The information below comes from the statement of deficiencies compiled by health inspectors and provided to AHCJ by the Centers for Medicare and Medicaid Services. It does not include the steps the hospital plans to take to fix the problem, known as a plan of correction. For that information, you should contact the hospital, your state health department or CMS. Accessing the document may require you to file a Freedom of Information Request. Information on doing so is available here.

Based on observations and interview, the facility failed to provide a sanitary environment in 4(ICU, Intermediate, Geri Psych and Adolescent Psych) of 4 patient units.

A tour was conducted on 1/16/2020 of the ICU and unit. The following was observed;

ICU Unit Nurses Station

A medication refrigerator was found on the floor. Inside the refrigerator was long black hairs, dirt, and dust surrounding patient medications.
The floor was heavily soiled with dust, dirt, and hair.
The freezer part of the refrigerator was caked in ice and unable to be cleaned properly.
4 large sharps containers (used for discarding used syringes, blood tubes, and used tubing) were found sitting on rolling dollies. The dollies were heavily soiled with dirt, dust, hair, paper trash, and plastic tops for syringes. There was spilled dried liquids down the side of the containers.
Employees used cups were stored with unused bottles of patient nutritional supplements.
The patient nutritional refrigerator had puddings, drinks, and snacks sitting in a heavily soiled refrigerator. The refrigerator was soiled with dust, food particles, dried spilled liquids, and long black hairs.
Hand antiseptic devices were located on the outside of each room. The hand sanitizers had a bottom tray to catch spilled antiseptic liquids. The nurses had laid their stethoscopes across the dirty trays on 6 separate devices exposing the stethoscopes to further contamination.

A patient room in the CV-ICU was considered cleaned and ready for a new patient. Staff #6 Housekeeping was putting a pillow case on the pillow. Staff #6 was asked if the room was clean and ready for a new patient. Staff #6 stated, "Yes. It's ready." Review of the patient room revealed the following unsanitary items:

The head board to the bed had multiple hairs and dust on it.
The bed frame was soiled with dirt, dust and hair
The trash can had spilled, dried liquids all down the side of the can.
Inside the patient closet/cabinet area the shelves were dusty, and a used and dirty feeding tube machine was found.
Inside a cabinet the toilet was found. The back of the toilet was soiled with dust, hair and rust. The toilet hardware had not been sanitized.
The floor and glass doors were soiled with dust and hair.
The computer station area was soiled with dust and had used tape stuck to the base. The key board was dusty and sticky. The plastic arm holding the station was broken.
Between the bed and window was paper and plastic trash found on the floor.
The IV pole bottom was missing paint. It was soiled with dust and hair.

An interview was conducted with Staff #6 on 1-16-2020. Staff #6 was asked if what she was required to clean on her 7:00am -3:30PM shift. Staff #6 stated that she is responsible to clean 25 rooms daily for general clean and if a patient discharged then she would have to clean the room for a new patient. She had three nurses station with medication room, clean utility rooms, hallways, soiled linen rooms, a patient shower area, and visitor bathrooms. Staff #6 confirmed she was the only housekeeper for this floor during those hours. Staff #6 confirmed the soiled items found in the ICU room.

An interview was conducted on 1-16-2020 with Staff #7 housekeeping supervisor. Staff #7 stated that the service is a contracted service and there are two more shifts. The shifts are from 3:30PM to 11:30PM and 11:30PM to 7:30AM. The evening and night shift are for the whole hospital and only clean discharged rooms.
Staff #7 was asked what type of cleaning is required for daily cleaning rooms that are occupied. Staff #7 stated, "emptying the trash, high dusting, sanitizing and spot cleaning, cleaning the bathrooms, and mopping the floors." Staff #7 stated they have 30-40 minutes to do a room turn over for a new patient and 15- 20 minutes for all patient rooms. If the housekeeper spent 20 minutes cleaning 25 rooms, it would take her 8.3 hours just to clean the rooms.
In 2009, the Association for Healthcare Environment (AHE) published recommended guidelines for environmental cleaning in healthcare. AHE suggests effective patient room cleaning upon discharge should take about 40 to 45 minutes.

The facility failed to ensure housekeeping was balancing room turnover time with quality. The cleaning processes requires special focus to ensure cleanliness and prevention of infection. Rushing through room turnover at the risk of neglecting appropriate cleaning and sanitation can cause problems for patients, in both satisfaction and potential infection.

3rd South Intermediate Patient Floor.
A tour was taken of 3rd South Intermediate floor. Staff #8 stated that she has 27 rooms and has multiple discharges during her shift. Room 320 was reported clean and ready for a new patient. The following issues were found:
The trash can had trash in it.
The shower floor was soiled with hair and had chips in the flooring.
The shower chair was molded underneath.
The bedside commode chair was rusted.
The base of the commode was dirty with hair, dust, and black substance around the bolt. A brown dried substance that resembled feces was found.
The top of the soiled linen basket was heavily soiled with dust dirt and hair.
The computer station was heavily soiled with hair, dust, and old tape and tape residue.
The bottom of the bedside table was soiled with dust and hair.
The corners of the room had caked up hair, dirt, and mildew was found on the floor and base of the wall.
The bed frames were soiled with dust, dirt and hair.
The bedside table had a door. Inside the door was a shelf covered in plastic. The plastic was soiled with spilled dried liquids, dust and hair.
The hand sanitizer dispenser was soiled with dust and dirt.

Psychiatric Building 1st Floor Geriatric Unit
A tour was taken on 1-16-19 of the psychiatric facility. Room 108 was found to have the following:
The soiled linen carts had a significant buildup of dirt, dust, hair, trash inside the unit.
The metal and glass door between the patient hallway and outside area was heavily mildewed.
The mattress was pulled up and multiple candy wrappers were found underneath.

Psychiatric Building 1st Floor Adolescent Unit
Room 319 was clean and ready for a new patient. The room found to have the following:
The shower had not been cleaned. It had multiple long hairs and soap scum in the shower.
The base of the commodes was heavily soiled with dirt, dust and hair.
The sink was soiled with hairs and the floor was soiled with dust and hair. Buildup was found in all the corners.
Staff #10 confirmed the findings and stated, "They will need to do better."

An interview was conducted on 1-16-2020. Staff #1 was shown the pictures of the units and rooms. Staff #1 was informed of the findings. Staff #1 stated that was "unacceptable" and would correct the issue.