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Based on an abbreviated complaint survey completed on March 6, 2019, it was determined that The Gardens at Wyoming Valley was not in compliance with the following requirements of 42 CFR Part 483, Subpart B, Requirements for Long Term Care and the 28 PA Code, Commonwealth of Pennsylvania Long Term Care Licensure Regulations.
Based on observation and staff interview, it was determined that the facility failed to provide housekeeping and maintenance services to maintain a clean and orderly environment on two of two nursing units [second floor and third floor].
Observation of the second floor hallway on March 6, 2019, at 8:20 a.m. revealed dirt, debris and paper scattered throughout the second floor hallway. A noticeable accumulation of dust and debris was observed surrounding the nurses station on the second floor. Further observation on the second floor hallway revealed a dirty cup on the handrail in the hallway near room 215.
Observation of Resident Lounge (Sunshine Terrace) on the second floor at approximately 8:20 AM revealed residents were eating breakfast. Observation was made of resident in Broda chair with an overturned cup under her chair with a large stain next to the cup appearing to be juice, under the resident's Broda chair. Further observation of this resident at approximately 10:20 a.m. revealed the cup had been removed from below the resident's Broda chair, but the large stain remained on the floor. At the time of this observation dried liquid stains were observed next to PTAC unit, dirt and debris observed to be accumulated against molding against walls and in corners of room as well as underneath storage shelf.
Further observation revealed a utility cart in room, which had dirt and debris and large sticky substances on cart as well as below cart. Continued observations in Sunshine Terrace were made throughout day revealing that the large dried liquid stain continued to be observed on the floor as initially observed at 8:20 AM that morning.
Observation of Resident Room 227 on March 6, 2019, at 8:25 a.m. revealed a large dried liquid stain on the floor, which appeared to be dried juice drink.
Observation of Resident Room 215 on March 6, 2019 at 8:30 a.m. revealed debris and paper on the floor of the resident room. Observation was also made of multiple stains on the floor, which were red and sticky appearing to be dried juice drink.
Observation of the third floor unit on March 6, 2019, at 8:40 a.m. revealed a large dried liquid spot upon exiting the elevator. Further observation revealed a large red dried sticky substance on third floor hallway near room 316.
Interview with the Nursing Home Administrator on March 6 2019, at approximately 1:00 p.m. confirmed that the environment and resident care equipment were to be maintained in a clean, orderly and sanitary manner.
1.	The dirt, debris and paper have been cleaned up on the 2nd floor hallway. Dust and debris have been cleaned by the 2nd floor nurses station. The cup on the handrail was removed. The spill in the sunroom has been cleaned. In addition, the dirt and debris by the PTAC unit have been were cleaned as well as the sunroom. The utility cart was removed and cleaned. Rooms 215 and 227 were clean on 3rd floor the area in front of the elevator doors was cleaned. Resident room 316 was cleaned as well.
2.	The NHA/Director of Housekeeping will complete an assessment of the common areas and the 2nd and 3rd floor resident rooms to insure no other areas are affected.
3.	The Environmental Services Director/designee will in-service the housekeeping staff regarding the cleanliness of corners and edges (dirt and debris) and spill eradication. The NHA/designee and the Director of Housekeeping will complete weekly rounds to identify areas of concern.
4. The NHA/designee will perform weekly audits to insure the environment is safe, clean and comfortable for 8 weeks, then monthly for 2 months.
5. The audit results will be presented to the QA committee for review and recommendation.