Pennsylvania Department of Health
WHITEHALL BOROUGH SKILLED NURSING AND REHABILITATION CENTER
Patient Care Inspection Results

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WHITEHALL BOROUGH SKILLED NURSING AND REHABILITATION CENTER
Inspection Results For:

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WHITEHALL BOROUGH SKILLED NURSING AND REHABILITATION CENTER - Inspection Results Scope of Citation
Number of Residents Affected
By Deficient Practice
Initial comments:


Based on a Revisit survey completed on April 15, 2024, at Whitehall Borough Skilled Nursing and Rehab Center, it was determined that the facility has continued non-compliance with one licensure regulation according to the 28 PA Code, Commonwealth of Pennsylvania Long Term Care Licensure Regulations.




 Plan of Correction:


211.12(f.1)(2) LICENSURE Nursing services. :State only Deficiency.
(2) Effective July 1, 2023, a minimum of 1 nurse aide per 12 residents during the day, 1 nurse aide per 12 residents during the evening, and 1 nurse aide per 20 residents overnight.

Observations:


Based on review of nursing time schedules and staff interview, it was determined that the facility administrative staff failed to provide a minimum of one nursing assistant per twelve residents during the day shift for eight of 11 days (4/7/24 through 4/14/24), and for eight of 11 days on evening shift (4/4/24, 4/5/25 and 4/8/24 through 4/13/24 and 4/14/24) and one nursing assistant per 20 residents on night shift, for ten of 11 days (4/4/24 through 4/11/24 and 4/13/24 and 4/14/24).

Findings include:

Review of staffing ratios from 4/4/24 through 4/14/24 revealed the following for day shift:

4/7/24census 16191.55 actual hours 100.63 hours required.
4/8/24census 15898.21 actual hours98.75 hours required.
4/9/24census 15893.04 actual hours98.75 hours required.
4/10/24census 15898.49 actual hours98.75 hours required.
4/11/24census 16176.18 actual hours100.63 hours required.
4/12/24census 16196.99 actual hours100.63 hours required.
4/13/24census 15891.17 actual hours98.75 hours required.
4/14/24census 16099.02 actual hours100.00 hours required.

Review of staffing ratios from 4/4/24 through 4/14/24 revealed the following for evening shift:

4/4/24census 15997.65 actual hours99.38 hours required.
4/5/24census 16293.81 actual hours101.25 hours required.
4/8/24census 15859.57 actual hours98.75 hours required.
4/9/24census 15853.60 actual hours98.75 hours required.
4/10/24census 16095.42 actual hours100.00 hours required.
4/11/24census 16184.87 actual hours100.63 hours required.
4/12/24census 15888.29 actual hours98.75 hours required.
4/14/24census 15689.51 actual hours97.50 hours required.


Review of staffing rations from 4/4/24 through 4/14/24 revealed the following for night shift:

4/4//24census 16053.71 actual hours 60.00 hours required.
4/5/24census 16258.71 actual hours60.75 hours required.
4/6/24census 16159.88 actual hours60.38 hours required.
4/7/24census 15846.41 actual hours59.25 hours required.
4/8/24census 15854.65 actual hours59.25 hours required.
4/9/24census 15854.14 actual hours59.25 hours required.
4/10/24census 16154.68 actual hours60.38 hours required.
4/11/24census 16156.16 actual hours60.38 hours required.
4/13/24census 16045.39 actual hours60.00 hours required.
4/14/24census 15651.44 actual hours58.50 hours required.

No additional excess higher-level staff were available to compensate for this deficiency.

During an interview on 4/15/24, at 3:36 p.m. the Nursing Home Administrator confirmed that the facility failed to meet the required nurse aide ratios as stated above.


 Plan of Correction - To be completed: 05/16/2024

There were no adverse effects to the residents of our facility as a result of decreased nursing assistant staffing ratios on the stated days.

A hall on Medbridge unit of 8 beds has been temporarily closed allowing for more condensed staff assignments and increased nursing assistant ratios.

The facility's RN Nurse Educator or designee will provide education to the Administrator, Director of Nursing, Assistant Director of Nursing, Human Resources and Scheduler on Pennsylvania requirements for nursing HPPD and nursing assistant ratios.

The facility has increased the number of external nursing assistant agency contracts and is using internal nursing assistant agency staff to supplement open shifts. To ensure appropriate staffing levels, staffing meetings will be held 5 days a week to review HPPD and nursing assistant ratios for prior, current and next day. If daily review does not meet state minimum staffing requirements, the facility will not take admissions.

Audits of nursing assistant ratios will be completed weekly x4 by the Administrator or designee to ensure the facility meets the state minimum staffing ratios. Results of the audits will be forwarded to our QAPI committee for review and recommendations.


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