MYERS PARK NURSING CENTER

.1310 (a) The interior walls of the institution, including doors, windows and window trim, and ceilings, shall be kept clean and in good repair. Observed walling damage in room 111. Observed touch up paint needed to walling throughout building.

.1313 (d) Institutions shall provide water heating facilities. Hot and cold running water under pressure shall be provided to carry out all operations. Hot water shall be provided at temperatures between 105 degrees Fahrenheit and 116 degrees Fahrenheit at handwashing and bathing facilities. Observed hot water ranging between 130F-131F in rooms 109 and 111.

.1319 (c) Linens provided by the institution that are not clean shall be cleaned and sanitized in accordance with this paragraph. When hot water in washing machines is used to sanitize linens provided by the institution, the washing machines shall be operated in accordance with the manufacturer's instructions. When chemicals are used to sanitize linens provided by the institution, linens shall be washed in accordance with the following: (1) using a solution of at least 50 parts per million chlorine; or (2) using laundry sanitizer that is registered in accordance with 40 C.F.R. 152 and that is used in accordance with the manufacturer's instructions. During time of inspection facility could not located documentation for notated rule. EHS advised facility to start maintaining documentation for notated rule. -General comment.

.1310 (a) The interior walls of the institution, including doors, windows and window trim, and ceilings, shall be kept clean and in good repair. Observed minor touch up paint needed to basement walling of facility. -General comment.

.1312 (a) All institutions shall provide toilet, handwashing, and bathing facilities that are available for use by residents and staff. These facilities shall be kept clean and in good repair. Observed loose toilet seat in room 120. -General comment.

.1312 (b) Bathrooms shall not be used for storage of items not currently in use. Observed wheelchairs stored in shared spa room on level 1.

.1320 (a) All food service equipment and utensils shall be kept clean and in good repair. Observed minor debris build up to dorm refrigerator unit shelving in nourishment room on level 1. Clean.

Observed floor drain cover missing in shower room on 2nd floor. **1309 (a) and (b) The floors in an institution shall be made of smooth, non-absorbent materials and shall be kept clean and in good repair. When carpet is present, it must be kept clean, odor free, and in good repair.

Observed wall damage in rooms 106, 215, 304 and 311, activity room on 2nd floor, restroom on 2nd floor. Observed water stained ceiling tiles in restroom on 2nd floor, shower rooms on 1st and 2nd floor and linen closet on the 3rd floor. **.1310 (a) The interior walls of the institution, including doors, windows and window trim, and ceilings, shall be kept clean and in good repair.

Observed dust build on vent covers in rooms 104 and 203. **.1311 (b) Ventilation equipment shall be kept clean and in good repair.

Observed slow drain in restroom in physical therapy and 304. Observed handwashing sink in need of repair in rooms 211, 203 and in restroom on 2nd floor.

Observed chairs stored in shower room on 2nd floor. **.1312 (b) Bathrooms shall not be used for storage of items not currently in use. Observed no hand wash sign posted in restroom on 1st floor. **.1312 (b) A sign shall be posted in each toilet room for institution employees, directing them to wash their hands after each visit to the toilet room and before returning to work.

Observed sink in laundry room missing paper towels. **.1312 (d) Handwashing facilities shall be supplied with soap and disposable towels or hand-drying devices.

Observed build up on shower bed/chairs in shower rooms on 1st and 3rd. Observed shower head in need of repair in shower room on 2nd floor. **.1312 (f) Bathing equipment that has contact with a resident's skin and is used by more than one resident shall be kept clean and shall be disinfected between resident uses. Equipment located within a bathing facility that uses a pump to move water shall be kept clean in accordance with the manufacturer's instructions.

Observed incomplete back up water supply plan. Spoke with maintenance during the inspection and informed him how the plan should be structured. **.1313 (e) The institution shall have a written plan to obtain a backup water supply in the event that the institution's primary water supply is interrupted for more than four consecutive hours. The written plan shall identify a backup water supply or alternate source of water that provides two liters of potable water per day per resident and institution employee for drinking and potable water for food preparation, hand washing, bathing, cleaning, dishwashing, laundry, and disposal of bodily waste. This may include a plan for relocating residents to a facility with a water supply that satisfies Paragraph (a) of this Rule. If an institution's primary water supply or backup water supply becomes unsafe for human consumption, then the water sources within the institution, such as sink faucets, shall be labeled or hooded to prevent their use, and the administrator shall provide potable water for use by the institution's residents and employees.

