Salem Health & Rehab: Feces Left on Toilet - VA
The brown smear, which inspectors described as "approximately the size of an average woman's hand," was first observed on the right side of the toilet bowl in a resident's bathroom on August 27 at 11:05 AM.
More than four hours later, at 3:15 PM the same day, the fecal matter remained exactly where inspectors had found it earlier. The administrator had just told inspectors that housekeeping staff were leaving for the day at 3:10 PM.
The next morning at 8:24 AM, the smear was still there.
When the director of nursing accompanied an inspector to view the soiled toilet on August 28, she acknowledged the problem and "stated she would let them know," according to the federal inspection report.
The persistent contamination occurred despite the facility's written policy requiring daily cleaning of resident rooms. When inspectors requested documentation, Salem Health & Rehabilitation provided a policy titled "Daily Resident/Patient Room Cleaning" that specified required cleaning supplies including "quaternary disinfectant," "bowl brush," and "cleaning rags" to "spot clean all necessary areas."
But one housekeeping worker told inspectors by phone on August 27 that "she does not clean the resident rooms every day."
The violation represents a basic failure in infection control at the 120-bed facility. Fecal contamination on surfaces poses serious health risks to vulnerable nursing home residents, who often have compromised immune systems and underlying medical conditions.
Federal regulations require nursing homes to maintain sanitary conditions and provide housekeeping services necessary to maintain a safe and clean environment. The facility's own policy acknowledged the importance of using chemical disinfectants to "kill germs on non-porous surfaces."
Yet the inspection found a clear gap between written procedures and actual practice. While housekeeping staff were present and working during the inspection period, basic bathroom cleaning in at least one resident room went undone for more than a day.
The timing of the discovery adds to the concern. Inspectors first documented the fecal smear late Tuesday morning and found it unchanged by mid-afternoon, even as housekeeping staff completed their shift. The contamination persisted overnight and remained visible when inspectors returned Wednesday morning.
The facility's response was limited. After the director of nursing viewed the soiled toilet with an inspector, she promised only to notify appropriate staff. No immediate cleaning occurred during the inspection.
Salem Health & Rehabilitation's administrators, including an administrator-in-training, director of nursing, assistant director of nursing, and regional director of clinical services, discussed the violation during a pre-exit meeting on August 28 at 4:00 PM.
The inspection report notes that "no further information was provided to the survey team prior to exit" that day. The facility offered no explanation for why the contamination went unaddressed for more than 24 hours or what steps would prevent similar incidents.
The violation was classified as causing "minimal harm or potential for actual harm" and affecting "few" residents. However, the finding represents a fundamental breakdown in basic hygiene practices that nursing homes are required to maintain.
The complaint investigation focused specifically on housekeeping and sanitation issues. Federal inspectors conduct such targeted reviews when they receive reports of potential violations from residents, families, or staff members.
Salem Health & Rehabilitation has faced previous scrutiny from federal regulators. The facility participates in Medicare and Medicaid programs, making it subject to regular inspections by state health departments acting on behalf of the Centers for Medicare & Medicaid Services.
The fecal contamination incident illustrates how gaps between policy and practice can compromise resident safety. Despite having written procedures for daily room cleaning and required disinfection supplies, actual cleaning fell short of basic standards.
The housekeeping worker's admission that she doesn't clean resident rooms daily contradicts the facility's own policy requirements. This disconnect suggests broader issues with staff training, supervision, or workload management that allowed contamination to persist in a resident's personal living space.
For residents and families, the violation raises questions about overall cleanliness standards at the facility. If a highly visible contamination issue in a bathroom went unaddressed for more than 24 hours, it suggests potential problems with routine cleaning and maintenance throughout the building.
The incident occurred during regular business hours when multiple staff members were present, making the oversight particularly concerning. The contamination was obvious enough that inspectors could document its exact size and location, yet housekeeping staff failed to identify and address it during their normal duties.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Salem Health & Rehabilitation from 2025-08-28 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: June 20, 2026 · Our methodology
SALEM HEALTH & REHABILITATION in SALEM, VA was cited for violations during a health inspection on August 28, 2025.
More than four hours later, at 3:15 PM the same day, the fecal matter remained exactly where inspectors had found it earlier.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.