Nursing Investigation Results -

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

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PARKHOUSE REHABILITATION AND NURSING CENTER
Inspection Results For:

There are  82 surveys for this facility. Please select a date to view the survey results.

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

Based on an Abbreviated Survey in response to a complaint, completed on June 2, 2019, it was determined that Parkhouse Rehabilitation and Nursing Center, was not in compliance with the following 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 for 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, facility documentation and staff interview, it was determined that the facility failed to monitor a resident's blood sugar upon admission to the facility related to a diagnosis of type 2 diabetes mellitus, (the type in which the beta cells of the pancreas produce insulin but the body is unable to use it effectively because the cells of the body are resistant to the action of insulin), for one of one resident reviewed (Resident CL1).

Findings include:

Clinical record review for Resident CL1 revealed admission physician's orders, dated December 4, 2018, which indicated a diagnosis of type 2 diabetes mellitus with complications.

Review of a nursing progress note dated December 4, 2018, written at 9:00 p.m. indicated, "Admission accucheck only till evaluated" (accu-check - a measure of glucose/sugar in the blood).

Continued review of Resident CL1's clinical record revealed documentation titled, "Weights and Vitals Summary", which revealed that the first time Resident CL1's accu-check was obtained was on December 6, 2018, at 11:00 p.m., two days after admission. The result of the accucheck was 238 mg/dl (normal range - 82 to 112 mg/dl).

An interview with the Nursing Home Adminstrator on June 2, 2019, at 3:00 p.m. confirmed that Resident CL1's accu-check was not completed for 48 hours after admission and that there was no documentation to indicate that the physician was made aware of the elevated accu-check result or that the resident had been evaluated.

The facility failed to monitor one resident's accu-check upon admission related to a diagnosis of type 2 diabetes mellitus.

Quality of Care
CFR(s): 483.25 - Previously cited 3/8/19 and 5/07/18

28 Pa. Code 201.14(a) Responsibility of licensee
Previously cited 3/8/19, 10/25/18, 5/07/18 and 3/01/17

28 Pa. Code 201.18(b)(1) Management
Previously cited 3/8/19, 5/07/18 and 3/01/17

28 Pa. Code 201.18(b)(3)(e)(1) Management
Previously cited 3/8/19 and 5/07/18

28 Pa. Code 211.5(f)(h) Clinical records
Previously cited 3/8/19 and 5/07/18

28 Pa. Code 211.5(g) Clinical records
Previously cited 3/8/19

28 Pa. Code 211.12(c) Nursing services
Previously cited 3/8/19 and 5/07/18

28 Pa. Code 211.12(d)(1)(5) Nursing services
Previously cited 3/8/19, 5/07/18, 11/21/17 and 3/01/17

28 Pa. Code 211.12(d)(2) Nursing services
Previously cited 3/8/19, 05/07/18 and 3/01/17

28 Pa. Code 211.12(d)(3) Nursing services
Previously cited 3/8/19 and 5/07/18

28 Pa. Code: 211.12(c)(d)(1)(2)(5) Nursing services
Previously cited 3/8/19








 Plan of Correction - To be completed: 06/12/2019

1.CL1 no longer residents at the
facility.
2.Facility performed a facility wide
audit of residents admitted within the past 30 days to ensure they
monitored the resident's blood sugar upon admission to the facility related to a diagnosis of type 2 diabetes mellitus.
3.Nurse Educator or designee will
re-educate licensed staff on
monitoring a resident's blood sugar upon admission to the facility related to a diagnosis of type 2 diabetes mellitus as per physicians orders and make the physician aware of results.
4. Audits will be performed by Unit
Manager or designee daily for 2 wks,then weekly for 2wks then monthly for 1 qtr
5. Result of Audits will be tracked
and trended at QA meeting for 1qtr
with follow up as recommended.


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