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

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Severity Designations


Minimal Citation - No Harm	Minimal Harm	Actual Harm	Serious Harm

There are 13 surveys for this facility. Please select a date to view the survey results.

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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:Name: - Component: -- - Tag: 0000

Based on an Emergency Preparedness Survey completed on March 11, 2024, at Green Valley Skilled Nursing 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: NEW FACILITY - Component: 10 - Tag: 0000

Facility ID #061502
Component 10
Main Building

Based on a Medicare/Medicaid Recertification Survey completed on March 11, 2024, it was determined that Green Valley Skilled Nursing and Rehabilitation Center was not in compliance with the following requirements of the Life Safety Code for a new 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 (111), protected wood frame structure, with an attic, which is fully sprinklered.

Plan of Correction:

NFPA 101 STANDARD Means of Egress - General:

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.

Means of Egress - General
Aisles, passageways, corridors, exit discharges, exit locations, and accesses are in accordance with Chapter 7, and the means of egress is continuously maintained free of all obstructions to full use in case of emergency, unless modified by 18/19.2.2 through 18/19.2.11.
18.2.1, 19.2.1, 7.1.10.1

Observations:
Name: NEW FACILITY - Component: 10 - Tag: 0211

Based on observation and interview, it was determined the facility failed to maintain exit access to be free of obstructions to full use in the event of an emergency, in two of three smoke compartments within the component.

Findings include:

1. Observation on March 11, 2024, between 12:05 PM and 1:15 PM, revealed the following obstructed corridors:

a. 12:05 PM, 3 soiled/trash containers were stored in Resident Room 101;
b. 12:35 PM, 3 soiled/trash containers were stored in Resident Room 202;
c. 12:35 PM, 3 soiled/trash containers were stored in Resident Room 306;
d. 1:00 PM, 3 soiled/trash containers were stored in Resident Room 403.

Interview at the time of the exit conference with the Administrator, Director of Maintenance on March 11, 2024, at 1:30 PM, confirmed the egress corridor storage.

Plan of Correction - To be completed: 04/09/2024

The facility stored the 3 bin soiled/trash containers in the dirty utility room.

The maintenance director and NHA toured the facility to ensure no other hazards were blocking egress from the facility.

Facility nursing staff will be reeducated to the requirement that carts must be stored in a proper location when not in use. Proper storage locations will be identified.

The maintenance director or designee will audit the hallways two times per week to ensure that the hallways remain clear of items that would block the egress in an emergency. Findings will be submitted to the quality assurance committee for review and input.

Plan of correction will be completed by April 9, 2024

NFPA 101 STANDARD Hazardous Areas - Enclosure:

Hazardous Areas - Enclosure
2012 New
Hazardous areas are protected in accordance with 18.3.2.1. The areas shall be enclosed with a 1-hour fire-rated barrier, with a 3/4-hour fire-rated door without windows (in accordance with 8.7.1.1). Doors shall be self-closing or automatic-closing in accordance with 7.2.1.8. Hazardous areas are protected by a sprinkler system in accordance with 9.7, 18.3.2.1, and 8.4.
Describe the floor and zone locations of hazardous areas that are deficient in REMARKS.
18.3.2.1, 7.2.1.8, 8.4, 8.7, 9.7

Area Automatic Sprinkler Separation N/A
a. Boiler and Fuel-Fired Heater Rooms
b. Laundries (larger than 100 square feet)
c. Repair, Maintenance, and Paint Shops
d. Soiled Linen Rooms (exceeding 64 gallons)
e. Trash Collection Rooms
(exceeding 64 gallons)
f. Combustible Storage Rooms/Spaces
(over 50 and less than 100 square feet)
g. Combustible Storage Rooms/Spaces
(over 100 square feet)
h. Laboratories (if classified as Severe
Hazard - see K322)

Observations:
Name: NEW FACILITY - Component: 10 - Tag: 0321

Based on observation and interview, it was determined the facility failed to maintain hazardous area doors to be self-closing, affecting one of three smoke compartments within the component.

Findings include:

1. Observation on March 11, 2024, at 11:45 AM, revealed the Kitchen Dry Storage Room door, with a fire-rating label, was held open with cardboard wedge under the door.

Interview at the time of the exit conference with the Administrator, Director of Maintenance on March 11, 2024, at 1:30 PM, confirmed the fire-rated door was wedged open.

Plan of Correction - To be completed: 04/09/2024

The maintenance director immediately removed the cardboard wedge from blocking the door.

The maintenance director and NHA toured the facility to ensure no other doors were being blocked open by inappropriate means.

The dietary staff will be reeducated to the need to ensure fire doors are closed or have the means to close on their own. They will be reeducated to the requirement to not block doors open.

The maintenance director or designee will audit the kitchen two times per week to ensure that fire doors are closed or have the ability to close during an emergency. Findings will be submitted to the quality assurance committee for review and input.

Plan of correction date is April 9, 2024

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