Pennsylvania Department of Health
HOMEWOOD AT PLUM CREEK
Building Inspection Results

Note: If you need to change the font size, click the "View" menu at the top of the page, place the mouse over the "Text Size" menu item, and select the desired font size.

Severity Designations


Minimal Citation - No Harm	Minimal Harm	Actual Harm	Serious Harm

There are 40 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.


HOMEWOOD AT PLUM CREEK - Inspection Results	Scope of Citation Number of Residents Affected By Deficient Practice

Initial comments:Name: - Component: -- - Tag: 0000

Based on an Emergency Preparedness Survey completed on February 26, 2024, at Homewood at Plum Creek, it was determined there were no deficiencies identified with the requirements of 42 CFR 483.73.

Plan of Correction:

Initial comments:Name: MAIN BUILDING - Component: 01 - Tag: 0000

Facility ID #342202
Component 01
B, C, D Buildings and Chapel

Based on a Medicare/Medicaid Recertification Survey completed on February 26, 2024, it was determined that Homewood at Plum Creek was not in compliance with the following requirements of the Life Safety Code for an existing health care occupancy. Compliance with the National Fire Protection Association's Life Safety Code is required by 42 CFR 483.90(a).

This is a one-story, Type V (111), protected wood frame structure, without a basement, which is fully sprinklered.

Plan of Correction:

NFPA 101 STANDARD Building Construction Type and Height:

This is a less serious (but not lowest level) deficiency and affects more than a limited 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. This deficiency was not found to be throughout this facility.

Building Construction Type and Height
2012 EXISTING
Building construction type and stories meets Table 19.1.6.1, unless otherwise permitted by 19.1.6.2 through 19.1.6.7
19.1.6.4, 19.1.6.5

Construction Type
1 I (442), I (332), II (222) Any number of stories
non-sprinklered and sprinklered

2 II (111) One story non-sprinklered
Maximum 3 stories sprinklered

3 II (000) Not allowed non-sprinklered
4 III (211) Maximum 2 stories sprinklered
5 IV (2HH)
6 V (111)

7 III (200) Not allowed non-sprinklered
8 V (000) Maximum 1 story sprinklered
Sprinklered stories must be sprinklered throughout by an approved, supervised automatic system in accordance with section 9.7. (See 19.3.5)
Give a brief description, in REMARKS, of the construction, the number of stories, including basements, floors on which patients are located, location of smoke or fire barriers and dates of approval. Complete sketch or attach small floor plan of the building as appropriate.

Observations:
Name: MAIN BUILDING - Component: 01 - Tag: 0161
Based on observation and interview, it was determined the facility failed to maintain the rated horizontal fire doors, to close and latch within the frame, in one of seven smoke compartments within the component.
Findings include:
1. Observation on February 26, 2024, at 11:45 AM, revealed the horizontal fire-rated access door, by the Beauty Shop Room B482, failed to self-close and latch. This is a Type V (111), protected wood frame structure.
Interview at the time of exit conference with the Maintenance Director on February 26, 2024, at 1:15 PM, confirmed the horizontal fire-rated access door would not self-close and latch.

Plan of Correction - To be completed: 04/15/2024

The enclosed plan of correction set forth in these documents does not constitute admission or agreement by the provider of the truth of the facts alleged or concluded set forth in the statement of deficiencies. The plan of correction is prepared and or executed solely because it is required by the provision of Federal and State law.

1. Each horizontal fire rated access door in the Healthcare areas B, C, D were evaluated and checked for self-closing and latching. The fire rated access door located outside B482 was replaced with a self-closing/latching door.
Education was provided by the Maintenance Director regarding the requirements to monitor self-closing and latching of horizontal fire rated doors/access.

2.An action plan was initiated, and audits will be done monthly x3 then quarterly by the QA Coordinator and Maintenance Director. The QA Coordinator will then report the findings to the QA committee quarterly to ensure compliance with this regulation. This corrective action will be completed by 4/15/24.

NFPA 101 STANDARD Sprinkler System - Maintenance and Testing:

Sprinkler System - Maintenance and Testing
Automatic sprinkler and standpipe systems are inspected, tested, and maintained in accordance with NFPA 25, Standard for the Inspection, Testing, and Maintaining of Water-based Fire Protection Systems. Records of system design, maintenance, inspection and testing are maintained in a secure location and readily available.
a) Date sprinkler system last checked _____________________
b) Who provided system test ____________________________
c) Water system supply source __________________________
Provide in REMARKS information on coverage for any non-required or partial automatic sprinkler system.
9.7.5, 9.7.7, 9.7.8, and NFPA 25

Observations:
Name: MAIN BUILDING - Component: 01 - Tag: 0353
Based on observation and interview, it was determined the facility failed to maintain the automatic sprinkler protection system, to be free from extraneous weight, affecting two of seven smoke compartments within the component.

Findings include:

1. Observation on February 26, 2024, at 11:30 AM, revealed rigid ventilation ducting laying on sprinkler piping system, above ceiling by the Personal Care and Skilled Nursing separation doors.

Interview at the time of exit conference with the Maintenance Director on February 26, 2024, at 1:15 PM, confirmed the rigid ducting on the sprinkler piping system.

2. Observation on February 26, 2024, at 11:40 AM, revealed data cable and white tubing laying across sprinkler piping and a white line tied to sprinkle piping in the attic space, above Beauty Shop Room B482.

Interview at the time of exit conference with the Maintenance Director on February 26, 2024, at 1:15 PM, confirmed multiple wires, in various locations, laying across, and rope tied to the sprinkle piping system.

3. Observation on February 26, 2024, at 12:05 PM, revealed various wires laying across sprinkler piping above the ceiling, by Resident Room D230.

Interview at the time of exit conference with the Maintenance Director on February 26, 2024, at 1:15 PM, confirmed multiple wires were laying on the sprinkler piping system.

Plan of Correction - To be completed: 04/15/2024

The enclosed plan of correction set forth in these documents does not constitute admission or agreement by the provider of the truth of the facts alleged or concluded set forth in the statement of deficiencies. The plan of correction is prepared and or executed solely because it is required by the provision of Federal and State law.

1. Each hallway and attic in the Healthcare areas B, C and D was evaluated and checked for excessive weight on the sprinkler system.
Observed areas #1, #2, and #3 were corrected to meet the sprinkler system maintenance regulation. All the corridors and attics were inspected to ensure compliance and any identified concerns related to the sprinkler protection system were corrected per the regulation. Education was provided by the Maintenance Director regarding maintaining the automatic sprinkler protection system to be free from extraneous weight.

2. An action plan was initiated, and audits will be done monthly x3 then quarterly by the QA Coordinator and Maintenance Director. The QA Coordinator will then report the findings to the QA committee quarterly to ensure compliance with this regulation. This corrective action will be completed by 4/15/24.

Back to County Map

Home : Press Releases : Administration
Health Planning and Assessment : Office of the Secretary
Health Promotion and Disease Prevention : Quality Assurance

Copyright � 2001 Commonwealth of Pennsylvania. All Rights Reserved.
Commonwealth of PA Privacy Statement