Pennsylvania Department of Health
GREEN VALLEY SKILLED NURSING AND REHABILITATION CENTER
Patient Care Inspection Results

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Severity Designations


Minimal Citation - No Harm	Minimal Harm	Actual Harm	Serious Harm

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GREEN VALLEY SKILLED NURSING AND REHABILITATION CENTER - Inspection Results	Scope of Citation Number of Residents Affected By Deficient Practice

Initial comments:

Based on an Abbreviated Complaint survey completed on September 24, 2024, at Green Valley Skilled Nursing and Rehabilitation Center it was determined there were no deficiencies cited under the requirements of 42 CFR Part 483 Subpart B Requirements for Long Term Care Facilities, but the facility was not in compliance with the 28 PA Code Commonwealth of Pennsylvania Long Term Care Licensure Regulations.

Plan of Correction:

§ 201.14(c) LICENSURE Responsibility of licensee.:

(c) The licensee through the administrator shall report as soon as possible, or, at the latest, within 24 hours to the appropriate Division of Nursing Care Facilities field office serious incidents involving residents as set forth in § 51.3 (relating to notification). For purposes of this subpart, references to patients in § 51.3 include references to residents.

Observations:

Based on observation and staff interview, it was determined the facility failed to report confirmed cases of COVID-19 within 24 hours of positives results to the State Licensing Agency, Department of Health, Division of Regulatory Oversight and Nursing Care Facilities.

Findings include:

Review of the Division of Regulatory Oversight and Nursing Care Facilities Message Board revealed a posted message dated August 12, 2024, related to LTCFs reporting of COVID-19 Outbreak noted the following:

Facilities are not required to report every new case of COVID-19 once an outbreak is identified. Only an initial report of a new outbreak, occurring greater than 14 days following the detection of the most recent case, should be made. A summary of COVID-19 data reporting is included under the Reporting Requirements and Recommendations section of the COVID-19 LTC Toolkit.

A review of the "Reporting Requirements and Recommendations" provided on page 41 of the COVID-19 Infection Control and Outbreak Response Toolkit for Long-Term Care published July 2023. Version 1.1 February 2024,
Table 8. Summary of Data Reporting for COVID-19, revealed that information about staff and residents that test positive for COVID-19 is to be reported through the Nursing Care Facilities Event Reporting System as needed and within 24 hours after diagnosis.

An outbreak is defined as one or more residents with a probable or confirmed case of COVID-19 acquired in the facility.

A staff outbreak is defined as one or more health care personnel with a probable or confirmed case of COVID-19 who was working in the facility while infectious

The facility census was 41 residents at the time of the survey ending September 24, 2024. A review of the facility's Respiratory Surveillance List revealed the facility had an outbreak of COVID-19 starting on August 16, 2024, with a facility resident.

Initially, the facility reported the outbreak of COVID-19 for the first resident, and again on August 30, 2024, for the first employee, however, had failed to timely report the continued outbreak of an additional 14 residents, and 9 additional employees who tested positive for COVID-19.

Interview with the Director of Nursing on September 24, 2024, at approximately 10:00 a.m. revealed the facility referred to a posted message dated August 12, 2024, titled "Messaging for LTCFs related to COVID-19 Outbreak", which stated that "facilities are not required to report every new case of COVID-19 once an outbreak is identified. Only an initial report of a new outbreak, occurring greater than 14 days following the detection of the most recent case, should be made".

The facility failed to review and/or adhere to the "Reporting Requirements and Recommendations section of the COVID-19 LTC Toolkit, version 1.1 February 2024,which was also referred to in the posted message dated August 12, 2024.

Interview with the Director of Nursing (DON) on September 24, 2024, at approximately 10:30 a.m. confirmed the facility failed to report confirmed cases of COVID-19 as required to the State Licensing Agency, PA Department of Health, Division of Regulatory Oversight and Nursing Care Facilities via the Nursing Care Facilities Event Reporting System.

Plan of Correction - To be completed: 10/05/2024

The facility reported the remaining unreported COVID cases to the Department on September 24, 2024.

No additional residents were affected by this issue.

The DON and NHA have reviewed the Covid-19 LTC toolkit and reviewed the instruction on Page 41 related to reporting new COVID cases timely.

The NHA or designee will audit new covid cases monthly to ensure that any new cases for residents or staff are reported to DOH on a timely basis. This audit will be completed weekly for two weeks and then monthly for three months and will be reviewed at that time. Findings will be submitted to the quality assurance committee for review and comment.

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