Pennsylvania Department of Health
SENA KEAN NURSING AND REHABILITATION
Patient Care Inspection Results

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Severity Designations


Minimal Citation - No Harm	Minimal Harm	Actual Harm	Serious Harm

SENA KEAN NURSING AND REHABILITATION
Inspection Results For:

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SENA KEAN NURSING AND REHABILITATION - Inspection Results	Scope of Citation Number of Residents Affected By Deficient Practice

Initial comments:

Based on a Medicare/Medicaid Recertification, State Licensure, and Civil Rights Compliance Survey completed on April 22, 2026, it was determined that Sena Kean Nursing and Rehabilitation Center was not in compliance with the following requirements of 42 CFR Part 483, Subpart B, Requirements for Long Term Care and the 28 PA Code, Commonwealth of Pennsylvania Long Term Care Licensure Regulations.\~

Plan of Correction:

483.10(f)(5)(i)-(iv)(6)(7) REQUIREMENT Resident/Family Group and Response:

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(f)(5) The resident has a right to organize and participate in resident groups in the facility.
(i) The facility must provide a resident or family group, if one exists, with private space; and take reasonable steps, with the approval of the group, to make residents and family members aware of upcoming meetings in a timely manner.
(ii) Staff, visitors, or other guests may attend resident group or family group meetings only at the respective group's invitation.
(iii) The facility must provide a designated staff person who is approved by the resident or family group and the facility and who is responsible for providing assistance and responding to written requests that result from group meetings.
(iv) The facility must consider the views of a resident or family group and act promptly upon the grievances and recommendations of such groups concerning issues of resident care and life in the facility.
(A) The facility must be able to demonstrate their response and rationale for such response.
(B) This should not be construed to mean that the facility must implement as recommended every request of the resident or family group.

§483.10(f)(6) The resident has a right to participate in family groups.

§483.10(f)(7) The resident has a right to have family member(s) or other resident representative(s) meet in the facility with the families or resident representative(s) of other residents in the facility.

Observations:

Based on review of facility policy, Resident Council minutes, and resident interviews, it was determined that the facility failed to ensure that residents were updated in a timely manner regarding Resident Council concerns, and the facility failed to correct Resident Council concerns for a period of four months (January 2026, through April 2026).

Findings include:

A facility policy "Resident Council" dated 1/12/26, revealed the facility supports residents' rights to organize and participate in the resident council. The purpose of the resident council is to provide a forum for a) residents, families and resident representatives to have input in the operation of the facility; b) discussion of concerns and suggestions for improvement; c) consensus building and communication between residents and facility staff; and d) disseminating information and gathering feedback from interested residents." A Resident Council Response Form will be utilized to track issues and their resolution. The facility department related to any issues will be responsible for addressing the item(s) of concern. The quality assurance and performance improvement (QAPI) committee will review information and feedback from the resident council as part of their quality review. Issues documented on council response forms may be referred to the QAPI committee, if applicable.

Review of the Resident Council minutes over the past three months, February 2026, through April 2026, revealed a pattern/trend with issues regarding staff shutting call lights off without meeting resident's needs, failure to follow the facility smoking plan to assist residents who desire to smoke, and dietary trays not being passed by nursing staff timely resulting in cold food for residents.

During a Resident Council meeting on 4/20/26, at 10:00 a.m. interviews with Residents R72, Resident R89, Resident R90, Resident 95, and Resident R86, who all attend Resident Council meetings regularly indicated that the concerns noted above have been voiced in several past monthly meetings with no resolution. The residents further indicated awaiting until the next monthly Resident Council meeting was not a timely response to learn of facility resolutions.

No evidence was provided to ensure the residents' concerns voiced and further stated in the Resident Council minutes for the past three months reviewed were noted of timely corrective actions, in addition to the residents being updated in a timely manner of those actions.

28 Pa. Code 201.14 (a) Responsibility of licensee

28 Pa. Code 201.18 (e)(1)(4) Management

28 Pa. Code 201.29(a) Resident rights

Plan of Correction - To be completed: 06/09/2026

Preparation and/or execution of this plan of correction does not constitute an admission or agreement by the provider of the truth of the facts alleged or conclusions set forth in the statement of deficiencies. The plan of correction is prepared and/or executed solely because it is required by the provisions of Federal and State Law. The plan of correction represents the facility's credible allegation of compliance.

Resident council concerns from February, March, and April have been addressed through staff education and reviewed with the council president.

