HUNTERSVILLE HEALTH & REHABILITATION CENTER

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 slow draining at hand sink in room 317, 224/225, 130, 109/110, 101. Repair needed, keep all hand washing sinks in good repair.

REPEAT .1312 (b) Bathrooms shall not be used for storage of items not currently in use.- Observed blood pressure rollers in spa rooms in 200 hall. Items need to be removed. Ensure to ONLY store any bathroom related items in spa rooms at anytimes.

.1312 (d) Handwashing facilities shall be supplied with soap and disposable towels or hand-drying devices.- Observed no paper towel available in the dispenser in soiled utility room in 100 and 300 hall, clean room in 200 hall. Ensure to provide all hand washing supplies at all hand sinks at all times.

General Comment: .1320 (a) All food service equipment and utensils shall be kept clean and in good repair.- Observed refrigerators in nourishment room in 300 hall, storage room in 100 and 200 hall need cleaning and keep clean. Observed soiled and rusted microwave in nourishment room 300 hall need cleaning, repair or replace. Keep all food service equipment clean and in good repair.

REPEAT .1312 (b) Bathrooms shall not be used for storage of items not currently in use.- Observed living room chairs, lounge chairs, and lifts stored in both spa rooms in 100 and 200 hall. Remove items that are not belong in the bathrooms. Only bath related items can be stored in spa room.

.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 personal care buckets and urinal without labeling of the individual. Ensure to label each individual items.

REPEAT .1318 (a) Medication carts shall be kept clean.- Observed spilled liquid medication in their section drawers of medication carts. Need cleaning and keep clean.

.1312 (b) Bathrooms shall not be used for storage of items not currently in use.- Observed 2 living room chairs in a spa room 100 hall. Remove items that are not belong in the bathrooms.

.1312 (d) Handwashing facilities shall be supplied with soap and disposable towels or hand-drying devices.- Observed no paper towel available in the dispenser and/or batteries is out in soiled utility room 100 hall, room 125-126 bathroom, clean utility room 200 hall. Ensure to provide all hand washing supplies at all hand sink at all time.

.1318 (a) Medication carts shall be kept clean.- Observed spilled liquid medication in their section drawers of medication carts. Cleaning needed and keep clean.

.1311 (b) Ventilation equipment shall be kept clean and in good repair. Observed dust buildup in a/c filters in rooms 211, 227, 106, 102, and 126. Keep filters clean.

.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 missing/loose handles on cabinets in kitchen area and in room 106. Repair.

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 flooring in closet/storage/med room need cleaning and keep clean. The bottom cabinet under hand sink in soiled room 300 hall need cleaning.

REPEAT .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 soiled hand sink in the gym, med rooms, soiled rooms. Soiled toilet in 212, minor mildew buildup under the shower chair here and there throughout the facility. Detail cleaning needed and keep clean. Point remain the same

REPEAT .1312 (d) Handwashing facilities shall be supplied with soap and disposable towels or hand-drying devices.- Observed no paper towels/soap available due to no batteries or empty in the dispensers (soiled room, clean room, med room, spa room) throughout the facility. Ensure to provide all hand washing supplies at all hand sink at all time.

REPEAT .1311 (b) Ventilation equipment shall be kept clean and in good repair. Observed AC filter need cleaning and keep clean regularly in room 216, 104, 107, 112.

REPEAT .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 soiled toilets, soiled top/bottom of toilet chairs, shower chairs need cleaning and keep clean in room 307-308, 311, 216, 322. Point remain the same.

REPEAT .1312 (b) Bathrooms shall not be used for storage of items not currently in use. Observed non related bath items (roller standing desk, pads, pillows, etc..) stored in spa rooms. Remove all non related bath items from bathing area. Only store bath related items.

REPEAT .1312 (d) Handwashing facilities shall be supplied with soap and disposable towels or hand-drying devices. Observed no paper towel at a hand sink in salon room. Ensure to provide all hand washing supplies at all hand sink at all time. No point at this time deducted at this time.

.1312 (e) EPA registered disinfectants shall be used in accordance with the manufacturer's instructions. When EPA registered disinfectants are mixed and prepared by institution employees, a measuring device, chemical testing device, or the methods and devices prescribed by the chemical manufacturer shall be used to prepare the concentration of chemicals in accordance with the disinfectant's label and the manufacturer's instructions. Observed house keeping cart with bottle of chemicals without labeling. Ensure to label all chemical bottles. Observed housekeeper not knowing how to use cleaning/disinfecting solution properly according to the manufacturer’s instructions. Ensure to educate all cleaning staff/staff how to use cleaning chemicals effectively according to manufacturer’s instructions.

.1316 (a) All solid wastes containing food scraps or other putrescible materials shall be kept in leak-proof, non-absorbent containers which shall be kept covered with tight-fitting lids when not in use. Observed dumpsters doors left opened when not in use. Keep all doors and lids close to prevent pest harboring.

.1318 (a) Food, utensils, medications, and equipment used on medication carts shall be kept clean. Observed water pitcher in medication cart dated 7/24/23 (a day old). Ensure to send pitchers of water into the kitchen to get clean properly every 4 hours as water get change per staff every 4 hours.

REPEAT .1319 (b) A resident's bed linens shall be changed when no longer clean. Observed soiled linens on residents bed in room 127, 325, 104. Need change and get clean when visibly soiled.

