Survey Savvy For CNA’s: Room Temps

Each week we will post an article intended to educate CNA’s on OBRA regulations. Detailed articles with advice on how to view resident care from the government’s stand point will be provided. These articles will be under a new category, “OBRA INSPECTIONS”.

Regulation Number:0257

Regulation Title: COMFORTABLE & SAFE TEMPERATURE LEVELS

Regulation Description: The facility must provide comfortable and safe temperature levels. Facilities initially certified after October 1, 1990 must maintain a temperature range of 71 – 81° F

What does this mean to CNA’s? Why should we be concerned with such a regulation? After all, we don’t have any say in these things, right??

Let’s look at things we do that might make the residents environment uncomfortable.

From an actual survey:

During stage one resident observations and interviews on 3/29/11 and 3/30/11, the following information was obtained:
-On 3/29/11 at 11:24 a.m., a resident in room #26 stated his room was always cold, “every night.” Three residents resided in the room.

-On 3/30/11 at 8:34 a.m., a resident in room #14 stated the building was always cold, “especially in this room. The window is open all the time, but I don’t know who opens it. It won’t stay shut.” The resident was observed seated in her wheelchair between the bed and window, wearing her winter jacket. The window was cracked open approximately half an inch. The temperature of the room near the window was 65 degrees Fahrenheit (F). Two residents resided in the room.

-On 3/30/11 at 8:45 a.m., a resident in room #12 stated her room was very cold. She was observed wearing her winter jacket and a blanket. The resident’s window was cracked open approximately one inch. The temperature of the room near the window was 63 degrees F. Two residents resided in the room.

During the environmental tour on 3/31/11 at 10:00 a.m. with the housekeeping supervisor (HS) and maintenance director (MD), the following information was obtained:
-The MD stated the resident in room #14 had told him “yesterday” that her room was too cold. The MD stated he responded by inspecting the resident’s room, discovering her window was not completely closed, and closing and locking the window. The MD stated the staff sometimes opened windows at night and did not completely shut and lock them.

-Room #12 was observed with the window cracked open slightly. The temperature of the room was cooler near the window. The MD closed and locked the window during the tour. The HS stated the staff sometimes left the room windows open in the morning because the rooms were odorous during the night.

-On 3/31/11 at 10:15 a.m., the resident in room #26 stated the room was cold at night. He stated he asked for extra blankets and received them, but was still cold during the night.

-On 3/31/11 at 10:57 a.m., the maintenance director stated the resident in room #26 complained of his room being cold at night because staff were leaving the bathroom window open to “air it out” overnight.

Who among us has not opened windows at work? I have! Even in the middle of the winter when rooms were so stifling hot it was unbearable. Never mind the hot summer months when the AC wasn’t working. Yet it never occurred to me that the simple act of opening a window and not closing it, could cause the residents such discomfort. A couple of winters ago we lost power for 4 days and had no heat for that time. It was in February. I did NOT like that at all and bundled up in many layers. I was still very cold. I like to compare that experience to how my residents might feel if the windows to their rooms were left open. We all know older people feel cold differently than the rest of us. Now I always make sure I shut windows no matter how I feel- it’s not about me.