Observed mattress surface peeling in rooms 203 and 311. Observed torn pillows in room 203. Observed dresser in need of repair in rooms 304. **.1319 (a) Furnishings in an institution, including furniture, curtains, rugs, and blinds, shall be kept clean and in good repair. Mattresses shall be kept clean, dry, and in good repair.

Observed floor in need of cleaning in room 303, 307, 321 and 209. **1309 (a) and (b) The floors in an institution shall be made of smooth, non-absorbent materials and shall be kept clean and in good repair. When carpet is present, it must be kept clean, odor free, and in good repair.

Observed wall in need of repair in room 303, 318, 321 and 209 and living room on 2nd floor. Observed water stained ceiling tile in the dining room on 3rd floor. Observed rusted ceiling tile in the shower room on 2nd floor and bathroom ceiling in rehab. Observed shower grout in need of cleaning in shower room on 2nd floor. **.1310 (a) The interior walls of the institution, including doors, windows and window trim, and ceilings, shall be kept clean and in good repair.

Observed toilet in need of cleaning in room 303. Observed sink in need of repair in room 307. Observed toilet seat missing in shower room. **.1312 (a) All institutions shall provide toilet, handwashing, and bathing facilities that are available for use by residents and staff. These facilities shall be kept clean and in good repair.

Observed soap missing in nourishment rooms. **.1312 (d) Handwashing facilities shall be supplied with soap and disposable towels or hand-drying devices.

Observed shower bed and shower chair in need of cleaning in shower room on 3rd floor. Observed shower chair in need of cleaning on 2nd floor. **.1312 (f) Bathing equipment that has contact with a resident's skin and is used by more than one resident shall be kept clean and shall be disinfected between resident uses. Equipment located within a bathing facility that uses a pump to move water shall be kept clean in accordance with the manufacturer's instructions.

Observed hot water reach 120F in bathroom on 3rd floor, 122F in room 321, 120F in shower room and 122F in room 209. **.1313 (d) Institutions shall provide water heating facilities. Hot and cold running water under pressure shall be provided to carry out all operations. Hot water shall be provided at temperatures between 105 degrees Fahrenheit and 116 degrees Fahrenheit at handwashing and bathing facilities.

Observed screws rusting in ice machine and dripping into ice. **.1314 (c) Ice shall be protected against physical, chemical, and biological contamination and shall be kept clean.

Observed bed rail and divider curtain stained in room 303. Observed window shade stained in room 321. **.1319 (a) Furnishings in an institution, including furniture, curtains, rugs, and blinds, shall be kept clean and in good repair. Mattresses shall be kept clean, dry, and in good repair.

Observed linen stained in room 321. **.1319 (b) A resident's bed linens shall be changed when no longer clean.

Observed spill on floor in room 220. Replace missing floor tiles where needed. **1309 (a) and (b) The floors in an institution shall be made of smooth, non-absorbent materials and shall be kept clean and in good repair. When carpet is present, it must be kept clean, odor free, and in good repair.

Observed several water stained ceiling tiles during the inspection. Observed damaged walls in several places during the inspection. Needs to be repaired. **.1310 (a) The interior walls of the institution, including doors, windows and window trim, and ceilings, shall be kept clean and in good repair.

Observed faucet handle missing in nourishment room on 3rd floor. Observed sink in need of cleaning and repair in barber shop. Observed toilet in need of cleaning in room 213. **.1312 (a) All institutions shall provide toilet, handwashing, and bathing facilities that are available for use by residents and staff. These facilities shall be kept clean and in good repair.

Observed urinals not labeled in room 307. **.1312 (c) When disposable bedpans, emesis basins, and urinals are reused, they shall be labeled so that they are associated with an individual resident.

