Pennsylvania Department of Health
BRINTON MANOR NURSING AND REHABILITATION CENTER
Patient Care Inspection Results

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BRINTON MANOR NURSING AND REHABILITATION CENTER
Inspection Results For:

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BRINTON MANOR NURSING AND REHABILITATION CENTER - Inspection Results Scope of Citation
Number of Residents Affected
By Deficient Practice
Initial comments:

Findings of an Abbreviated Complaint Survey completed on January 24, 2024, at Brinton Manor, identified deficient practice, related to the reported complaint allegations, under the requirements of 42 CFR Part 483, Subpart B Requirements for Long Term Care Facilities and the 28 PA Code, Commonwealth of Pennsylvania Long Term Care Licensure Regulations as they relate to the Health portion of the survey process.


 Plan of Correction:


483.25 REQUIREMENT Quality of Care:This is a less serious (but not lowest level) deficiency and is isolated to the fewest number of residents, staff, or occurrences. This deficiency is one that results in minimal discomfort to the resident or has the potential (not yet realized) to negatively affect the resident's ability to achieve his/her highest functional status.
§ 483.25 Quality of care
Quality of care is a fundamental principle that applies to all treatment and care provided to facility residents. Based on the comprehensive assessment of a resident, the facility must ensure that residents receive treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan, and the residents' choices.
Observations:


Based on clinical record review, resident and staff interviews it was determined the facility failed to follow physician orders for medication treatments for one of three residents reviewed. (Resident R1)

Findings Include:

Review of Resident R1's clinical record revealed diagnoses of the following including but not limited to of Obstructive Sleep Apnea and Acute Respiratory Failure with Hypoxia.

Interview conducted with Resident R1 on January 24, 2024, at approximately 2:40 p.m. revealed after resident's admission on December 8, 2023; Resident R1 went nearly two weeks without his/her CPAP (continuous positive airway pressure machine) which is required for him/her to breathe properly.

Review of Resident R1's clinical record revealed the resident was admitted into the facility on December 8, 2023.

Further review of the resident's clinical record revealed a progress note dated December 14, 2023, indicating the resident needed a new CPAP machine, due to previous machine malfunctioned.

Review of Resident R1's progress notes dated December 15, 2023, thru December 21, 2023, indicated the resident did not receive a CPAP machine.

Review of Resident R1's progress note dated December 21, 2023, at 4:23 p.m., indicated the resident was shown how to use new CPAP machine.

Review of Resident R1's medications administration record for December 2023, revealed the resident was receiving the CPAP treatments on days when the progress notes documented the equipment was not available.

During interview with the Director of Nursing (DON) on January 24, 2024, at 4:25 p.m. inquiry was made concerning the conflicting documentation. The DON failed to explain the conflicting documentation.

Interview conducted with Nursing Home Administrator(NHA) and Director of Nursing (DON) on January 24, 2024, at 5:00 p.m., revealed Resident R1 was diagnosed with sleep apnea during a hospital stay. Director of Nursing indicated that Resident R1 never went without a CPAP machine. DON stated the progress notes were referring to the resident receiving a new CPAP machine to take home, although the resident does not have a discharge plan. The NHA and DON failed to explain why the progress notes indicated the resident had not received a new CPAP machine timely.

28 Pa. Code 211.12 (a)(c)(d)(3)(5) Nursing Services


 Plan of Correction - To be completed: 02/16/2024

1. R1 received a CPAP and is wearing the CPAP per physician orders. 

2. A house-wide audit of CPAP machines has been conducted by the Director of Nursing to ensure availability and to ensure machines are in good working order per physician orders. Any identified issues with machines will be addressed by respiratory services. 

3. DON/Designee will reeducate nursing staff on ensuring CPAP's are in good working order and how to inform respiratory services and/or maintenance of CPAP machine issues.   

4. Audits will be conducted by the DON or designee on residents with CPAP machines to ensure availability and to ensure machines are in good working order weekly x4 weeks. Audits will be reported to QAPI for review and further recommendation as needed.  

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