When county health authorities conducted an inspection of a kitchen at a 98-bed skilled nursing home in Petaluma, California, they were met with unmistakable evidence of a rat infestation. The inspection report from April 3, 2024, revealed rodent droppings scattered across food and equipment throughout the kitchen. Additionally, bite marks were discovered on various bags of dried pasta, muffin mix, cereal, and cases of bananas. The report also noted that some dried goods and single-service items exhibited yellow liquid stains, which could potentially be rodent urine.
Health inspectors found gaps or openings in the wall underneath a washing up area, underneath the back screen door, in cabinets around piping underneath the dining room handwashing sink, in cabinets underneath the handwashing sink in the employee break room, and underneath the door of the dining room.
The county ordered the kitchen closed on the same day as the inspection. Meals for the residents had to be brought in from a neighboring nursing home. Environmental health officials approved the use of the dining area to ration the catered meals into single-service containers and immediately distribute to the residents.
The facility was ordered to clean and sanitize the kitchen and repair gaps and openings where rodents could enter from outside. The nursing home worked with state and county officials to resolve the identified problems, including hiring a construction company to help with repairs. The walls and floors surrounding the large cooking appliances and underneath the two-compartment sink were then resurfaced and a pest control company was contracted.
Compliance Perspective
Issue
F925 Effective Pest Control Program in the State Operations Manual Appendix PP states that facilities are to maintain an effective pest control program so that the facility is free of pests and rodents. An effective pest control program is defined as measures to eradicate and contain common household pests (e.g., bedbugs, lice, roaches, ants, mosquitoes, flies, mice, and rats). Providing a healthy environment for residents is a top priority, and preventing pests is a significant part of ensuring quality of care. Gnaw marks on food packaging, pipes, and electrical cables could be a sign of mice or rats. A rash on a resident’s leg or arm could be a sign of fleas or bedbugs. Tiny dark spots on bed linens could be a sign of bedbugs. Front-line employees are the first line of defense in maintaining a pest-free facility. These include housekeeping, maintenance, kitchen and dining staff, and direct care staff.
Discussion Points
- Review policies and procedures regarding the facility’s environmental infection control and pest control programs. Pest management is not a one-time event. There must be ongoing sanitation, pest monitoring, and prevention. Update your policies if needed to comply with F925 and the most current standards of practice.
- All staff should receive training on the importance of observing residents and immediately reporting any change in their condition or the presence of pests in any part of the facility. Those responsible for managing the pest control program should receive specific training for the types of issues likely to occur in the facility’s geographic area. A program titled Pest Control in Healthcare Facilities is available in Med-Net Academy Prime in the Regulatory Category, and as a CE program in the Management of Environmental Concerns Series in Prime, as well as in the Med-Net Store.
- Periodically audit to ensure regular visits from a pest control professional are occurring, and that the visits are documented along with any proposals for remediation. Include observation for indictors of the presence of pests in the activity of regularly conducting environmental rounds. Check to make sure the appropriate follow-up has been completed and documented for any findings.
*This news alert has been prepared by Med-Net Concepts, LLC for informational purposes only and is not intended to provide legal advice.*