Observed hot water reach 123F in room 213. **.1313 (d) Institutions shall provide water heating facilities. Hot and cold running water under pressure shall be provided to carry out all operations. Hot water shall be provided at temperatures between 105 degrees Fahrenheit and 116 degrees Fahrenheit at handwashing and bathing facilities.

Observed droppings in the cabinet in the nourishment room on 2nd floor. **.1317 (a) Pests shall not be present in an institution's building or buildings.

Observed dresser in need of cleaning in room 220, handles missing and torn pillow in room 213. **.1319 (a) Furnishings in an institution, including furniture, curtains, rugs, and blinds, shall be kept clean and in good repair. Mattresses shall be kept clean, dry, and in good repair.

Observed cabinet damaged from water leak in the nourishment room on 2nd floor. Observed cabinets in need of repair in nourishment rooms. Observed rusted screws in ice machine and rusted water coming in contact with ice. **.1320 (a) All food service equipment and utensils shall be kept clean and in good repair.

Observed wall damage in the bathroom in room 107, wall in nourishment room (1st floor), room 213, 205 and the laundry room. Observed water stained ceiling tiles near the elevator and in the nourishment room on the 2nd floor. NOTE: Facility is going through renovations and there has been an improvement. **.1310 (a) The interior walls of the institution, including doors, windows and window trim, and ceilings, shall be kept clean and in good repair.

Observed urinals not labeled in room 213. **.1312 (c) When disposable bedpans, emesis basins, and urinals are reused, they shall be labeled so that they are associated with an individual resident.

Observed shower bed torn in the bathing room on the 2nd floor. **.1312 (f) Bathing equipment that has contact with a resident's skin and is used by more than one resident shall be kept clean and shall be disinfected between resident uses. Equipment located within a bathing facility that uses a pump to move water shall be kept clean in accordance with the manufacturer's instructions.

Observed hot water reach 78F in rooms 218 and 219. **.1313 (d) Institutions shall provide water heating facilities. Hot and cold running water under pressure shall be provided to carry out all operations. Hot water shall be provided at temperatures between 105 degrees Fahrenheit and 116 degrees Fahrenheit at handwashing and bathing facilities.

Observed ice chest accessible on the 1st floor. Needs to be locked when not in use. **.1314 (c) Ice machines and storage chests accessible to residents, guests, or the public shall provide ice through automatic ice dispensing equipment and shall not permit ice to be accessed using a scoop or bucket.

Observed torn pillow in room 110. Observed handles missing on dresser in room 213. **.1319 (a) Furnishings in an institution, including furniture, curtains, rugs, and blinds, shall be kept clean and in good repair. Mattresses shall be kept clean, dry, and in good repair.

Observed cabinet damaged from water leak in the nourishment room on 2nd floor. **.1320 (a) All food service equipment and utensils shall be kept clean and in good repair.

Observed floor in need of cleaning in room 302, 304 (restroom), 308. Observed tile missing in spa (2nd floor). Observed floor in room 116 in need of cleaning, strong urine odor. **1309 (a) and (b) The floors in an institution shall be made of smooth, non-absorbent materials and shall be kept clean and in good repair. When carpet is present, it must be kept clean, odor free, and in good repair.

Observed wall damage in room 302, 308, nourishment room (2nd floor) and above exit. Observed baseboard damaged in the nourishment room (1st floor). Observed ceiling damage in the nourishment room (2nd floor). Observed paint peeling in laundry room and the stairwell. **.1310 (a) The interior walls of the institution, including doors, windows and window trim, and ceilings, shall be kept clean and in good repair.

Observed vent cover missing in storage closet on the 3rd floor. Needs to be replaced. **.1311 (b) Ventilation equipment shall be kept clean and in good repair.

Observed toilet in need of cleaning in rooms 302 and 304. Observed toilet loose in room 308. **.1312 (a) All institutions shall provide toilet, handwashing, and bathing facilities that are available for use by residents and staff. These facilities shall be kept clean and in good repair.

Observed no handwash sign in the restroom on 1st floor. **.1312 (b) A sign shall be posted in each toilet room for institution employees, directing them to wash their hands after each visit to the toilet room and before returning to work.

Observed urinal in need of labeling in room 200 and 201. **.1312 (c) When disposable bedpans, emesis basins, and urinals are reused, they shall be labeled so that they are associated with an individual resident.

