Dove Healthcare - Superior

F-F588 for reasonable accommodation of needs).

Surveyor asked R7 how she was able to attend her appointment on 03/10/25 if she did not have a wheelchair. R7 stated staff borrowed R43's w/c, as it is a bariatric w/c.

Surveyor noted R43 was currently on contact precautions related to a C. diff infection.

Surveyor immediately interviewed CNA I. CNA I stated, Ok, I had nothing to do with this. I helped [R7] get ready for her appointment yesterday morning. I don't know why she doesn't have a w/c. I asked Nursing Home Administrator (NHA) and DON what I should do, and they told me to use [R43's] w/c, as [R7] needed a bariatric w/c. I knew [R43] had C.

Diff.

They told me to clean the w/c before I used it. I was not going to be responsible for someone getting C. diff because I didn't clean the chair properly. I mean, I don't have time to be cleaning w/c's with bleach. I told them to clean it. NHA and [Nurse Manager (NM) BB] cleaned the w/c and brought it to [R7's] hallway for me.

When I got the w/c, I know they did not clean it with bleach because I could not smell bleach. I could smell the purple top wipes. I know what those smell like.

Example 8

SHOWER ROOM

On 03/11/25 at 8:16 AM, Surveyor observed clean linens in shower room on railings, inside shower stall, and on shower bench.

Personal care items including a bar of soap and disposable razor were present inside shower in an open metal rack.

525397

Form Approved OMB

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.

Building 525397 B.

Wing 03/13/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Dove Healthcare - Superior 1800 New York Ave Superior, WI 54880