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Based on observations and interviews with key staff June 18-20, 2013, it was determined that the facility failed to maintain the CAH to ensure safety of patients.

Findings include:

1. On June 18, 2013, at 12:30 p.m., a surveyor observed that the wall was chipped in Room #3206. This finding was confirmed in an interview with the Facilities Director on June 18, 2013 at 12:30 p.m.
2. On June 18, 2013, at 2:00 p.m., a surveyor observed that the baseboard in the Recovery Room bathroom was not sealed at the floor/wall joint. This finding was confirmed in an interview with the Facilities Director on June 18, 2013, at 2:00 p.m.
3. On June 18, 2013, at 2:00 p.m., a surveyor observed that the baseboard was missing on both sides of the bathroom door in the Recovery Room. This finding was confirmed in an interview with the Facilities Directors on June 18, 2013, at 2:00 p.m.
4. On June 18, 2013 at 2:40 P.M. a surveyor observed that the baseboard was missing under the sink at the Nurses Station in the Recovery Room. This finding was confirmed in an interview with the Facilities Director on June 18, 2013, at 2:40 p.m.
5. On June 18, 2013, at 2:17 p.m., a surveyor observed that the baseboard in the corridor in the Recovery Room were not sealed to the floor. This finding was confirmed in an interview with the Facilities Director on June 18, 2013, at 2:17 p.m.
6. On June 18, 201,3 at 2:20 p.m., a surveyor observed that the Central Sterile Room [CSR] wall was not sealed. This finding was confirmed in an interview with the Facilities Director on June 18, 2013, at 2:20 p.m.
7. The following findings were observed in the Emergency Department at approximately 9:50 a.m., on June 18, 2013;
a) A surveyor observed that a package of wipes was stored on the floor of the clean utility room;
b) A surveyor observed that behind the fire doors there was a build up of dirt;
c) A surveyor observed that the public bathroom had grimy corners;
d) In Room 2 the formica moulding was missing on the counter;
e) In Room 5 the rocking chair cushion set was ripped and the Formica on the counter was chipped;
f) In Room 6 the light switch cover was cracked; and
g) In the public bathroom behind the sink, the sheetrock was not intact.
8. These findings were confirmed by the Vice President of Nursing at approximately 9:58 a.m. on June 18, 2013.
9. During a tour of the Trenton Health Center, on June 19, 2013 at approximately 8:10 a.m., it was observed that the upholstery on the exam table in Room 2 was torn and the exhaust fan in the wet bathroom was dirty.
10. During a tour of the Southwest Harbor Clinic on June 19, 2013 at 9:15 a.m., it was observed that the bathroom door was chipped.
11. During a tour of the Family Health Center on June 19, 2013, at 10:35 a.m., it was observed that the floor in the bathroom was not sealed and the exhaust fan in the bathroom was dirty.
12. During a tour of Cooper-Gilmore Health Center on June 19, 2013, at 10:45 a.m. it was observed that the toilet was not sealed to the floor in the public bathroom and there were dirty vents in the staff bathroom and the janitor closet.
13. During a tour of the Women's Health Center on June 19, 2013 , at 11:37 a.m., it was observed that a bottle of sterile water was opened on march 15, 2012 and never discarded.
14. During a tour of the Breast center on June 19, 2013, at 12:30 p.m., it was observed that the baseboard was not sealed to the floor in the bathroom.
15. These findings in the outpatient areas were confirmed by the Facilities Director on June 19, 2013.
9. During a tour of the Dietary Department on June 20, 2013, at approximately 10:07 a.m., it was noted that the the hood screen was dirty.
16. The surveyor observed on June 20, 2013, at 10:30 a.m., that a bottle of Lite Soy Sauce was being stored at room temperature and the label stated refrigerate after opening.
17. During the tour of the Dietary Department on June 20, 2013, at 10:41 a.m., the surveyor observed that there was dust on the back of the ice machine.
18. These findings were confirmed by the Dietary staff on June 20, 2103, at approximately 10:43 a.m.
19. The air gap for the vegetable sink, in the kitchen, was observed to be only 1 1/2 inches and it needed to be 2 inches. This finding was confirmed by the Facilities Director at the time of the observation.

