Nursing Investigation Results -

Pennsylvania Department of Health
Patient Care Inspection Results

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Severity Designations

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Minimal Citation - No Harm Minimal Harm Actual Harm Serious Harm
Inspection Results For:

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RIVERSIDE CARE CENTER - Inspection Results Scope of Citation
Number of Residents Affected
By Deficient Practice
Initial comments:
Based on an Abbreviated Survey in response to two complaints completed on November 22, 2019, it was determined that Riverside Care Center had deficiencies that have the potential for minimal harm to residents as related to the 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.

 Plan of Correction:

483.10(g)(14)(i)-(iv)(15) REQUIREMENT Notify of Changes (Injury/Decline/Room, etc.):Least serious deficiency and is isolated to the fewest number of residents, staff, or occurrences. This deficiency has the potential for causing no more than a minor negative impact on the resident.
483.10(g)(14) Notification of Changes.
(i) A facility must immediately inform the resident; consult with the resident's physician; and notify, consistent with his or her authority, the resident representative(s) when there is-
(A) An accident involving the resident which results in injury and has the potential for requiring physician intervention;
(B) A significant change in the resident's physical, mental, or psychosocial status (that is, a deterioration in health, mental, or psychosocial status in either life-threatening conditions or clinical complications);
(C) A need to alter treatment significantly (that is, a need to discontinue an existing form of treatment due to adverse consequences, or to commence a new form of treatment); or
(D) A decision to transfer or discharge the resident from the facility as specified in 483.15(c)(1)(ii).
(ii) When making notification under paragraph (g)(14)(i) of this section, the facility must ensure that all pertinent information specified in 483.15(c)(2) is available and provided upon request to the physician.
(iii) The facility must also promptly notify the resident and the resident representative, if any, when there is-
(A) A change in room or roommate assignment as specified in 483.10(e)(6); or
(B) A change in resident rights under Federal or State law or regulations as specified in paragraph (e)(10) of this section.
(iv) The facility must record and periodically update the address (mailing and email) and phone number of the resident

Admission to a composite distinct part. A facility that is a composite distinct part (as defined in 483.5) must disclose in its admission agreement its physical configuration, including the various locations that comprise the composite distinct part, and must specify the policies that apply to room changes between its different locations under 483.15(c)(9).

Based on review of facility policy, clinical records and staff interview, it was determined that the facility failed to make certain that the resident representative was notified of an accident for one of seven residents (Resident R2).

Findings include:

The facility policy "Family Notification" last reviewed 8/2/19, indicated that the facility was to notify the resident representative of any significant change in resident status/condition to include but not limited to decline in condition, health and unusual incident/accident.

Review of the clinical record progress notes dated 10/7/19, indicated Resident R2's roommate's dialysis fistula (access site used to perform dialysis) malfunctioned and blood sprayed on Resident R2 and throughout the room.

Review of the clinical record did not include any notification of the accident to Resident R2's resident representative.

During an interview on 11/20/19, at 3:15 p.m. the Director of Nursing confirmed that Resident R2's resident representative was not notified of the accident on 10/7/19.

28 Pa. Code 211.12(d)(3)(5) Nursing services.

 Plan of Correction - To be completed: 12/12/2019

I hereby acknowledge the CMS 2567-A, issued to RIVERSIDE CARE CENTER for the survey ending 11/22/2019, AND attest that all deficiencies listed on the form will be corrected in a timely manner.

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