Observed soap and paper towels missing in the med room on the 2nd floor. **.1312 (d) Handwashing facilities shall be supplied with soap and disposable towels or hand-drying devices.

Observed bathing chair and shower beds in need of cleaning in spa (3rd, 2nd and 1st floor). **.1312 (f) Bathing equipment that has contact with a resident's skin and is used by more than one resident shall be kept clean and shall be disinfected between resident uses. Equipment located within a bathing facility that uses a pump to move water shall be kept clean in accordance with the manufacturer's instructions.

Observed no back up water supply plan. **.1313 (e) The institution shall have a written plan to obtain a backup water supply in the event that the institution's primary water supply is interrupted for more than four consecutive hours. The written plan shall identify a backup water supply or alternate source of water that provides two liters of potable water per day per resident and institution employee for drinking and potable water for food preparation, hand washing, bathing, cleaning, dishwashing, laundry, and disposal of bodily waste. This may include a plan for relocating residents to a facility with a water supply that satisfies Paragraph (a) of this Rule. If an institution's primary water supply or backup water supply becomes unsafe for human consumption, then the water sources within the institution, such as sink faucets, shall be labeled or hooded to prevent their use, and the administrator shall provide potable water for use by the institution's residents and employees.

Observed pillow damage in rooms 302, 304, 308, 200 and physical therapy. Observed curtain divider torn in rooms 302 and stained in room 304. Observed mattress peeling in room and peeling staining in 308. Observed countertop in need of repair in nourishment room (1st). **.1319 (a) Furnishings in an institution, including furniture, curtains, rugs, and blinds, shall be kept clean and in good repair. Mattresses shall be kept clean, dry, and in good repair.

Observed linen stained in room 200. **.1319 (b) A resident's bed linens shall be changed when no longer clean. Observed linen torn in room 201 and 308. **.1319 (b) Bed linens that are provided by the institution for use by residents shall be free from holes and tears.

Observed microwave in need of cleaning in nourishment room (1st). **.1320 (a) All food service equipment and utensils shall be kept clean and in good repair.

Observed no soap at the handwashing sink in nourishment room (1st and 2nd). **.1320 (c) Any area where food is portioned, served, or handled shall be equipped with a handwashing facility with a hot and cold mixing faucet, soap, and single-use towels or a hand-drying device.

Observed wall tile cracked in the shower room on the 3rd floor. Observed water stained ceiling tile in the nourishment room on the 2nd floor. Observed wall damage in the shower room on the 1st floor and in the shower room. **Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.

Observed toilet in need of cleaning in room 304 and in the shower room on the 1st floor and toilet seat peeling in the shower room on the 2nd floor **Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Observed handwashing sink clogged in the shower room on the 3rd floor. **Keep all handwashing facilities clean and in good repair. 15A NCAC 18A .1312 (b)

Observed dresser drawer face missing in room 304 and another dresser with staining. **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).

Observed interior of microwave rusting in the nourishment room on the 3rd floor. **Non-food contact surfaces of equipment shall be cleaned at such intervals as to keep them in a clean and sanitary condition. See rule .1320 (c).

Observed wall damage in room 320 and 303. Observed water stained ceiling tile in the weight room on the 3rd floor and the nourishment room on the 2nd floor. Observed ceiling in need of repair in the storage room in the laundry room. **Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.

Observed fall pad in the shower room and the shower chair in need of cleaning on the 3rd floor. Observed Observed shower bed in need of cleaning beneath the blue netting and the shower chair cracked. **Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f).

Observed patient care items stored on the floor in the storage closet on the 3rd floor and the linen closet on the 2nd floor. **All patient care or consumable items shall be stored at least 8 inches above the floor. 15A NCAC 18A .1318 (a).

Observed curtain with staining in bedroom 320 and 217. Observed torn pillow in room 217. Observed mattress torn in 203. **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).

Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed walls, baseboards, and door frames throughout facility with chipping paint, minor dings and holes throughout various areas of facility. Observed stained ceiling tile and part of ceiling beginning to fall located in rehab gym. Observed wall damage to wall in shower room located on first floor. REPEAT VIOLATION.