Based on observations and interviews with key staff, it was determined that the facility failed to ensure that all essential mechanical, electrical and patient care equipment was maintained in safe operating condition.

Findings include:

1. On June 18, 2013, at 1:15 p.m., a surveyor observed that the casters on the chair in Operating Room #1 were rusty. This finding was confirmed in an interview with the Facilities Director on June 18, 2013, at 1:15 p.m.
2. On June 13,2013, at 1:15 p.m., a surveyor observed that the wheels of the cart in Operating Room #1 were rusty. This finding was confirmed in an interview with the Facilities Director on June 18, 2013, at 1:15 p.m.
3. On June 18, 2013, at 1:20 p.m., a surveyor observed that the wheels were rusty on the basin stand in Operating Room #2. This finding was confirmed in an interview with the Facilities Director on June 18, 2013, at 1:20 p.m.
4. On June 18, 2013, at 1:20 p.m., a surveyor observed that the wheels of the laundry hamper were rusty in Operating Room #2. This finding was confirmed in an interview with the Facilities Director on June 18, 2013 at 1:20 p.m.
5. On June 18, 2013, at 9:56 a.m., a surveyor observed an intravenous [IV] pole with rusty castors in the Emergency Department.
6. This finding was confirmed by the Vice President of Nursing at 10:00 a.m. on June 18, 2013.
7. During a tour of the Southwest Harbor clinic on June 19, 2103, at 9:17 a.m., it was observed in the Minor Procedure room that one chair and one IV stand had rusty castors.
8. During a tour of the Family Health Center on June 19, 2013, at 10:37 a.m., it was observed that there was a chair with rusty castors.
9. During a tour of the Dietary Department on June 20, 2013, at 10:07 a.m., it was observed that there was no guard on the fifteen (15) quarts mixer.
10. These findings were confirmed by the Facilities Director during the time of the observations.

Based on a tour of the surgical services department, record review, review of policies and procedures and interviews with key staff on June 19, 2013, it was determined that the facility failed to have a system for controlling infections and communicable diseases.
Findings include:
1. During the tour of Operating Room 2 the following was found:
a. Two (2) 8 oz [ounce] bottles of drinking water, one opened and labeled "Ralf" and one labeled "new," were found inside a drawer of anesthesia machine 2.
b. One (1) bottle of "Purell" hand sanitizer was found with an expiration date of "5/2012", was found on the top of the anesthesia cart.
c. Four (4) tracheal tubes were found on the top of the anesthesia cart. The sterile packages had been opened and syringes attached.
i. The tracheal tubes sizes were- 7.0 mm(1), 7.5 mm (1), 8.0 mm (2).
d. One needle was found on the top of the anesthesia cart.
e. During an interview with the Director of Surgical Services on June 19, 2013, at approximately noon, he confirmed the findings and stated "it's (endotracheal tubes) for emergency use." He confirmed that there were no more surgical procedures scheduled for that day.
f. On June 19, 2013, at 2:20 p.m., the Director of Surgical Services confirmed that there is no policy that prohibits the consumption of food or drink in the operating rooms. Additionally he stated that it was not a standard practice to eat or drink in the operating rooms.
2. During the tour of Operating Room 1, the following was found:
a. Three (3) tracheal tubes were found on the top of the anesthesia cart. The sterile packages had been opened and syringes attached.
i. The tracheal tubes sizes were- 7.0 mm(1), 7.5 mm (1), 8.0 mm (1).
b. One (1) 8 oz bottle of drinking water, labeled "Chris," was found inside a drawer of anesthesia machine 1.
c. During an interview with the Director of Surgical Services on June 19, 2013, at approximately 12:30 p.m., he confirmed the findings and stated "No comment."
d. On June 19, 2013, at 2:20 p.m., the Director of Surgical Services confirmed that there was no policy that prohibited the consumption of food or drink in the operating rooms. Additionally he stated that it was not a standard practice to eat or drink in the operating rooms.
3. During a tour of the "Minors Room" (Minor Surgery Room) on June 19, 2013, the following was found:
a. The counter top was visibly soiled.
b. The Director of Surgical Services confirmed that the room had been "Terminally Cleaned" as he wiped the soil from the surface with his bare hand.