Pennsylvania Department of Health
SHIPPENVILLE HEALTHCARE AND REHABILITATION CENTER
Building Inspection Results

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Severity Designations


Minimal Citation - No Harm	Minimal Harm	Actual Harm	Serious Harm

There are 38 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.


SHIPPENVILLE HEALTHCARE AND REHABILITATION CENTER - 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 July 17, 2024 at Shippenville Healthcare and Rehabilitation Center, it was determined there were no deficiencies identified with the requirements of 42 CFR 483.73.

Plan of Correction:

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

Facility ID #026002
Component 01
Main Building

Based on a Medicare/Medicaid Recertification Survey completed on July 17, 2024, it was determined that Shippenville Healthcare and Rehabilitation Center was not in compliance with the 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 483.70(a).

This is a one-story, Type V (000), unprotected, wood frame building, that is fully sprinklered.

Plan of Correction:

NFPA 101 STANDARD Portable Fire Extinguishers:

Least serious deficiency but affects more than a limited number of residents, staff, or occurrences. This deficiency has the potential for causing no more than a minor negative impact on the resident but is not found to be throughout this facility.

Portable Fire Extinguishers
Portable fire extinguishers are selected, installed, inspected, and maintained in accordance with NFPA 10, Standard for Portable Fire Extinguishers.
18.3.5.12, 19.3.5.12, NFPA 10

Observations:
Name: MAIN BUILDING 01 - Component: 01 - Tag: 0355

Based on observation and interview, the facility failed to maintain portable fire extinguisher requirements for one of over ten portable fire extinguishers.

Findings include:

Observation on July 17, 2024, at 8:44 a.m., revealed the dementia wing corridor portable fire extinguisher had the monthly inspection tag ripped off. The facility was unable to provide documentation for monthly inspections of the extinguisher.

Interview with the maintenance supervisor on July 17, 2024, at 8:44 a.m., confirmed the deficiency at the time of the survey.

Plan of Correction - To be completed: 08/15/2024

1. The Director of Maintenance added a tag to the extinguisher noted to have a torn tag on the day of the survey. Education provided to the staff regarding fire extinguisher monthly check tags and process to follow if it is missing.
The Director of Maintenance or designee will randomly audit fire extinguishers for appropriate tags monthly for 3 months.
2. The Director of Maintenance or designee will report the findings of this audit to the monthly Quality Assurance and Performance Improvement committee meeting.

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