|§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.
Based on interviews with residents and staff interviews it was was determined that the facility failed to provide care in an environment, which promotes each resident's quality of life by failing to respond timely to residents' request for assistance as reported by 11 residents out of 19 interviewed (Residents 111, 72, 79, 80, 90, 91, 105, 123, 152, 140, and 41).
Interview with Resident 111 on June 4, 2019 at 1:30 p.m. revealed that the resident stated that he waits a minimum of 30 minutes, at times, for staff to answer his call bell. The resident stated that this may occur during any shift or time of day. The resident relayed that he feels the facility is short staff, which results in delays in staff responding to resident needs.
Interview with Resident 72 on June 4, 2019, at 1:15 p.m. revealed that the resident stated that she generally waits 30 minutes or longer for staff to answer her call bell. The resident relayed that the facility does not have enough staff to meet residents' needs timely.
During interview with Resident 79 on June 4, 2019, at 1:20 p.m. the resident stated that he has waited at least 20 minutes and up to 1 hour for staff to answer his call bell because the facility is short staffed.
Interview with Resident 80 on June 4, 2019 at 1:25 p.m. revealed that the resident stated that he has waited up to an hour staff to answer his call bell and provide needed assistance. The resident felt that the facility "could use more staff."
Interview with Resident 90 on June 4, 2019, at 1:40 p.m. the resident stated that she has waited an hour or longer at times for staff to respond to her call bell and provide assistance when needed. The resident explained that she had reported to the facility that her wheelchair has been "squeaking" for some time, but to date, staff have not repaired it.
Interview with Resident 91 on June 4, 2019 at 1:50 p.m. revealed that the resident stated that he has waited at least 30 minutes for staff to answer his call bell and meet his needs for assistance. The resident relayed that he felt that staff were not deployed properly to provide timely care and meet his needs.
Interview with Resident 105 on June 4, 2019 at 2:00 p.m. revealed that the resident stated that he has waited over an hour for staff to respond to his call bell and provide requested care. The resident stated that he feels that the facility "could use more staff."
Interview with Resident 123 on June 4, 2019 at 12:15 p.m. revealed that the resident reported that he has waited a minimum of 30 minutes at times for staff to respond to his call bell and provide assistance. The resident feels that the facility is short staffed and that these delays in staff response to requests for assistance occur at any time, during any shift of nursing duty.
Interview with Resident 152 on June 4, 2019 at 12:30 p.m. revealed that the resident stated that he waits at least a half hour and at times up to an hour for staff to respond to his request for assistance via the nurse call bell system. The resident stated that it was his impression that the facility was short staffed and that insufficient nurse staffing was the cause of the problem.
Interview with Resident 140 on June 4, 2019, at 1:05 p.m. revealed that the resident expressed concerns with the adequacy of nurse staffing because she usually waits more than 30 minutes for staff to answer her call bell and provide assistance when requested.
Interview with Resident 41 on June 4, 2019, at 1:46 p.m. the resident indicated that she also waits at least 1 hour for someone to answer her call bell and the facility could use more staff.
During interview with the Director of Nursing on June 4, 2019, at 2:30 p.m. the DON was unable to explain the residents' concerns regarding staffs' failure to respond to the residents' requests for assistance in a timely manner, which was negatively affecting the residents' quality of life in the facility.
483.10(a)(1)(2)(b)(1)(2) Resident Rights/Exercise of rights
Previously cited: 12/15/18, 7/13/18
28 Pa. Code 211.12 (a)(c)(d)(4)(5) Nursing Services
Previously cited: 3/26/19, 7/13/18, 4/11/18, 1/4/18, 8/4/17
28 Pa. Code 201.29 (j) Resident Rights
Previously cited: 7/13/18, 1/4/18
28 Pa. Code 201.18 (e)(1)(2)(3)(6) Management
Previously cited: 7/13/18
| ||Plan of Correction - To be completed: 07/08/2019|
1. Call Bell Satisfaction surveys were conducted with Residents 111,72,79,80,90,91,105,123,152,140 and 41 and Resident 90's w/c has been repaired. Staffing levels for 3 different weeks were reviewed at the time of this survey and noted to be adequate and ranging between 3.03 to 3.75 hrs/resident.
2. Call Bell Satisfaction surveys will be completed with all capable residents as well as Implementation of a Guardian Angel program for all residents to monitor all aspects of care and satisfaction.
3. All Staff will be re-educated on timely call bell response times and adequate staffing levels to meet individual needs of the residents and promote their quality of life as well as what the Guardian Angel Program entails.
4. Staffing levels will be calculated daily and shared with the residents at their Monthly resident council meeting. Call Bell Response time audits will be conducted weekly on all 3 shifts as well as random Resident call bell satisfaction surveys weekly x 8 weeks to ensure solutions are sustained. All results will be discussed at monthly QA meetings.
5. Completion date: July 8, 2019.