Pennsylvania Department of Health
ROSE CITY NURSING AND REHAB AT LANCASTER
Patient Care Inspection Results

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ROSE CITY NURSING AND REHAB AT LANCASTER
Inspection Results For:

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ROSE CITY NURSING AND REHAB AT LANCASTER - Inspection Results Scope of Citation
Number of Residents Affected
By Deficient Practice
Initial comments:

Based on an abbreviated revisit survey, state monitor survey and complaint investigation completed on January 18, 2024, it was determined that Rose City Nursing and Rehab at Lancaster, failed to follow their plan of correction dated Janaury 2, 2024, and continues to be in non-compliance with the following requirements of 42 CFRPart 483, Subpart B Requirements for Long Term Care and the 28 PA. Code, Commonwealth of Pennsylbania Long Term Care Licensure Regulations.



 Plan of Correction:


§ 211.12(f.1)(2) LICENSURE Nursing services. :State only Deficiency.
(2) Effective July 1, 2023, a minimum of 1 nurse aide per 12 residents during the day, 1 nurse aide per 12 residents during the evening, and 1 nurse aide per 20 residents overnight.

Observations:


Based on review of facility staffing data, it was determined that the facility failed to ensure a minimum of one nurse aide per 12 residents on both day and evening shifts, and one nurse aide per 20 residents on night shift for the days of January 3 through and including January 17, 2024.

Findings include:

Review of the days of January 3 through and including January 17, 2024, revealed the following dates on day shift did not meet the requirement of one nurse aide per 12 residents: January 1, 3, 4, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16 and 17, 2024.

Review of the days of January 3 through and including January 17, 2024. revealed the following dates on evening shift did not meet the requirement of one nurse aide per 12 residents: January 3, 5, 7, 8, 10, 11, 12, 15, 16, and 17, 2024.

Review of the days of January 3 through and including January 17, 2024, revealed the following date on night shift did not meet the requirement of one nurse aide per 20 residents: January 3, 6, 9, and 12, 2024.

The facility staffing ratios being below state minimum standard were relayed to the Nursing Home Administrator on January 18, 2024, at 11:45 a.m.



 Plan of Correction - To be completed: 02/19/2024

1. Facility cannot retroactively correct the CNA staffing ratio below minimum requirements
2. NHA, DON, and staffing scheduler have weekeday meetings to ensure CNA staffing ratios are above minimum requirement of 1:12 for day and evening shifts and 1:20 for night shifts
3. NHA, or designee, will educate staffing scheduler and DON on maintaining at least the minimum required CNA staffing ratios.
4. NHA, or designee, will perform audits or have discussions daily with DON and staffing scheduler to ensure CNA staffing ratios are at, or above state minimum required ratios. Results of audits will be presented at monthly Quality Assurance and Improvement Plan meetings for review and recommendations.

§ 211.12(f.1)(5) LICENSURE Nursing services. :State only Deficiency.
(5) Effective July 1, 2023, a minimum of 1 RN per 250 residents during all shifts.
Observations:


Based on review of facility staffing data, it was determined that the facility failed to ensure a minimum of one RN per 250 residents on all shifts for the days of facility staffing (January 3 through and including January 17, 2024).

Findings include:

Review of the Staffing for the days of January 3 through and including January 17, 2024, revealed on the day shift of January 5, 7 and 13, and 14, 2024, there was no RN assigned

Review of the Staffing for the days of January 3 through and including January 17, 2024, revealed on the evening shift of January 5, 7 and 9, 2024, there was no RN assigned.

Review of the Staffing for the days of January 3 through and including January 17, 2024, revealed on the night shift of January 4, 6, 7, 8, 9, 13, and 17, 2024, there was no RN assigned

Interview with the Nursing Home Administrator on January 18, 2024, at 11:45 a.m. confirmed that the RN staffing ratios were not met on the above days and shifts.


 Plan of Correction - To be completed: 02/19/2024

1. Facility cannot retroactively correct the RN ratio below minimum requirements
2. NHA, DON, and staffing scheduler have weekday meetings to ensure RN ratio is above minimum required 1:250 per shift.
3. NHA, or designee, will educate staffing scheduler and DON on maintaining at least the minimum required RN ratio.
4. NHA, or designee, will perform audits or have discussions daily with DON and staffing scheduler to ensure RN ratio is at, or above state minimum required ratio. Results of audits will be presented at monthly Quality Assurance and Improvement Plan meetings for review and recommendations.


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