AM, It's been on the floor for a long time. -The Central Supply floor was dusty and contained a soil of dirt and paper/ plastic debris. Cases and individual boxes of medical supplies were stored directly on the floor. -The East Nursing Supply room floor contained a soil of dust, cotton balls, plastic tubing caps, plastic coverings from medical supplies and a laboratory container indicating a lack of routine cleaning. -The counter tops surrounding the sinks in the Alzheimer ' s Unit dining room and the East Nurses station were soiled with a brown residue and stained. -The corner molding at the East Nurses Station was broken out and cracked. The carpet covering on the side walls of this Nurses Station was frayed. -The North wall of the Main Dining Room contained 6 inch by 4 inch gouged hole. -The floor behind the ice machine in the Main Dining Room contained an accumulation of dust and soil. The exterior surface of the cabinet next to the ice machine was soiled with dried on tea stains. A drawer in this cabinet also contained tea stains. The floor of the sink cabinet contained water and soil stains. -The Oxygen Storage Room floor contained an accumulation of dust and debris. F. The exterior window sills on the entire facility were paint chipped. The bare wood was exposed on the window sills. G. Interview with the Administrator on 4/3/12 from 11:30 AM until 11:35 AM revealed resident floor mats needed to be cleaned on a regular scheduled basis and that the facility's exterior window sills needed to be painted. |
2016-01-01 |