Nursing Investigation Results -

Pennsylvania Department of Health
MANORCARE HEALTH SERVICES-MONROEVILLE
Patient Care Inspection Results

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MANORCARE HEALTH SERVICES-MONROEVILLE
Inspection Results For:

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MANORCARE HEALTH SERVICES-MONROEVILLE - Inspection Results Scope of Citation
Number of Residents Affected
By Deficient Practice
Initial comments:
Based on an Abbreviated Survey in response to a complaint completed on September 19, 2019, it was determined that Manorcare Health Services- Monroeville 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 related to the health portion of the survey process.












 Plan of Correction:


483.10(i)(1)-(7) REQUIREMENT Safe/Clean/Comfortable/Homelike Environment: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.
483.10(i) Safe Environment.
The resident has a right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

The facility must provide-
483.10(i)(1) A safe, clean, comfortable, and homelike environment, allowing the resident to use his or her personal belongings to the extent possible.
(i) This includes ensuring that the resident can receive care and services safely and that the physical layout of the facility maximizes resident independence and does not pose a safety risk.
(ii) The facility shall exercise reasonable care for the protection of the resident's property from loss or theft.

483.10(i)(2) Housekeeping and maintenance services necessary to maintain a sanitary, orderly, and comfortable interior;

483.10(i)(3) Clean bed and bath linens that are in good condition;

483.10(i)(4) Private closet space in each resident room, as specified in 483.90 (e)(2)(iv);

483.10(i)(5) Adequate and comfortable lighting levels in all areas;

483.10(i)(6) Comfortable and safe temperature levels. Facilities initially certified after October 1, 1990 must maintain a temperature range of 71 to 81F; and

483.10(i)(7) For the maintenance of comfortable sound levels.
Observations:
Based on observations, review of resident concern logs and resident and staff interviews, it was determined that the facility failed to provide a clean and comfortable environment for residents on two of three nursing units (first and second floor nursing unit).

Findings include:

During observations on the first floor nursing unit on 9/19/19, from 9:05 a.m. through 9:30 a.m. revealed the following:
- Room 107 - a soiled brief in the trash can, sticky floor
- Room 110 - discolored, stained grout around base of toilet, no trash can liner
- Room 105 - discolored, stained grout around base of toilet
- Room 103 - feces on toilet seat, confirmed at 9:18 a.m. by Licensed Practical Nurse (LPN) Employee E1.
- Room 125 - discolored, stained grout around base of toilet, floor dirty, confirmed at 9:29 a.m. by LPN Employee E2.

During observations on the second floor nursing unit on 9/19/19, from 9:30 a.m. through 9:50 a.m. revealed the following:
- Room 233 - discolored, stained grout around base of toilet, floor dirty, confirmed at 9:40 a.m. by Nurse Aid (NA) Employee E3.
- Room 231 -discolored, stained grout around base of toilet, floor dirty, confirmed at 9:42 a.m. by NA Employee E3.

Review of the facility Concern Log for September 2019, indicated that a concern raised by multiple residents on 9/9/19, stated "residents on East wing (rooms 120-134) stating floors not getting mopped, trash not being emoted, bathrooms not getting cleaned."

During an interview on 9/19/19, at 9:25 a.m. Resident R2 stated that her bathroom is not adequately cleaned and the floor is often dirty or sticky.

During an interview on 9/19/19, at 9:35 a.m. Resident R3 stated that her bathroom is not adequately cleaned by staff.

During an interview on 9/19/19, at 9:38 a.m. Resident R1 stated that his bathroom is not adequately cleaned, the floor is often dirty and trash cans are not emptied by staff.

During an interview on 9/19/19, at 10:50 a.m. the Nursing Home Administrator confirmed that the resident bathrooms listed above were not cleaned adequately by housekeeping personnel.


28 Pa. Code 207.2(a) Administrator's responsibility.
Previously cited 3/29/19, 5/20/19, 8/23/19.


 Plan of Correction - To be completed: 10/29/2019


The statements made on this plan of correction are not an admission to and do not constitute an agreement with the alleged deficiencies herein. To remain in compliance with all federal and state regulations, the center has taken or is planning take the actions set forth in the following plan of correction. The following plan of correction constitutes the center's allegation of compliance. All alleged deficiencies cited have been or are to be corrected by the date indicated.
Residents R1, R2, and R3 will be interviewed by Nursing Home Administrator/ designee to determine if they have concern with resident bathroom cleanliness and a concern form will be initiated if so. Identified bathrooms will be cleaned and the grout will be cleaned or replaced.
A comprehensive audit using the Environmental Observations QAPI tool will be conducted of the remainder of resident rooms to identify any further Environmental concerns. Any issues identified on the audit will be corrected.
Current Center Staff and new hires as they pertain to these departments will be educated on the Housekeeping Manual for Standard and Policies for waste removal, resident rooms, and bathing/ toilets by the Administrator/ designee. Maintenance will be notified of issues using the TELS system.
7 environmental observation room audits will be completed weekly x 4 and monthly x 2 by the Nursing Home Administrator/ designee to ensure deficient practice does not recur. Results of the audits will be submitted to the QA committee for review and recommendations.


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