A civil lawsuit was filed against a Texas nursing home and the healthcare company which owns it after a resident died two weeks after being found covered with ants. The family said they had been notified by the facility that ants had been found in the resident’s room and on her body. The resident was nonverbal and had no way of asking for help.
One of the family members spoke to a nurse who said she’d been taking ants off the resident and was getting bitten while doing it. The family took photos of what they believed were ant bites on the resident’s arms and legs. They said they were told by leadership at the facility that the wounds were a result of heat rash.
The resident’s family said they saw her condition get worse in the days that followed, and nineteen days later, she died. Her death certificate doesn’t mention the ant bites or the wounds seen on her body. Her cause of death was listed as Alzheimer’s disease.
The incident was detailed in a report completed by a surveyor with the Texas Health and Human Services Commission, who was on site at the nursing facility for an unrelated visit. The report states that the facility failed to ensure a resident with physical debilities and severe cognitive impairment was checked on as needed throughout the night shift as she was found with active ants crawling on her while she was in bed. She had ant bites throughout her body causing resident pain, red welts, and hives that required immediate medical intervention and treatment. A nurse aide told the surveyor that she tried to knock all the ants off of the resident before moving her to the recliner in the room, but that it was impossible to check on every resident every two hours.
According to the report, the facility administrator contacted pest control after the incident to spray inside and outside of her room, and her room had been deep cleaned by housekeeping staff. Additionally, the report stated that the administrator and the director of nursing said they audited all of the residents’ rooms and no additional ants were found. The facility also implemented skin assessments.
Issue:
F925 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). Any sighting of a swarm of ants indoors, and particularly fire ants, is a warning. Residents should be watched closely until the ants can be eliminated.
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.
- Periodically audit to make sure 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.