Moisture shall be controlled such that there is no evidence of microbial growth on interior surfaces and objects. 15A NCAC 18A .1311 (d). Observed black build up on ceiling and wall in chemical storage room located on ground floor near laundry room

Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Observed bathing mat in shower room on second floor with build up.

A cleaning detergent and an EPA registered hospital disinfectant shall be accessible to all bathing areas. 15A NCAC 18A .1312 (f). Observed no EPA registered hospital disinfectant located on first and second floor shared spa rooms. REPEAT VIOLATION.

The premises shall be kept neat, clean, and free of litter. 15A NCAC 18A .1317 (c). Observed broken furniture stored outside of dumpster area.

Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed walls, baseboards, and door frames throughout facility with chipping paint, minor dings and holes throughout various areas of facility. Observed stained ceiling tile and part of the ceiling beginning to fall located in rehab gym. Observed stained ceiling tile in linen closet on first and second floor. Observed stained ceiling tile on second floor near shared shower room. REPEAT VIOLATION.

Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Observed bathing mats peeling in all shared shower rooms throughout facility. Observed bath tub located in first floor shared spa room with pink and black build up surrounding the chalking of tub. Observed build up under shower chair located on first floor. Observed debris under and on shower mats throughout facility. Observed build up in the shower located in room 221 Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Observed loose toilet seats in the following areas: rooms 116, 216, and 318. Observed build up under toilet seat in the following areas: rooms116 and 112. REPEAT VIOLATION.

A cleaning detergent and an EPA registered hospital disinfectant shall be accessible to all bathing areas. 15A NCAC 18A .1312 (f). Observed no EPA registered hospital disinfectant located in first floor shared spa room. REPEAT VIOLATION.

All patient care or consumable items shall be stored at least 8 inches above the floor. 15A NCAC 18A .1318 (a). Observed boxes of single service cups and bowls stored on the floor in linen closet on second floor. Suitable rooms or spaces shall be provided for the storage of all necessary equipment, furniture, and supplies, and kept clean. 15A NCAC 18A .1318 (a). REPEAT VIOLATION.

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). Observed torn pillow in room 221. Observed furniture in common areas peeling and chipping throughout facility. REPEAT VIOLATION.

Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b). Observed staining on linen in rooms 318 and 206. Major improvement from previous inspection.

Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed ceiling tile stains throughout facility. Observed missing ceiling tiles rooms 220 and 218. Observed ceiling peeling in storage closet located in basement. Observed bathroom walls tile peeling and in need of repair throughout facility.

Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Observed soiled shower seats in all shared bathing spas within facility. Observed bathing mattresses in shared spa areas with rust build up. Replace/Clean. Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Observed loose toilet seats throughout facility that include rooms 116, rehabilitation rest room and, 302. Repair.

A cleaning detergent and an EPA registered hospital disinfectant shall be accessible to all bathing areas. 15A NCAC 18A .1312 (f). Observed no EPA registered hospital disinfectant located within all shared bathing areas.2

Ice shall be handled, transported, stored, and dispensed in such a manner as to be protected against contamination. 15A NCAC 18A .1314 (b). Observed screws in ice machine guard dripping rust down to bottom of guard. Observed black build up inside of ice machine.

The premises shall be kept neat, clean, and free of litter. 15A NCAC 18A .1317 (c). Observed chair and tables stored outside of dumpster area. Per conversation with head of maintenance the items had been out there for a while. EHS advised facility to make arrangements for the items to be picked up.

All patient care or consumable items shall be stored at least 8 inches above the floor. 15A NCAC 18A .1318 (a). Observed toilet paper stored on floor and boxes of single service cups in storage rooms throughout facility.

Medication carts shall be cleaned when visibly soiled. 15A NCAC 18A .1318 (c). Observed heavy build up on pill crushers on each medication cart checked during time of inspection. Unused medication cups shall be kept covered or inverted. 15A NCAC 18A .1318 (c). Observed medication cups on medication cart on level 2 of facility uncovered and exposed to air contamination.

Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b). Observed holes in sheets throughout facility. Observed stains on bed linen in rooms 220, 218, 202, and 318.