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Based on observation, staff interviews, review of "Maintenance Requisition Form," and review of "Infection Control, Safety, Risk Management and Antimicrobial Stewardship Program Committee Meeting Minutes," the facility failed to ensure the premises were clean and orderly on one (1) of one (1) day of survey.

Findings Include:

Observation of Dietary Department during facility tour at 11:05 a.m.- 11:30 a.m. on 08/24/2023 with the Area Manager revealed dead roaches and body parts of roaches under the three (3) compartment sink, in the dish washer room, and in the storage room area.

Interview with the Director of Nurses (DON) on 08/24/2023 at 10:30 a.m.- 11:00 a.m. confirmed he aware of "problems with bugs in the kitchen."

Interview with the Area manager on 08/24/2023 at 11:05 a.m. confirmed she is aware of "roaches in the kitchen."

Interview with Kitchen Cook/Dietary aide #1 on 08/24/2023 at 11:50 a.m. - 12:00 p.m. confirmed she has seen roaches around the water in the dish room and around the three (3) compartment sink area.

Interview with Dietary aide #2 on 08/24/2023 at 12:01 p.m. - 12:09 p.m. confirmed she has witnessed roaches in dietary department mainly in the storage room area. The dietary aide also confirmed that another Dietary Aide #3 witnessed roaches coming out of the red coolers.

Interview with Environment Services (EVS) Director on 08/24/2023 at 12:17 p.m. - 12:40 p.m. confirmed the "Staff Sightings Report Log," for the pest control company documented observations of insect and rodent activities on 02/01/2023 and 03/30/2023, reports of roaches in the food court 05/26/2023, 07/11/2023, and 07/18/2023, roaches in kitchen 08/14/2023, big roaches in facility number three (3) hall.

Interview with Administrator on 08/24/2023 at 2:30 p.m. confirmed she began employment at this facility the week of May 22, 2023, and at this time she was made aware of roaches in the kitchen, she met with the Area Manager and then requested additional services from pest control company.

Review of Laird Hospital, Inc. "Maintenance Requisition Form" date 07/18/2023 by Department Head of Kitchen/Dietary aide staff #4 revealed, " ...Specific Location Area Dietary Kitchen (EVERYWHERE) Department- kitchen. Room - Everywhere. Description of Work Request - Spray for insect control Dire Need EVERY week - Repeated request for same ..."

Review of facility "Infection Control, Safety, Risk Management and Antimicrobial Stewardship Program Committee Meeting Minutes," dated 02/15/2023 confirm issues with pest, " ...having recurrences of roaches in food carts, need to have a deep clean as well as the kitchen area."

Review of Ochsner Rush Health Quality and Patient Safety Committee Meeting on July 27, 2023, at 8:00 a.m. revealed no infection control or sanitation issues were reported.

During exit conference on 08/24/2023 at 4:00 p.m. with Administrator, DON, and Area Manager survey findings were discussed, and no further documentation was submitted for review.

Based on staff interview, review of "Pest Control Work Orders," review of "Pest Control Sighting Log," review of "Sanitation Check Lists," and review of the "Infection Control, Safety, Risk Management and Antimicrobial Stewardship Program Committee Meeting Minutes," the Governing Body failed to ensure the facility is providing healthcare in a safe environment, due to unsanitary conditions of the Dietary Department on one (1) of one (1) day of survey.

Findings Include:

Interview with Administrator on 08/24/2023 at 2:45 p.m. confirmed she has not reported anything to the Governing Body related to Sanitation issues with roaches in the facility kitchen and cafeteria areas.

Review of the pest control work order dated 08/03/2023 confirmed, "evidence of Live German roaches found at Cafeteria Area/Room dishwasher and Cafeteria Area/Room - Exterior walls - west."

Review of pest control work order dated 07/28/2023 confirmed, "evidence of Live German roaches and American roaches found Cafeteria Area Room- Dishwasher."

Review of pest control work order dated 06/06/2023 confirmed, "evidence of Live German Roaches in the Cafeteria Area/ Room - Dishwasher."

Review of pest control work order dated 05/11/2023 confirmed, "evidence of Live House Ants, Little black ants, and pavement ants and evidence of dead American roaches in Cafeteria Area/ Room - Exterior walls - West".

Review of pest control work order dated 04/07/2023 confirmed, "evidence of Live American and German roaches in Cafeteria Area/Room- Dishwasher."

Review of pest control work order dated 03/11/2023 confirmed," evidence of dead German roaches in Cafeteria Area/Room at baseboards and dishwasher."

Review of pest control work order dated 02/20/2023 confirmed, "evidence of German roaches- body parts in Cafeteria Area/Room at baseboards and dishwasher."

Review of pest control work order dated 01/24/2023 confirmed," evidence of spiders at Cafeteria Area/Room - Baseboards and dishwasher."

Review of the Facility's "Pest Control Sighting Log," record confirmed observations of insect and rodent activity on the following dates: "02/01/2023, Dietary Department- roaches, 03/24/2023 kitchen - mouse, 03/30/2023 food cart - roaches, 05/26/2023- kitchen - roaches, 07/11/2023 Kitchen and bathroom -roaches, 07/18/2023 kitchen - roaches, 08/14/2023 and three (3) hall - Big roaches."

Review of facility "Infection Control, Safety, Risk Management and Antimicrobial Stewardship Program Committee Meeting Minutes," dated 02/15/2023 confirm issues with pest, " ...having recurrences of roaches in food carts, need to have a deep clean as well as the kitchen area."

Review of Ochsner Rush Health Quality and Patient Safety Committee Meeting on July 27, 2023, at 8:00 a.m. revealed no infection control or sanitation issues were reported.

Review of facility "Sanitation Check Lists" for 05/05/2023, 06/29/2023, and 08/22/2023 inspected by Registered Dietitian (RD) confirmed issues with the Dietary Department equipment and environment most likely affecting the pest control issues.

Review of the Facility "Sanitation Check Lists," completed by the Registered Dietitian and documented as unsatisfactory on 05/05/2023, 06/29/2023, 08/22/2023, confirms the facility has ongoing issues with walk in freezer #36 motor with dust, refrigerators #48 and #55 with dust. Walk in Refrigerator gaskets with mildew on inside or on gaskets, Comments Walk in refrigerator needs replacing > 1 (one) year, WARE WASHING AND GARBAGE DISPOSAL #65 Dish Machine- garbage disposal not working, needs replacing, broken and work order was done. #67 Dish Machine the wall behind not in good repair comments all three dates have walls under dish machine needs painting: FLOORS, WALLS, CEILING #96 Ceiling paint peeling at entrance to kitchen and dish room comments Paint peeling > One (1) year. Overall comments at end of 08/22/2023, has "*Floor in walk in cooler is wet, rusting and needs replacing. "

During exit conference on 08/24/2023 at 4:00 p.m. with Administrator, DON and Area Manager, survey findings were discussed, and no further documentation was submitted for review.