Health inspection·June 20, 2024

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, observation, resident and staff interview, and review of the facility policy, the facility failed to keep a resident's room clean and sanitary. This affected one (Resident #12) of three residents reviewed for environment. The facility census was 57. Findings include: Review of the medical record for Resident #12 revealed an admission date 03/21/24. Diagnosis included anxiety disorder. Review of the Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #12 was cognitively intact. Interview on 06/20/24 at 10:35 A.M. with Resident #12 stated the housekeeping staff does not wipe down the furniture in her room. Resident #12 stated they do not sweep under her bed, or corners in the room. Resident #12 stated she took out her own trash from her room because it does not get taken care of. Resident #12 stated her toilet was disgusting, dirty, smells, and had urine ring around the toilet. Observation on 06/20/24 at 10:40 A.M. with Resident #12's room revealed all three of her bedroom walls, and around her air conditioner wall unit was dirty with an unknown black substance, dirt, food particles, and hair balls. Resident #12's bathroom floor was dirty with dirt particles and unknown particles on the floor. Resident #12 had a urine ring around her toilet base. The bathroom trash can had dirt and spots under and around the trash can. Resident #12's floor had scattered unknown black spots on her floor. Observations on 06/20/24 from 11:58 A.M. through 12:10 P.M. with Housekeeping Aide (HKA) #289 revealed she was cleaning Resident #12's room with blinds closed and lights out. HKA #289 opened the blinds at the window and cleaned Resident #12's end table around personal items, and half the bedside table which was part with no personal items. At 12:09 P.M., HKA #289 stated she was almost done cleaning Resident #12's room. Interview on 06/20/24 at 12:09 P.M. with HKA #289 verified she was mopping Resident #12's room a second time. HKA #289 verified she only mopped the main areas and pathways to the room. HKA #289 stated she did not mop under the walker, trash can, or bed. HKA #289 stated she did miss the areas that had dirt and food particles that were against the walls, under the bed, around the air conditioner wall unit, around the end table, around at the bedside table, or in the bathroom. HKA #289 confirmed there was dirt pile (in a pile of dirt that was approximately six inch in diameter in room when sweeping). HKA #289 also confirmed the hairball, urine ring around the toilet, and dirt and spots in the Page 1 of 2 365327 365327 06/20/2024 Montgomery Care Center 7777 Cooper Road Cincinnati, OH 45242

F 0584 Level of Harm - Minimal harm or potential for actual harm bathroom. HKA #289 stated she did not do the best job on Resident #12's room and could have done better. HKA #289 verified that she only wiped down half the bedside table, and around the personal items, and the end table around the personal items. HKA #289 stated Resident #12 was particular and did not want her to touch her personal items. HKA #289 verified on the bedside table there was dust, dirt, and unclean on the side with her personal items. Residents Affected - Few Interview on 06/20/24 at 12:50 P.M. with Floor Technician (FT) #242 stated he also cleaned the resident rooms. FT #242 stated he would move the small items off the bed side table, and end table to perform a better job in wiping down residents most used items. FT #242 stated the unknown black substance around the air conditioner wall unit had glue that was covered in dirt that was hard to get off the floor. FT #242 stated there was black scuff marks all over Resident #12's room possibly from Resident #12's wheelchair. FT #242 stated Resident #12 was not that particular, to move her personal items to clean areas in the room. FT #242 stated he moved trash cans, walkers, and sweep under resident's beds and furniture to do light cleaning. Review of the facility's undated policy titled Cleaning and Disinfection of Environmental Surfaces revealed non-critical surfaces included bed rails, some food utensils, bedside tables, furniture, and floors. Environmental surfaces will be disinfected (or cleaned) on a regular basis (daily, three times a week, and when surfaces are visibly soiled. Horizontal surfaces will be dusted regularly using clean clothes moistened with an Environmental Protection Agency (EPA)-registered disinfectant (or detergent). Review of the facility policy titled Standard Precautions, dated December 2007, revealed staff should ensure that environmental surfaces, beds, bedside equipment, and other frequently touched surfaces are appropriately cleaned. This deficiency represents non-compliance investigated under Complaint Number OH00154206. 365327 Page 2 of 2