Pennsylvania Department of Health
FOREST PARK NURSING AND REHABILITATION
Building Inspection Results

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FOREST PARK NURSING AND REHABILITATION
Inspection Results For:

There are  41 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.
FOREST PARK NURSING AND REHABILITATION - 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 April 1, 2024, at Forest Park Nursing and Rehabilitation, 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 #060802
Component 01
Main Building

Based on a Medicare/Medicaid Recertification Survey completed on April 1, 2024, it was determined that Forest Park Nursing and Rehabilitation 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 (000), unprotected wood frame structure, with a basement, which is fully sprinklered.




 Plan of Correction:


NFPA 101 STANDARD Travel Distance to Exits: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.
Travel Distance to Exits
Travel distance (excluding suites) to exits are measured in accordance with 7.6.
* From any point in the room or suite to exit less than or equal to 150 feet (less than or equal to 200 feet if the building is fully sprinklered)
* Point in a room to room door less than or equal to 50 feet
18.2.6, 19.2.6
Observations:
Name: MAIN BUILDING - Component: 01 - Tag: 0261

Based on observation and interview, it was determined the facility failed to provide travel distance to exits, to be 200 feet or less, affecting one of three smoke compartments within the component.Findings include:1. Observation on April 1, 2024, at 11:00 AM, revealed the travel distance, from Resident Rooms 51 & 60, exceeded 200 feet to the exit discharge.

Interview at the time of the exit conference with the Regional Director of Nursing, Director of Nursing, Director of Maintenance and Maintenance Assistant on April 1, 2024, at 1:45 PM, confirmed the travel distance exceeded 200 feet.



 Plan of Correction - To be completed: 05/30/2024

The facility wishes to have DOH conduct a new FSES under Life Safety Code.
NFPA 101 STANDARD Emergency Lighting:Least serious deficiency but was found to be widespread throughout the facility and/or has the potential to affect a large portion or all the residents. This deficiency has the potential for causing no more than a minor negative impact on the resident.
Emergency Lighting
Emergency lighting of at least 1-1/2-hour duration is provided automatically in accordance with 7.9.
18.2.9.1, 19.2.9.1
Observations:
Name: MAIN BUILDING - Component: 01 - Tag: 0291

Based on document review and interview, it was determined the facility failed to provide documentation of monthly and annual testing of battery back up lighting, affecting the entire component.

Findings include:

1. Review of documentation on April 1, 2024, between 10:00 AM and 11:15 AM, revealed the facility failed to provide documentation verifying monthly and annual testing of installed battery back-up emergency lighting, at the transfer switch.

Interview at the time of the exit conference with the Regional Director of Nursing, Director of Nursing, Director of Maintenance and Maintenance Assistant on April 1, 2024, at 1:45 PM, confirmed the facility failed to supply documentation of battery operated light testing.



 Plan of Correction - To be completed: 05/30/2024

1. The generator and the transfer switch battery back up lighting will be tested monthly and annually.
2. The testing will be documented on the Emergency Lighting logs.
3. The NHA/Designee will conduct audits of the logs monthly for twelve months.
4. The audits will be reviewed at the monthly Quality Assurance Committee for compliance.

NFPA 101 STANDARD Sprinkler System - Maintenance and Testing: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.
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 system, to be free of obstructions, affecting one of three smoke compartments within the component.

Findings include:

1. Observation on April 1, 2024, between 11:30 AM and 11:34 AM, revealed the sprinkler heads were covered with debris, at the following locations:

a. 11:30 AM, Main Laundry Room 1 Dryer Chase;
b. 11:32 AM, Main Laundry Room, 1dryer area;
c. 11:34 AM, Main Laundry Room, 2 washer area.

Interview at the time of the exit conference with the Regional Director of Nursing, Director of Nursing, Director of Maintenance and Maintenance Assistant on April 1, 2024, at 1:45 PM, confirmed debris was covering the sprinkler heads.



 Plan of Correction - To be completed: 05/30/2024

1. Date sprinkler system last checked 3/19/2024. Diamond Sprinkler Inc provided system test. Water system supply source is City Water.
2. Maintenance of the automatic sprinkler system will be placed on the Monthly clean and check log.
3. The NHA/Designee will conduct audits of the logs monthly for twelve months.
4. The Audits will be reviewed at the monthly Quality Assurance Committee for compliance.

NFPA 101 STANDARD Subdivision of Building Spaces - Accumulation:Least serious deficiency but was found to be widespread throughout the facility and/or has the potential to affect a large portion or all the residents. This deficiency has the potential for causing no more than a minor negative impact on the resident.
Subdivision of Building Spaces - Accumulation Space
Space shall be provided on each side of smoke barriers to adequately accommodate the total number of occupants in adjoining compartments.
18.3.7.5.1, 18.3.7.5.2, 19.3.7.5.1, 19.3.7.5.2
Observations:
Name: MAIN BUILDING - Component: 01 - Tag: 0373

Based on observation and interview, it was determined the facility failed to maintain smoke compartments, to be not larger than 22,500 square feet, affecting three of three smoke compartments within the component.

Findings include:

1. Observation on April 1, 2024, between 10:30 AM and 1:00 PM, revealed all three smoke compartments, within the building, were extended zones.

Interview at the time of the exit conference with the Regional Director of Nursing, Director of Nursing, Director of Maintenance and Maintenance Assistant on April 1, 2024, at 1:45 PM, confirmed the smoke compartments were greater than 22,500 square feet.



 Plan of Correction - To be completed: 05/30/2024

The facility wishes to have DOH conduct a new FSES under Life Safety Code.

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