Facility procedure has been updated to include resolving council concerns and reporting the resolutions to the council president within 7 days of the resident council meeting.

Facility staff responsible for guiding resident council were educated on the change in procedure on 4/28/2026.

Facility Nursing Home Administrator or designee will audit resident council minutes to ensure resolution to council concerns are presented to the council president within 7 days of the meeting monthly for three (3) months.

Results of audits will be reviewed with the Quality Assurance Performance Improvement (QAPI) Committee

§483.35(a)(1)(2) REQUIREMENT Sufficient Nursing Staff:

§483.35 Nursing Services.

The facility must have sufficient nursing staff with the appropriate competencies and skills sets to provide nursing and related services to assure resident safety and attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident, as determined by resident assessments and individual plans of care and considering the number, acuity, and diagnoses of the facility's resident population in accordance with the facility assessment required at §483.71.

§483.35(a) Sufficient Staff.

§483.35(a)(1) The facility must provide services by sufficient numbers of each of the following types of personnel on a 24-hour basis to provide nursing care to all residents in accordance with resident care plans:

(i) Except when waived under paragraph (e) of this section, licensed nurses; and

(ii) Other nursing personnel, including but not limited to nurse aides.

§483.35(a)(2) Except when waived under paragraph (e) of this section, the facility must designate a licensed nurse to serve as a charge nurse on each tour of duty.

Observations:

Based on review of facility policy and resident observations, and staff interviews, it was determined that the facility failed to have sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable physical, mental, and psychosocial well-being for seven of 23 residents (Residents R15, R23, R28, R38, R54, R82, and R83).

Findings include:

A facility policy entitled "Cleaning of Wheelchairs and Geri-chairs" dated 1/12/26, indicated that wheelchairs are cleaned according to the resident's shower schedule on the 11:00 p.m. 7:00 a.m. shift prior to the shower day.

Observations on 4/19/26, between 2:00 p.m. and 4:30 p.m. and 4/20/26, between 9:00 a.m. and 2:30 p.m. revealed that Residents R15, R23, R28, R38, R54, R82, and R83's wheelchairs with copious amounts of dried food particles, dried liquids, accumulation of dust and dirt, and debris on frames, wheels, arm rests, seats, seat cushions, and leg rests.

During an interview on 4/21/26, at 10:41 a.m. Registered Nurse RN Employee E6 confirmed the condition of the above wheelchairs were as stated.

During an interview on 4/22/26, at 9:41 a.m. the Nursing Home Administrator confirmed that the wheelchairs were to be cleaned on the overnight shift by nursing staff, and that they frequently failed to maintain adequate staff on that shift, and that could have contributed to failure to clean the wheelchairs.

28 Pa. Code 201.14(a) Responsibility of licensee

28 Pa. Code 201.18(b)(1)(3) Management

28 Pa. Code 211.12(d)(1)(5)(f.1)(3) Nursing services

Plan of Correction - To be completed: 06/09/2026

The wheelchairs for residents R15, R23, R28, R38, R54, R82, and R83 have been cleaned.

A one-time audit of 100% of facility wheelchairs has been completed with those noted to be found with dried food particles, dried liquids, dust and dirt, and debris on frames, wheels, arm rests, seats, seat cushions, and leg rests being thoroughly cleaned.

Current Nurse Aide staff will be re-educated on 5/15/2026 on the facility policy entitled "Cleaning of Wheelchairs and Geri-chairs" with emphasis that wheelchairs are to be cleaned on the 11:00p – 7:00a shift prior to the resident's shower day. The education has been added to the agency orientation.

A wheelchair cleaning task will be added to Nurse Aide documentation for each resident's shower day.

Facility Director of Nursing or designee will audit 4 resident wheelchairs post shower to ensure the wheelchair has been properly cleaned for five (5) days, weekly for three (3) weeks, monthly for two (2) months.

Results of audits will be reviewed with the Quality Assurance Performance Improvement (QAPI) Committee

483.25(i) REQUIREMENT Respiratory/Tracheostomy Care and Suctioning:

§ 483.25(i) Respiratory care, including tracheostomy care and tracheal suctioning.
The facility must ensure that a resident who needs respiratory care, including tracheostomy care and tracheal suctioning, is provided such care, consistent with professional standards of practice, the comprehensive person-centered care plan, the residents' goals and preferences, and 483.65 of this subpart.

