HospitalInspections.org

Based on observation and interview, it was determined that the facility was not always maintained to ensure the safety of its patients.

Findings were:

? Emergency pull cords located in patient restrooms throughout the hospital were found tied around the railing next to the toilets. The tying of the cords rendered them useless. If a patient fell while in the restroom, it would be impossible to call for help.
? In the rehab pool area, large areas of the cement surface of the walkways around the pool were heavily pitted. This created a fall hazard for the often times fragile patients who require physical rehabilitation.
In an interview with the Director of Nurses on 7/22/14, it was acknowledged that the tied pull cords and the uneven surface in the pool area presented a safety hazard for the patients at Yoakum County Hospital.

Based on a tour of the facility and a review of documentation, the facility failed to provide a preventive maintenance program to ensure that all essential mechanical, electrical and patient care equipment was maintained in safe operating condition.

Findings were:

Facility policy titled "Emergency Crash Cards/Defibrillators" states, in part, "General Procedure:...6. The integrity of the lock and lock number of the cart is checked every shift and recorded. units that do not function on a 24 hour basis will check the integrity of the lock once each workday."

During a tour of the emergency department on 7-22-14, the crash cart checklist for ER Room #2 was missing documentation of lock integrity and lock number for 8 of the 43 shifts thus far in the month of July 2014.

During a tour of the emergency department on 7-22-14, the crash cart checklist for ER Room #3 was missing documentation of lock integrity and lock number for 3 of the 43 shifts thus far in the month of July 2014.

The above information was confirmed in an interview with staff #16 on the afternoon of 7-22-14 in the emergency department.

Based on observation and interview, it was determined that the facility failed to provide a safe and sanitary environment for its patients and staff.

Findings were:

"OSHA/Bloodborne Pathogen Regulations Policy #138-030-060" stated in part "The facility provides sufficient housekeeping and maintenance personnel to maintain the interior and exterior of the facility in a safe, clean, orderly, and attractive manner."


Tour of the facility on 7/22/14 revealed the following:

? Dead bugs in fluorescent lights in all areas of the hospital including the physical rehabilitation area, patient treatment floor, the GI scope storage room and in the Emergency Department. This indicated improper maintenance of these areas.
? 1 of 3 hydro collators had white particulate matter floating on the top of the water inside. The Director of the Physical Therapy Department identified this substance as water deposits.
? The double doors located near the gift shop that lead outside to a parking lot had visible light between and under the doors. These doors required weather stripping. This open space could allow vectors into the facility.
? In the kitchen, floor tiles were noted to be broken under the dishwasher. These broken tiles surrounded a drain that was heavily rusted and broken.
? In the Observation Room, located in behind the nursing station in the patient treatment area, dust was noted on high horizontal surfaces, small tears were observed in the fitted sheets of one of 3 beds and the laminate coverings of the cabinetry was chipping off.
? In several of the "clean" unoccupied patient rooms, dust was noted on high horizontal surfaces.
? In the Lab area behind the Reagent refrigerator, the wall surface appeared dirty and swollen and the molding was pulling away from the wall. The floor appeared in need of stripping and waxing. Several ceiling tiles were stained, indicating a water leak. The sheetrock wall in the "draw room" was gouged and damaged, making thorough cleaning of the surface impossible.
? In the CT room, a drop of blood was noted on the treatment table. The paint on the door frame was chipped, making cleaning of the surface impossible.
? In the "clean" (but not sterile) GI treatment area, a fly swatter was found sitting on top of a monitor. Dead bugs were noted in the light fixture in the scope storage room.
? Small tears were noted in the mattress of a bed in bay 3 of the recovery area. This made cleaning impossible and cross contamination likely.
? In the Emergency Room, there were several stained ceiling tiles and dust was noted on high horizontal surfaces in ER rooms 2 and 3.
In an interview with the Director of Nurses and with the Risk Manager on 7/22/14, the above infection control issues were confirmed.

Based on observation, a review of documentation and interviews with staff, the hospital failed to implement and enforce policies and procedures that ensured that the nutritional needs of inpatients are met in accordance with recognized dietary practices and the orders of the practitioner responsible for the care of the patients.

Findings were:

During a tour of the facility kitchen on 7-22-14, staff members #7, #8 and #9 were each asked to recite to the surveyor the appropriate temperature range for each the kitchen refrigerator and kitchen freezer.
? Staff #7 stated that the refrigerator temperature should be maintained at less than 41 degrees Fahrenheit and that the freezer temperature should be maintained at less than 0 degrees Fahrenheit.
? Staff #8 stated that the refrigerator temperature should be maintained within a range of 37-40 degrees Fahrenheit and that the freezer temperature should be maintained within a range of 0-3 degrees Fahrenheit.
? Staff #9 stated that the refrigerator temperature should be maintained within a range of 38-40 degrees Fahrenheit and that the freezer temperature should be maintained at a temperature of 2 degrees Fahrenheit and subsequently stated, "I don't know!"

Facility policy titled "Storing of Supplies" states, in part, "All dietary employees are responsible to store food supplies correctly. The dietary supervisor will check weekly to make sure foods are stored properly. 5. All perishable food items are stored in either the walk-in refrigerator or refrigerator at 40 degrees or below or the freezer at 0 degrees or below."

A review of the documentation sheet for refrigerator and freezer temperatures for the month of July revealed that the refrigerator was outside of the acceptable temperature parameter 1 day of 22 thus far in July. The freezer was outside of the acceptable temperature parameter 11 days of 22 thus far in July. The documentation sheet did not list the desired temperatures for either the refrigerator or freezer and also gave no instructions for staff to follow in the event that the temperature was outside of the acceptable temperature parameter.

The above was confirmed in an interview with staff #16 on the afternoon of 7-22-14.