| Violation Item
| Demerits
| Violation Description
| CDI | R | VR |
|
|---|
|
1
|
1
|
Floors easy to clean, no obstacles, drains where needed |
No |
No
|
No |
Observed damaged floors in residents rooms in front of air conditioning and heating units and therapy room. Repair base tile cove molding and general cleaning of floor in 200 hall shower room. Thoroughly clean floors in residents rooms behind doors. Thoroughly clean floors throughout in hallway and storage rooms! Observed floors soiled throughout in areas.
Keep all flooring in good repair. 15A NCAC 18A .1309 (a) and (b). |
|
3
|
2
|
Walls and ceilings cleanable, clean, good repair |
No |
No
|
No |
Observed damage to walls in resident rooms throughout behind beds and next to heating and cooling units in rooms. Observed questionable fecal matter on walls near hand railings and emergency call buttons in bathrooms. THOROUGHLY CLEAN WALLS THROUGHOUT FACILITY IN BATHROOMS AND RESIDENTS ROOMS. Clean debris from behind handrails and the handrails also. Thoroughly clean, repair and repaint front entrance door and foyer door. Repair damaged wall paper in hallway on 100 hall.
Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. |
|
5
|
1
|
Ambient air temperature 65 to 85 F, equipment clean |
No |
No
|
No |
Observed debris present in top of heating and cooling units in residents rooms. Thoroughly clean debris from top of heating and cooling units. Observed dust build up on ventilation in bathrooms within residents room. Thoroughly clean vents in bathrooms.
Keep all ventilation equipment clean and in good repair. 15A NCAC 18A .1311 (b). |
|
8
|
1
|
Facilities conveniently located, clean and in good repair |
No |
No
|
No |
Observed fecal matter on of toilet chair (top and underside) and urine stains on toilet seat in several patients bathrooms; throughout clean bathroom/toilet fixtures. Observed pitted faucet fixtures on hand washing sinks throughout in resident bathrooms within room and common bath/showers. Replace pitted faucet fixtures on hand washing sinks. Observed hand washing sinks obstructed with storage in front of sink and storage too close to hand washing sinks(cross contamination). DO NOT OBSTRUCT OR BLOCK HAND WASHING SINKS! Recommend keeping an eighteen inch clearance around hand washing sinks! Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Keep all hand washing facilities clean and in good repair. 15A NCAC 18A .1312 (b) |
|
10
|
1
|
Bedpans, urinals, bedside commodes and emises basins properly cleaned and disinfected |
No |
No
|
No |
Observed Unlabeled bedpans and emesis basin in room 204.
Label all disposable bed pans with the residents/patients name and date. 15A NCAC 18A .1312 (c).
-Hopper in both soiled utilities rooms blocked and unaccessible. Clean out room to provide a clear path to hoppers for the proper disposal of waste and proper cleaning of bedpans. Observed items stored on top of hopper. Do not store or place items on top of hopper. |
|
19
|
1
|
Ice protected, dispensed, equipment clean in good repair |
No |
No
|
No |
Observed build up of pink debris on chute of ice machine in nutrition room. Observed stagnated water with microbial growth in the base of ice scoop holder in nutrition room. Thoroughly clean exterior of ice cooler chest.
Ice machines, buckets, other containers, and scoops shall be cleaned on a regular schedule such that they are kept free of scum, rust, mold or other contamination. 15A NCAC 18A .1314 (b). |
|
22
|
1
|
Solid waste disposed of frequently, no insect breeding or nuisance |
No |
No
|
No |
Observed bed frame, mattresses, broken wheelchairs and pallets stored behind the building and in dumpster corral. Remove pallets, mattresses and bed frame from premises. Observed open doors on dumpster. Observed can wash drain clogged/blocked, located out back door. Repair drain in can wash so mop water does not drain out onto the grass area.
All solid wastes shall be disposed of with sufficient frequency and in such a manner as to prevent insect breeding or public health nuisances. 15A NCAC 18A .1316 (d). |
|
28
|
1
|
Adequate storage, area clean, items properly stored |
No |
No
|
No |
Observed storage of patient contact items stored on the floor throughout facility in storage rooms. Observed package of briefs in spa tub in common shower/bath. Observed linen stored on spa tub in common bath/shower. Do not store or place brief or clean linen in or on spa bath.
All patient care or consumable items shall be stored at least 8 inches above the floor. 15A NCAC 18A .1318 (a). |
|
30
|
2
|
Medication carts clean, sharps containers affixed, food and utensils handled properly |
No |
No
|
No |
Observed single use cups stored improperly throughout the facility on medication carts. Cover drinking utensils while being stored on carts Observed base of drawers and pill crushers on med carts soiled. Thoroughly clean base of drawers on med carts and pill crushers!
Unused medication cups shall be kept covered or inverted. 15A NCAC 18A .1318 (c).
Medication carts shall be cleaned when visibly soiled. 15A NCAC 18A .1318 (c). |
|
32
|
2
|
Furniture clean and in good repair. Mattresses clean, dry, odor free |
No |
No
|
No |
Observed fall pad visibly soiled with blood. Observed cabinet doors visibly soiled with blood. Observed broken hinges on cabinets throughout the facility in residents rooms. Observed stained chairs throughout facility in residents rooms. Thoroughly clean all furniture throughout the facility on a regular basis. Thoroughly clean curtains on windows and separating beds. Replace missing laminate/bands on furniture/fixture or paint exposed wood where bands/laminate is missing. Observed paint/stain worn from foot boards and head boards on resident beds. Refurbish or replace footboards and head boards in resident rooms. Observed over bed tables soiled in resident rooms. Thoroughly clean over bed tables.
All furniture, bed springs, mattresses, sleeping mats, draperies, curtains, shades, venetian blinds, or other furnishings in institutions shall be kept clean and in good repair. 15A NCAC 18A .1319 (a). |
|
33
|
1
|
Linen changed when soiled. Soiled linen handled properly |
No |
No
|
No |
Observed sheets visibly soiled with blood on patients bed in room 224. Observed sheets visibly soiled with questionable fecal matter on patients bed in room 204. These "clean" bed were made by CNA's. HAVE WHOEVER IS MAKING THE BEDS TO PULL ANY SOILED SHEETS, FITTED SHEETS, SPREADS,ETC.
Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b). |
|
35
|
0.50
|
Patient contact items in good repair, properly stored, cleaned and disinfected |
No |
No
|
No |
Observed damaged arm rest on jerry chair. Replace damaged arm rest on jerry chair. Observed package of briefs in spa tub in common shower/bath. Observed linen stored on spa tub in common bath/shower. Do not store or place brief or clean linen in or on spa bath. Observed torn/damaged bed spread on resident bed. Discard any torn/damaged linen in residents room. Repair padding on therapy table.
Patient contact items shall be kept clean and in good repair. 15A NCAC 18A .1319 (c). |