Observations:

Based on review of facility policy, clinical records, observations, and staff interviews it was determined that the facility failed to appropriately maintain supplemental oxygen equipment for four of 23 residents reviewed for respiratory services (Residents R54, R38, R92, and R60).

Findings include:

A facility policy entitled "Oxygen" dated 1/12/26, indicated that any tubing not in use will be placed in a bag to ensure tubing remains clean and dry.

Observations on 4/19/26, revealed:

-At 3:20 p.m. Resident R38's oxygen tubing hanging on the portable oxygen tank attached to the back of his/her wheelchair and the tubing not in a bag, and the tubing for his/her respiratory nebulizer machine lying on the floor.
-At 3:25 p.m. Resident R54's oxygen tubing lying next to his/her bed on the floor and not in a bag.
-At 3:33 p.m. Licensed Practical Nurse (LPN) Employee E3 picked Resident R38's respiratory nebulizer tubing up from the floor then attached the tubing to Resident R38's nebulizer mask and was going to administer an as needed medicated nebulizer treatment.

During an interview at that time Registered Nurse (RN) Employee E2 confirmed that Resident R38's oxygen and nebulizer tubing should be stored in a bag and should be discarded.

During an interview at 3:35 p.m. RN Employee E2 confirmed that Resident R54's oxygen tubing should be stored in a plastic bag to prevent contamination.

Observations on 4/20/26, revealed:

-At 9:40 a.m. Resident R92 with a clear bag hanging on his/her concentrator [medical device that pulls oxygen in, filters it, and delivers purified oxygen to patients], and his/her oxygen tubing for the portable tank attached to the back of his/her wheelchair hanging over the top of the portable tank on the back of the wheelchair.
-At 9:45 a.m. Resident R60's supplemental oxygen tubing for the portable tank wrapped around the right wheel of his/her wheelchair and required cutting to release it.

-During an interview at that time, LPN Employee E4 confirmed the above-mentioned observations and cut Resident R60's oxygen tubing from the wheel of his/her wheelchair.

Observations on 4/21/26, revealed:

-At 10:38 a.m. Resident R38's oxygen tubing for the portable tank attached to the back of his/her wheelchair hanging over the top of the portable tank on the back of the wheelchair.
-At 10:41 a.m. Resident R54's oxygen tubing for the portable tank attached to the back of his/her wheelchair hanging over the top of the portable tank on the back of the wheelchair.

During an interview at 10:45 a.m. RN Employee E5 confirmed the above-mentioned observations and that the oxygen tubing should be stored in a bag to prevent contamination.

28 Pa. Code 211.12(d)(1)(5) Nursing services

Plan of Correction - To be completed: 06/09/2026

Oxygen tubing for resident's R38, R54, R92, and R60 have been placed in bags.

A one-time audit of 100% of residents utilizing supplemental oxygen equipment has been performed to ensure that no oxygen tubing is left not stored in a plastic bag, with corrections made as necessary.

Current licensed staff will be re-educated on 5/15/2026 on the facility policy entitled "Oxygen" with emphasis on storing oxygen tubing in a bag to prevent contamination. The education has been added to agency orientation.

Facility Director of Nursing or designee will audit 4 residents utilizing supplemental oxygen to ensure that no oxygen tubing is left not stored in a plastic bag for five (5) days, weekly for three (3) weeks, monthly for two (2) months.

Results of audits will be reviewed with the Quality Assurance Performance Improvement (QAPI) Committee

483.10(h)(1)-(3)(i)(ii) REQUIREMENT Personal Privacy/Confidentiality of Records:

This is a less serious (but not lowest level) deficiency and is isolated to the fewest 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.

§483.10(h) Privacy and Confidentiality.
The resident has a right to personal privacy and confidentiality of his or her personal and medical records.

§483.10(h)(l) Personal privacy includes accommodations, medical treatment, written and telephone communications, personal care, visits, and meetings of family and resident groups, but this does not require the facility to provide a private room for each resident.

§483.10(h)(2) The facility must respect the residents right to personal privacy, including the right to privacy in his or her oral (that is, spoken), written, and electronic communications, including the right to send and promptly receive unopened mail and other letters, packages and other materials delivered to the facility for the resident, including those delivered through a means other than a postal service.