.1321 (a) All food and food supplies provided by an institution for consumption by residents shall be from approved sources, stored, and handled as set forth in 15A NCAC 18A .2600. Observed box of single use cups stored on the floor in storage room in 100 hall. Keep items off the floor at least 6 inches above.

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 storage room floors collecting debris. Recommend elevating storage off the floor to facilitate cleaning. Keep all floors clean.

.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 wall damage in resident and storage rooms. Keep all walls in good repair.

.1311 (a) The areas interior to an institution's building or buildings shall be equipped with at least 10 foot candles of light at 30 inches above the floor. Observed spas with non-functioning lights. Replace any non-functioning bulbs.

.1311 (b) Ventilation equipment shall be kept clean and in good repair in suite 114/113. Keep all ventilation equipment clean.

.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 bathing chairs in rooms 314, 330, and 114, with brown residue. Observed toilet seat loose in 200 Spa room. Observed rusted toilet chair in room 201. Observed damaged backsplash at therapy bathroom and activity room sinks. Observed water damaged cabinet under sink in therapy room. Observed medication room sinks with debris and residue. Observed one shower curtain in 322 with pink residue.

.1312 (b) Bathrooms shall not be used for storage of items not currently in use. Observed spa areas that contain toilets with non-bathroom related storage such as floor pads and positioning pads. Remove all non bathroom/toilet room related storage.

.1312 (d) Handwashing facilities shall be supplied with soap and disposable towels or hand-drying devices. Observed the 100 spa room and one utility room with no hand washing soap.

.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 spa tub missing disinfectant inside the tub that is used to circulate and disinfect the tub. Observed a VitalOxide product that indicates that it is a non-rinse sanitizer in a Spa room. Replace the product with a hospital grade disinfectant and remove the sanitizer from the spa area.

.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. The back up water supply information provided in the emergency response manual does not address the following: Hooding faucets and water fountains when water is not safe for human consumption. Amount of water provided per resident/employee per day. A loss of water procedures for hand washing, bathing, cleaning, and disposal of bodily waste.

.1316 (a) All solid wastes containing food scraps or other putrescible materials shall be kept in leak-proof, non-absorbent containers which shall be kept covered with tight-fitting lids when not in use. Observed dumpster missing a lid and dumpster sliding doors left open. Keep the dumpster doors and lids closed.

.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 living room couches throughout the facility collecting debris and one couch with a medication under the pillows. Clean all couches and clean daily. Observed damaged mattress in room 314. Keep all mattresses in good repair.

.1319 (b) Linens that are not clean shall be placed in a covered container or bag devoted to this purpose at the point of use and stored in the covered container or bag until sanitized. Observed soiled towels in room 114/113 bathroom on the floor. Place soiled linen in a covered container once used.

.1319 (d) Clothing and linens that are provided by a resident for the resident's personal use shall be that resident's personal laundry. Personal laundry that is not clean shall be kept separate from clean clothing and linens using covered containers or bags that are labeled to indicate their contents and kept clean between uses. Observed a non-occupied/clean room, 301, with clothing from the last resident under the mattress. Keep resident clothing separate from clean linen and ensure resident items are removed between each resident.

.1319 (e) Laundry areas and equipment shall be kept clean. Observed melted plastic inside one dryer. Keep all laundry equipment in good repair. Observed personal food on the clean linen folding table, keep laundry equipment clean.

.1319 (f) Wheelchairs, walkers, lifts, and other mobility equipment shall be kept clean and sanitized between uses by different residents. Observed damaged wheelchairs in the therapy room and in room 330. Replace damaged wheel chairs so they can be be cleaned and sanitized between users.

.1324 (d) The institution shall have gloves, personal protective equipment, disinfectant, individual disposable towels, and a coagulating agent on-site for employees to use and a written procedure for employees to follow when responding to vomitus or fecal matter on institution surfaces. The procedure shall specify the actions that employees shall take to minimize the exposure of employees, residents, guests, food, and additional surfaces to vomitus or fecal matter. Observed no vomit or fecal matter clean up plan available. Provide a written plan and maintain available for staff and review during the inspections.

REPEAT Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed numerous walls scuffed in need of touch-up painting and repair in long term resident rooms. (Note) Points kept at half due to improvement.

REPEAT Toilet rooms shall not be used for storage. See rule .1312 (b). Observed numerous amounts of storage inside spa rooms throughout facility; spa storage must be limited bathing items only.

REPEAT 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). Observed storage rooms overflowing with misc items , equipment in need of proper storing to facilitate cleaning.

Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b). Observed disposable pillows being reused having rips / tears on surfaces in need of removal; Observed soiled comforters in resident rooms throughout in need of changing. (Note) disposable pillows that enter facility with new residents brought from hospital need to be discarded.

REPEAT Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed walls scuffed throughout most occupied patient rooms.

Toilet rooms shall not be used for storage. See rule .1312 (b). Observed 200 hall spa having misc storage unrelated to showering stored inside in need of removal.

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). Observed all storage rooms having numerous storage boxes directly on flooring in need of elevated storage to facilitate cleaning.

Keep all flooring clean. 15A NCAC 18A .1309 (a). Observed carpet throughout most halls having worn / stained surfaces in need of repair / cleaning.

Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed scuff marks in resident rooms caused by wheel chairs in need of touch up painting.