Nursing Investigation Results -

Pennsylvania Department of Health
EPWORTH HEALTHCARE AND REHABILITATION CENTER
Patient Care Inspection Results

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EPWORTH HEALTHCARE AND REHABILITATION CENTER
Inspection Results For:

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EPWORTH HEALTHCARE AND REHABILITATION CENTER - Inspection Results Scope of Citation
Number of Residents Affected
By Deficient Practice
Initial comments:
Based on a complaint survey completed on January 23, 2020, it was determined that Epworth Healthcare 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.



 Plan of Correction:


483.60(i)(1)(2) REQUIREMENT Food Procurement,Store/Prepare/Serve-Sanitary: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.
483.60(i) Food safety requirements.
The facility must -

483.60(i)(1) - Procure food from sources approved or considered satisfactory by federal, state or local authorities.
(i) This may include food items obtained directly from local producers, subject to applicable State and local laws or regulations.
(ii) This provision does not prohibit or prevent facilities from using produce grown in facility gardens, subject to compliance with applicable safe growing and food-handling practices.
(iii) This provision does not preclude residents from consuming foods not procured by the facility.

483.60(i)(2) - Store, prepare, distribute and serve food in accordance with professional standards for food service safety.
Observations:


Based on review of policies, as well as observations and staff interviews, it was determined that the facility failed to ensure that food was served under sanitary conditions.

Findings include:

The facility's policy regarding hand washing/hand hygiene, dated March 11, 2019, revealed that all staff were to be trained and regularly inserviced on the importance of hand hygiene in preventing the transmission of healthcare-associated infections. Staff were to follow the hand washing/hand hygiene procedures to help prevent the spread of infection, and the use of gloves did not replace hand washing/hand hygiene. The hand washing procedure included to lather the hands with soap and rub together, to rinse the hands thoroughly under running water, and to dry the hands thoroughly with paper towel, and then turn the faucet off with a clean, dry paper towel.

Observations in the Second Floor dining area on January 23, 2020, at 5:55 p.m. revealed that Dietary Worker 1 finished checking the temperatures of the food items on the steam table, went to the trash can and removed her disposable gloves, went to the sink and washed her hands, then turned the faucet off using her clean hand and then obtained paper towels to dry her hands. At 5:57 p.m. and 6:04 p.m., Dietary Worker 1 placed food items onto plates for residents who were to receive meals in the dining area. She then went to the trash can and removed her disposable gloves, went to the sink and washed her hands, then turned the faucet off using her clean hand, and then obtained paper towels to dry her hands.

Interview with the Dietary Manager on January 23, 2020, at 6:25 p.m. confirmed that Dietary Worker 1 should have used a paper towel to turn the faucet off after she was done washing her hands.

42 CFR 483.60(i)(1)(2) Food Procurement, Store/Prepare/Serve-Sanitary.
Previously cited 6/3/19.

28 Pa. Code 211.6(f) Dietary services.
Previously cited 6/3/19.



 Plan of Correction - To be completed: 02/11/2020

-Dietary Worker 1 educated on hand washing policy by Dietary Manager.
-Dietary staff and newly hired dietary staff will be educated on hand washing policy and procedure by Dietary Manage or designee. Dietary staff and newly hired dietary staff will complete a competency on hand washing.
-Dietary Manager or designee will perform random observations of dietary staff hand washing during the preparation and serving of food weekdays. This audit will be performed four times weekly for 4 weeks, then weekly for two months.
-Audit results will be reviewed through Quality Assurance Process Improvement committee.

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