REGULATION: Electrical Systems - Other List in the REMARKS section any NFPA 99 Chapter 6 Electrical Systems requirements that are not addressed by the provided K-Tags, but are deficient. This information, along with the applicable Life Safety Code or NFPA standard citation, should be included on Form CMS-2567. Chapter 6 (NFPA 99)

Scope: Isolated
Severity: Potential to cause more than minimal harm
Citation date: June 29, 2021
Corrected date: August 25, 2021

Citation Details

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review during a Life Safety Code survey completed on 6/29/21, an electrical duplex outlet was not maintained. Specifically, a live duplex electrical outlet in a resident room was disconnected from the wall and had exposed wires. This affected one (D Wing) of four resident units. The finding is: Observation in D Wing on 6/24/21 at 11:40 AM revealed a duplex electrical outlet was located inside the closet of Resident room [ROOM NUMBER]. Continued observation revealed the outlet had been disconnected from its electrical box that had been installed in the closet wall. The outlet cover, receptacles and five inches of electrical wires were hanging loosely out of the wall. Continued observation revealed one of the electrical wires had been disconnected from the receptacles and the exposed metal ends of the wire were spread apart. The screw that secured the outlet cover to the wall and a wire nut (a cone shaped threaded plastic cap that is used to connect wires together) were observed on the floor below the outlet. During an interview at the time of the observation, the Maintenance Mechanic stated he was not aware that any electrical outlet was located in any resident room closet, and this electrical outlet must have been mistakenly installed inside the closet instead of along the wall between the bathroom and the closet. Also, at this time, the Maintenance Mechanic used a voltmeter (instrument that measures either direct or alternating electric current) on the outlet and stated the outlet was hot (carrying electricity from the service panel to the outlet). On 6/24/21, at the time of the observation, Resident #12 was interviewed. During this interview, Resident #12 claimed responsibility for removing the electrical outlet from inside the closet. On 6/24/21 at 4:15PM , Resident #12 stated a butterknife and a rag were used to remove the electical outlet with the intent to short circuit the outlet. During an interview on 6/28/21 at 3:50 PM, the Director of Plant Operations stated the facility performs room audits on each Resident Room for housekeeping and maintenance concerns. He further stated each resident room is audited approximately once every three months. Review of the audit form called Environmental Services Resident Room Audit revealed an audit of Resident room [ROOM NUMBER] was performed on 3/26/21. 10 NYCRR 415.29(a)(2), 711.2(a)(1) 2012 NFPA 99: 6.1, 6.1.1, 1.3, 1.3.1,, 6.3.2,, 2011 NFPA 70: 110.3(A)(8), 406.5, 406.6

Plan of Correction: ApprovedAugust 6, 2021

Education provided by facility Administrator to Director of Maintenance on the regulations and auditing policy. A 100% audit/inspection of all room, and specifically closets for any undetected plugs was performed to account for all outlets in each resident room. Each of the plugs will be audited for proper service, repair, condition, and function weekly for two months and bi weekly for one, and monthly thereafter. With review by the QAPI/safety committee after for further recommendations. Plugs will be audited minimally quarterly there after unless more frequent is determined by the QAPI/ Life safety committee. Responsible person: Director of plant operations Completion date: 08/25/2021