PEMBROKE, KY - Federal inspectors found extensive maintenance problems and unsanitary conditions throughout Christian Heights Nursing and Rehabilitation Center during a February 2025 inspection, documenting deteriorating infrastructure that created an unsafe environment for residents.
Broken Toilets and Persistent Sanitation Problems
The most serious violation involved a malfunctioning toilet shared by four residents that remained clogged with waste for multiple days during the inspection period. When inspectors first observed the bathroom on February 18, they found the toilet filled with brown and yellow substances that emitted strong odors of feces and urine. Yellow dried material consistent with urine was visible on the broken toilet seat, which hung sideways from the fixture.
Maintenance equipment including a plumber's snake and plunger with duct tape were present, indicating ongoing attempts to address the problem. However, when inspectors returned two days later on February 20, the toilet remained filled with waste material and continued to produce strong odors, though the tools had been removed.
The facility's Maintenance Director acknowledged the severity of the situation during interviews. "Currently it must be unstopped one to two times a day," he told inspectors. "It has gotten to the point that work orders are not being put in because I know I must check it every day." He explained that the facility was experiencing repeated blockages caused by a resident and was attempting to order a different type of toilet to prevent future occurrences.
This type of sanitation failure poses significant health risks to nursing home residents, who often have compromised immune systems. Exposure to sewage and waste materials can lead to serious infections, respiratory problems, and other health complications. Federal regulations require nursing homes to maintain sanitary conditions specifically to protect this vulnerable population from preventable illnesses.
Widespread Structural Deterioration
Inspectors documented extensive physical deterioration throughout the facility that compromised the homelike environment required by federal standards. Multiple resident rooms showed signs of significant neglect, including chipped and peeling paint, damaged walls, and broken flooring that created both safety hazards and unsanitary conditions.
In one room housing residents R48 and R55, inspectors found chipped paint and gouge marks on doors and doorframes, rubber baseboards pulled away from walls, and yellow-orange stains on the floor. When interviewed, R48, who was determined to be cognitively intact, expressed frustration with the conditions. "It would be nice if the peeling paint and poor condition of the walls and floor was repaired," he told inspectors.
Similarly, resident R40, also cognitively intact, shared a room with extensive wall damage including large areas of chipping paint, pulled-away baseboards, and a hole in the bathroom door. "She would like to see it fixed, referring to the condition of the walls, floors, and paint," according to the inspection report.
The structural problems extended beyond cosmetic issues to create genuine safety concerns. Broken and missing floor tiles were documented in multiple rooms, creating uneven surfaces that could cause falls. For elderly residents who may have mobility issues or use assistive devices, these surface irregularities represent serious hazards that could result in fractures or other injuries.
Environmental Health Hazards
Beyond the obvious maintenance problems, inspectors identified conditions that created ongoing health risks for residents. One room shared by residents R110 and R16 had a strong urine odor along with broken, uneven flooring and food particles scattered on the floor. Such conditions can attract pests and create breeding grounds for bacteria.
Multiple bathrooms showed signs of poor maintenance that could harbor harmful microorganisms. In resident R26's bathroom, inspectors found flooring around the toilet base covered with a reddish-brown substance. Another room had sink caulking that was discolored brown and peeling away from fixtures, creating gaps where water damage and mold growth could occur.
Poor caulking and damaged surfaces in wet areas like bathrooms are particularly problematic in healthcare settings. These conditions can lead to water damage, mold growth, and bacterial contamination. For nursing home residents, who may have respiratory conditions or weakened immune systems, exposure to mold and bacteria can cause serious health complications.
Maintenance and Cleaning Deficiencies
The facility's approach to addressing these problems appeared inadequate and poorly coordinated. The Maintenance Director explained that his preference was to complete all repairs in one room before moving to another, but revealed that only one room had received all necessary repairs at the time of inspection. He indicated that financial constraints were limiting the facility's ability to address widespread problems.
"They may not match when we get them, but it will be better than nothing," the Maintenance Director said regarding floor tiles being purchased a few at a time. He also described plans to install vinyl wall coverings up to four or five feet from the floor to address wall damage, but stated that these improvements would have to wait for funding availability.
The Environmental Services Director provided cleaning schedules showing that each room was supposed to receive a monthly deep clean including wall washing, curtain cleaning, and furniture moving. However, the documented conditions suggested these procedures were either not being followed or were insufficient to address the facility's problems.
Professional cleaning standards in healthcare facilities require more frequent attention to high-risk areas like bathrooms and immediate response to sanitation issues. The fact that a toilet remained clogged with waste for multiple days indicates a failure in both maintenance protocols and infection control procedures.
Additional Issues Identified
Inspectors documented numerous other maintenance and cleanliness problems throughout the facility, including paint peeling from walls where wallpaper borders had been painted over, crumbling wall corners with debris piles, missing shower tiles, and food particles on dining room floors and tables. A handrail outside the Director of Nursing's office had accumulated dust and debris that remained present throughout the inspection period.
These widespread issues collectively created an environment that failed to meet federal standards for a safe, clean, comfortable, and homelike setting. The combination of structural deterioration, sanitation problems, and inadequate maintenance response demonstrated systemic failures in the facility's operations that directly impacted resident quality of life and safety.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Christian Heights Nursing and Rehabilitation Cente from 2025-02-21 including all violations, facility responses, and corrective action plans.
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