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

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SILVER STREAM NURSING AND REHABILITATION CENTER
Inspection Results For:

There are  137 surveys for this facility. Please select a date to view the survey results.

Surveys don't appear on this website until at least 41 days have elapsed since the exit date of the survey.
SILVER STREAM NURSING AND REHABILITATION 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 January 26, 2024, it was determined that Silver Stream Nursing and Rehabilitation 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 related to the health portion of the survey process.



 Plan of Correction:


483.10(a)(1)(2)(b)(1)(2) REQUIREMENT Resident Rights/Exercise of Rights: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.
§483.10(a) Resident Rights.
The resident has a right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility, including those specified in this section.

§483.10(a)(1) A facility must treat each resident with respect and dignity and care for each resident in a manner and in an environment that promotes maintenance or enhancement of his or her quality of life, recognizing each resident's individuality. The facility must protect and promote the rights of the resident.

§483.10(a)(2) The facility must provide equal access to quality care regardless of diagnosis, severity of condition, or payment source. A facility must establish and maintain identical policies and practices regarding transfer, discharge, and the provision of services under the State plan for all residents regardless of payment source.

§483.10(b) Exercise of Rights.
The resident has the right to exercise his or her rights as a resident of the facility and as a citizen or resident of the United States.

§483.10(b)(1) The facility must ensure that the resident can exercise his or her rights without interference, coercion, discrimination, or reprisal from the facility.

§483.10(b)(2) The resident has the right to be free of interference, coercion, discrimination, and reprisal from the facility in exercising his or her rights and to be supported by the facility in the exercise of his or her rights as required under this subpart.
Observations:


Based on clinical record review, observations, and interviews with residents and staff, it was determined that the facility failed to ensure resident dignity for one out of seven residents reviewed (Resident R1).

Findings include:

Review of the clinical record revealed that Resident R1 revealed that the resident was admitted to the facility on March 18, 2021, with diagnosese of Obstructive Sleep Apnea (OSA) (OSA occurs when the upper airway becomes blocked, leading to brief pauses in breathing during sleep), and Asthma (Asthma is a chronic lung disease caused by inflammation and muscle tightening around the airways, which makes it harder to breathe).

Observation of Resident R4 on January 26, 2024, at 10:40 a.m., revealed the Resident R1 had untrimmed facial hair, and long, fingernails with dark substance under the fingernails.

During interviewed with Resident R1 on January 25, 2024 the resident stated that no staff offered him to trim the facial hair and nails. Employee E5, a Licensed Nurse of the unit was made aware of the observation, and that Resident R1's observed appearance indicated a need for personal hygiene services to maintain adequate personal grooming.

28 Pa Code:201.29(j) Resident rights.

28 Pa Code: 211.11(d)(1)(5) Nursing services.






 Plan of Correction - To be completed: 03/01/2024

1)Resident identified had facial hair trimmed and nails cleaned and cut.

2)A sample of five residents will be audited to check personal hygiene specific to nails and grooming.

3)Education will be provided by Director of nursing/designee to CNA on personal hygiene and nail care

4)Once weekly audits will be conducted by Director of Nursing/designee on a random sample of five residents on grooming and nail care for four weeks. After which audits will be conducted once monthly for three months to determine compliance. Results will be presented at QAPI for review.
483.25(i) REQUIREMENT Respiratory/Tracheostomy Care and Suctioning: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(i) Respiratory care, including tracheostomy care and tracheal suctioning.
The facility must ensure that a resident who needs respiratory care, including tracheostomy care and tracheal suctioning, is provided such care, consistent with professional standards of practice, the comprehensive person-centered care plan, the residents' goals and preferences, and 483.65 of this subpart.
Observations:

Based on observation, clinical record review, review of facility policy and staff interview, it was determined that the facility failed to provide appropriate respiratory care and services for one of seven residents reviewed (Resident R1).

Findings include:

Review of the clinical record revealed that Resident R1 was admitted to the facility on March 18, 2021, with diagnosis including, Obstructive Sleep Apnea (OSA) (OSA occurs when the upper airway becomes blocked, leading to brief pauses in breathing during sleep), and Asthma (Asthma is a chronic lung disease caused by inflammation and muscle tightening around the airways, which makes it harder to breathe).

A review of Resident R1's clinical records revealed a physician order, dated March 21, 2023, to administer Oxygen 4 liters/minute, via nasal canula (nasal cannula is a thin tube, often affixed behind the ears and used to deliver oxygen directly to the nostrils from a source connected with tubing), every shift; and a physician order, dated, December 1, 2023, to change oxygen tubing weekly, every night shift, every Friday, sign, and date tubing on Friday nights per facility protocol.

On January 26, 2024, at 10:40 a.m., it was observed that Resident R1 was administered with oxygen at three point five liters per minute, via nasal canula; and that the staff did not change the oxygen tube, as the date on the oxygen tube marked was September 2023. At the time of observation, the finding was confirmed with Employee E5, a Licensed Nurse.

28 Pa Code 211.12(d)(5) Nursing services








 Plan of Correction - To be completed: 03/01/2024

1) Resident identified immediately had oxygen tubing changed.

2) An audit of residents with oxygen tubing will be conducted to ensure tubing correctly dated and changed as required by regulation.

3) Education will be provided by Director of Nursing/designee to nursing staff on ensuring oxygen tubing is changed as required.

4) Once weekly audits for four weeks will be conducted by Director of Nursing/designee on residents with oxygen tubing to ensure tubing is correctly dated and changed. Once monthly audits will be conducted for three months thereafter to determine compliance. Audit results will be presented at QAPI for review.

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