Health inspection·November 21, 2024

F 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation and interviews, the facility failed to ensure that equipment were secure and inaccessible to unauthorized staff and residents for 1 (second floor storage room) of 1 storage areas reviewed for equipment storage. The facility failed to ensure equipment supplies were all stored in locked compartments and permit only authorized personnel to have keys when the only storage room in the facility was on the second floor was left unlocked and unattended. This failure could result in resident access leading to a risk for harm and possible injury. Findings included: In an observation on [DATE] at 10:09 a.m. revealed an unlocked, unorganized and dirty storage room on the second floor. In the storage room revealed the following equipment: 1) Broken Wheelchairs, 2) a broken bed frame with sharp edges exposed on the frame, 3) a broken overbed table, with sharp edges where veneer was missing, 4) poles used for g-tube (feeding tubes for formula) and used for infusion of medications, 5) a bedside table with a drawer broken, 6) a suitcase, 7) repair parts for wheelchairs, 8) several mattresses stacked up almost to the ceiling, 9) one large bottle of mouthwash, 10) a bottle of unmarked white liquid, 11) a bottle of hand gel, Page 1 of 2 455823 455823 11/21/2024 Treemont Healthcare and Rehabilitation Center 5550 Harvest Hill Rd Dallas, TX 75230

F 0921 12) plastic bags, and Level of Harm - Minimal harm or potential for actual harm 13) a dirty pair of gloves on the floor. Residents Affected - Few Further observation revealed the equipment was piled up on top of each other and appeared to have been shoved into the room. In an observation and interview on [DATE] at 10:23 a.m. with ADON A revealed the storage room should always remain locked. ADON A stated she had been in the room earlier that morning and gotten a Hoyer lift and had locked it back. The ADON stated she did not know how many keys there were for the storage room, she did not know if the charge nurses had a key. She stated she had not seen it unlocked before. ADON A stated that a resident or a staff member could have access to the storage room if the door was not locked and this could cause harm to them if they go inside the room. In an interview on [DATE] at11:15 a.m. with LVN C revealed the storage room must stay locked. There were equipment and supplies in the room that could be stolen or were dangerous for others if the person got in the room. LVN C stated she was not sure if she had a key for the room, someone else must be unlocking the door. LVN C stated she had not seen anyone go in there, but she knew the CNAs kept the Hoyer lift in there, but she had not paid attention if the door was locked or unlocked. In an interview on [DATE] at12:20 p.m. with CNA B revealed the storage room was always unlocked, when she needs to place her Hoyer lift in there or get it out. The CNA knew there was a lock on the door, so if you closed it all the way it will automatically lock. She stated she had never seen any residents try to go into the room. CNA B stated she did not know if the room was supposed to be locked or not, but if a resident got into the room, they could get hurt she guessed because of the equipment in the room. In an interview on [DATE] at 4:10 p.m. with the Administrator revealed it was her expectation that storage rooms should be always locked. The Administrator said that the nurses were responsible to keep the storage room locked. She stated if they were not locked, residents and unauthorized staff could get into the storage room and there would be opportunities for harm. Review of the Policy and Procedure Monthly CS Sweep Instructions dated [DATE], reflected, It is our company guideline that a complete sweep of all areas that contain nursing supplies is done at least monthly to ensure that nothing expired is in place on our shelves Nothing Directly on the floor or 18 from the clingthis is a fire and a safety hazard . stored equipment: Equipment is to be stacked and organized neatly so it can be easily identified if needed for a resident. Equipment is to be cleaned with a clean trash bag placed over it so it is known that the equipment is clean and ready use. If equipment is broken, label as broken . 455823 Page 2 of 2