TEXAS CITY, TX- SEABREEZE NURSING AND REHABILIATION

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 47215

Based on interview and record review, the facility failed to ensure residents were free from abuse, neglect, exploitation or mistreatment for 5 of 73 residents (Resident #8, Resident #12, Resident #18, Resident #20, and Resident #30) reviewed for abuse and neglect in that:

The facility failed to ensure residents at the facility were provided with hot water and baths/showers for a month, that would allow them to maintain cleanliness and access to activities of daily living. The facility neglected to provide hot water in the facility for over a month. The residents in the building had not had showers in weeks and there was no documentation to show that residents had a bed bath or a shower for the month of September.

-The facility neglected to ensure residents at the facility were relieved from filth, and distress.
-Resident #8 had cried to staff about her discomfort of not having a bed bath or shower in weeks.
–Resident #12 was diagnosed with the need for assistance with personal care. She had a urinary tract infection and had not taken a bed bath or shower in a month.
–Resident #18 had been diagnosed with a skin rash and other non-specific skin eruption and had not taken a bed bath or shower in a couple of weeks. She had been identified as having a fish like smell and a urine odor.
-Resident #20 developed complications with possible bacteria in her urine during the time she went without a bath and shower. She was hospitalized for two days, 9/6/2024 to 9/8/2024 and was given medication to treat a possible urinary tract infection. She was one of 9 residents at the facility being treated for an UTI.
-Resident #30 had a shower in a month and reported his concerns to his family.

On 10/15/24 at 3:07 p.m., an Immediate Jeopardy (IJ) was identified. While the IJ was lowered on 10/16/24 at 3:17 p.m., the facility remained out of compliance at a a scope of pattern with the potential for more than minimal harm, due to the facility need to evaluate the effectiveness of the corrective systems.

This failure affected Residents #8, #12, #18, #20, and #30 and placed an additional 68 residents who were without hot water and showers at risk of skin breakdowns, infections, and illnesses which could cause a decline in health.

Record Review of Resident #8’s progress notes dated 09/19/24 revealed, Resident #8s family member called the facility and is upset that there is no hot water. Informed the RP that the water issue is currently being serviced. She said Resident #8 needs a shower. Informed the RP that the resident has refused showers. Staff has tried several offers to do so per the assigned CNA and the charge nurse. The RP requested to then speak to the CNA, to verify whether or not the resident did indeed, refuse her shower. The CNA informed the RP that the resident did refuse her shower.

Record Review of Resident #8’s progress notes on 09/22/24 Resident: Is being Monitored for an Active Infection. Transmission Based Precautions in Place: Urinary tract Infection: Antibiotic: flagyl/Macrobid.

Observation and interview on 09/23/24 at 9:14a.m., with Resident #8 revealed her resting in bed.

Observation and interview on 09/23/24 at 3:10p.m., with Resident #8 said she had not had a bath or shower in two weeks. She said she was independent and had been wiping herself off with wet wipes.

Interview on 9/23/2024 at 5:15p.m., with LVN B, said the residents were refusing showers because they did not want to take cold showers. She said she did not have documentation to show that the residents refused to take a shower. She said she had been off, but on the Wednesday before 9/16/24, the hot water was fine. She said on Monday, 9/16/24, a family member told her Resident #8 had not had a shower and she was crying. She said she told the Administrator at that time, that there was no hot water, and they could not make the water work. She said the Administrator said maintenance was working on it. She said not having hot water in the building could spread germs and if the residents are not taking showers, it can cause skin breakdowns and infections.

Observation and interview on 9/23/24 at 9:30a.m., with Resident #12 revealed she was in bed awake and alert. She said she did not receive assistance as needed. She said sometimes she did not get help when she needed to be changed. She had her glasses were dirty and stained with brown substances. She said she would spray her glasses from time to time. On her wall it stated she gets up during her shower time, but she said she had not received a shower and had not gotten out of bed for a while.

Follow-up interview on 09/23/24 at 1:00p.m., with Resident #12, said she would get up when she had her shower, but she did not want to take a cold shower. She said the last time she took shower was over three weeks ago because there was no hot water.

Observation and interview on 9/23/2024 at 8:30a.m., with Resident #18 revealed her sitting on an uncovered mattress, that was soiled. Her right and left legs were swollen with red marks on both feet. She had a pile of dirty linen at her bedside. Resident #18’s room smelled of urine. There were gnats by her food near the sink area. C-pap mask was hanging on her dresser drawer. She had an electric wheelchair in the corner of the room. There were cases of briefs and nutrient bottles underneath the sink. She said she had not had a bath in several weeks and was told there was an issue with the hot water. She said she was receiving bed baths by staff.

Observation and interview on 9/23/2024 at 9:00a.m., with Resident #18 revealed her lying in bed and had a fish and urine odor. She said she had not had a shower in a month.

Observation and interview on 9/23/2024 at 3:09p.m., with Resident #20 revealed her eating a sandwich while sitting in her wheelchair near the nurse’s station. She said she had not showered nor given a bed bath in almost a month. She said she had been having diarrhea for five weeks with no showers. She said she had no deodorant. She said at first, she refused showers because of the frequency of the diarrhea but when she was ready to take a shower she couldn’t because there was no hot water in the facility. She said the only time she was cleaned is when they used wipes when changing her briefs.

Follow-up observation and interview on 9/24/2024 at 10:45a.m., with Resident #20 revealed her sitting in a wheelchair, attending resident council. She said when she did not receive a bed bath or shower, she smelled a lot and went to the hospital for two days. She said she did not feel good. She said she believed she had E. Coli and bacteria in her urine. She said she was put on antibiotics. She said she believe the antibiotics caused her diarrhea. She said not having a shower while having diarrhea made her feel dirty. She said it did not make her feel good going without a shower for over a month.

Resident #30’s care plan edited 9/12/2024 revealed, Recurring UTI’s, have a suprapubic catheter. Edited 7/29/24, resolve infections without complications.

Observation and interview on 9/25/2024 at 11:40a.m. with Resident #30 revealed him lying in bed watching tv. He was covered in a blanket. He has a catheter bag as well. He said he did not receive showers when there was no hot water. He said he almost got sick from the water being so cold. He said he did not have an issue with a particular staff member regarding showers.

Observation and interview on 9/23/2024 at 4:30p.m., with the Administrator and the Maintenance Director, revealed the Administrator in the laundry room, washing mop heads. The Laundry Supervisor said the laundry had not been done because there was no hot water, and no one had delivered clean clothes to the residents because it would just get dirty and add to the dirty laundry barrels that were already full.

Interview on 9/25/2024 at 9:48a.m., with the Doctor, said if baths and showers are not given within a month it would not be proper incontinent care for the residents. He said it could cause the residents to have an infection. He said if a resident is having diarrhea and BMs without proper care, it could cause skin problems, irritation, infections, and open sores. He said not cleaning the residents could cause infections especially females. He said not having proper incontinence care could lead to a serious problem. He said it is important for residents to take baths for hygiene and to be clean. He said the Mcgreer criteria follows a specific criterion for urinary tract infections. He said even if they do not meet the criteria, they can still have the infection. He said it could still count it as a urinary tract infection especially if a resident was still complaining of the infection and taking antibiotics.