Pennsylvania Department of Health
ELK HAVEN NURSING HOME
Building Inspection Results

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Severity Designations


Minimal Citation - No Harm	Minimal Harm	Actual Harm	Serious Harm

There are 39 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.


ELK HAVEN NURSING HOME - 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 June 13, 2024, at Elk Haven Nursing Home, 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 #051502
Component 01
Main Building

Based on a Medicare/Medicaid Recertification Survey completed on June 13, 2024, it was determined that Elk Haven Nursing Home 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 II (000), unprotected, non-combustible building, that is fully sprinklered.

Plan of Correction:

NFPA 101 STANDARD Cooking Facilities:

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.

Cooking Facilities
Cooking equipment is protected in accordance with NFPA 96, Standard for Ventilation Control and Fire Protection of Commercial Cooking Operations, unless:
* residential cooking equipment (i.e., small appliances such as microwaves, hot plates, toasters) are used for food warming or limited cooking in accordance with 18.3.2.5.2, 19.3.2.5.2
* cooking facilities open to the corridor in smoke compartments with 30 or fewer patients comply with the conditions under 18.3.2.5.3, 19.3.2.5.3, or
* cooking facilities in smoke compartments with 30 or fewer patients comply with conditions under 18.3.2.5.4, 19.3.2.5.4.
Cooking facilities protected according to NFPA 96 per 9.2.3 are not required to be enclosed as hazardous areas, but shall not be open to the corridor.
18.3.2.5.1 through 18.3.2.5.4, 19.3.2.5.1 through 19.3.2.5.5, 9.2.3, TIA 12-2

Observations:
Name: MAIN BUILDING 01 - Component: 01 - Tag: 0324

Based on observation and interview, the facility failed to provide a fire suppression system in two of three kitchens.

Observation and interview on June 13, 2024, at 10:37 a.m., revealed on main floor, C wing, activities room, a cooking stove without a fire suppression hood. No documentation was provided for the limited use policy of the residential cooking equipment.

Ref: NFPA 101- 19.3.2.5

Interview with the maintenance director on June 13, 2024, at 10:37 a.m., confirmed the cooking equipment deficiency.

Plan of Correction - To be completed: 07/10/2024

1.The main floor, C Wing, activities room cooking stove is used for food warming or limited cooking.

2.Policy developed on limited use of residential cooking equipment

3.Policy to be reviewed at next monthly Quality Assurance meeting

NFPA 101 STANDARD Electrical Systems - Receptacles:

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.

Electrical Systems - Receptacles
Power receptacles have at least one, separate, highly dependable grounding pole capable of maintaining low-contact resistance with its mating plug. In pediatric locations, receptacles in patient rooms, bathrooms, play rooms, and activity rooms, other than nurseries, are listed tamper-resistant or employ a listed cover.
If used in patient care room, ground-fault circuit interrupters (GFCI) are listed.
6.3.2.2.6.2 (F), 6.3.2.2.4.2 (NFPA 99)

Observations:
Name: MAIN BUILDING 01 - Component: 01 - Tag: 0912

Based on observation and interview, the facility failed to maintain electrical receptacles in one of more than thirty rooms.

Findings include:

Observation and interview on June 13, 2024, at 10:43 a.m., revealed the facility failed to ensure ground fault circuit interrupter (GFCI) protection within six feet of sinks on the main floor, in C wing laundry, near the hand sink.

Interview with the maintenance director on June 13, 2024, at 10:43 a.m., confirmed the electrical outlet deficiency.

Plan of Correction - To be completed: 07/10/2024

1. C Wing laundry receptacle near the hand sink was replaced with a ground fault circuit interrupter(GFCI)

2. The Maintenance Director was educated on the need for GFCI outlets in water source areas of the facility.

3. All rooms with water sources will be assessed to ensure proper GFCI receptacles are in place and replace them if indicated.

Initial comments:Name: BUILDING 02 - Component: 02 - Tag: 0000

Facility ID #051502
Component 02
Therapy Building 02

Based on a Medicare/Medicaid Recertification Survey completed on June 13, 2024, it was determined that Elk Haven Nursing Home 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 two-story, Type II (111), protected, non-combustible building, that is fully sprinklered.

Plan of Correction:

NFPA 101 STANDARD Cooking Facilities:

Observations:
Name: BUILDING 02 - Component: 02 - Tag: 0324

Based on observation and interview, the facility failed to provide a fire suppression system in two of three kitchens.

Observation and interview on June 13, 2024, at 11:39 a.m., revealed on the main floor, OT/PT therapy room, a cooking stove without a fire suppression hood. No documentation was provided for the limited use policy of the residential cooking equipment.

Ref: NFPA 101- 19.3.2.5

Interview with the maintenance director on June 13, 2024, at 11:39 a.m., confirmed the cooking equipment deficiency.

Plan of Correction - To be completed: 07/10/2024

1. The main floor, OT/PT, therapy room cooking stove is used for food warming or limited cooking

2. Policy developed on limited use of residential cooking equipment

3. Policy to be reviewed at next monthly Quality Assurance meeting

Plan of correction does not constitute admission or agreement by the provider of the truth of the facts alleged or conclusions set forth in the statement of deficiencies. This Plan of Correction is prepared and/or executed solely because it is required by the provisions of the Federal and State law.

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