§483.10(h)(3) The resident has a right to secure and confidential personal and medical records.
(i) The resident has the right to refuse the release of personal and medical records except as provided at §483.70(h)(2) or other applicable federal or state laws.
(ii) The facility must allow representatives of the Office of the State Long-Term Care Ombudsman to examine a resident's medical, social, and administrative records in accordance with State law.

Observations:

Based on review of facility policy, observations and staff interview, it was determined that the facility failed to maintain privacy of confidential information during medication administration for two of five medication carts (West A Cart and East A Cart).

Findings include:

A facility policy entitled "Computer Terminals/Workstations" dated 1/12/26, indicated in so far as practical/feasible, computer terminals/workstations will be positioned or shielded so that screen are not visible to the public or to unauthorized staff; only authorized users are granted access to resident and facility information; and a user may not leave his/her workstations or terminal unattended unless the terminal screen is cleared and the user if logged off.

Observation on 4/19/26, at 3:55 p.m. revealed the West A medication cart was parked in West A hallway and was unattended with the computer screen containing resident information visible to anyone passing by in the corridor.

During an interview at the time of the observation, Licensed Practical Nurse (LPN) Employee E1 acknowledged the lack of privacy with resident information on the computer screen.

Observation on 4/20/26, at 8:35 a.m. revealed the East A medication cart was parked in East A hallway and was unattended with the computer screen containing resident information visible to anyone passing by in the corridor.

During an interview at the time of the observation, LPN Employee E5 acknowledged the lack of privacy with resident information on the computer screen.

28 Pa. Code 211.12(d)(1)(2)(5) Nursing services

Plan of Correction - To be completed: 06/09/2026

Employees E1 and E5 have been re-educated on the facility policy entitled "Computer Terminals/Workstations".

A one-time audit of 100% of workstations/terminals has been performed to ensure that no unattended computers were left displaying resident information.

Current licensed staff will be re-educated on 5/15/2026 on the facility policy entitled "Computer Terminals/Workstations" with emphasis on not leaving workstations or terminals unattended unless the terminal screen is cleared and the user is logged off. The education has been added to the agency orientation.

Facility Director of Nursing or designee will audit 3 direct care workstations/terminals per shift (ensuring at least 1 workstation on each unit) to ensure that those left unattended have had the screens cleared and the user is logged off for five (5) days, weekly for three (3) weeks, monthly for two (2) months.

Results of audits will be reviewed with the Quality Assurance Performance Improvement (QAPI) Committee

483.45(g)(h)(1)(2) REQUIREMENT Label/Store Drugs and Biologicals:

§483.45(g) Labeling of Drugs and Biologicals
Drugs and biologicals used in the facility must be labeled in accordance with currently accepted professional principles, and include the appropriate accessory and cautionary instructions, and the expiration date when applicable.

§483.45(h) Storage of Drugs and Biologicals

§483.45(h)(1) In accordance with State and Federal laws, the facility must store all drugs and biologicals in locked compartments under proper temperature controls, and permit only authorized personnel to have access to the keys.

§483.45(h)(2) The facility must provide separately locked, permanently affixed compartments for storage of controlled drugs listed in Schedule II of the Comprehensive Drug Abuse Prevention and Control Act of 1976 and other drugs subject to abuse, except when the facility uses single unit package drug distribution systems in which the quantity stored is minimal and a missing dose can be readily detected.

Observations:

Based on review of facility policy, observations and staff interview, it was determined that the facility failed to prevent the opportunity for potential unauthorized access of medications on two of five medication carts (East A Cart and West B Cart).

Findings include:

A facility policy entitled "Medication Labeling and Storage" dated 1/12/26, indicated that compartments (including, but not limited to, drawers, cabinets, rooms, refrigerators, carts, and boxes) containing medications and biologicals are locked when not in use, and trays or carts used to transport such items are not left unattended if open or otherwise potentially available to others.

Observation on 4/19/26, at 3:51 p.m. revealed the West B Medication Cart was parked in the West B hallway unlocked and unattended.

During an interview at 3:55 p.m. Licensed Practical Nurse (LPN) Employee E1 confirmed that the medication cart should have been locked.

Observation on 4/20/26, at 8:35 a.m. revealed the East A Medication Cart was parked in the East A hallway unlocked and unattended.

During an interview at that time, LPN Employee E5 verified the cart was not secured while he/she left the cart to attend to a resident.

28. Pa. Code 201.18(b)(1) Management

28 Pa. Code 211.12(d)(1) Nursing services

Plan of Correction - To be completed: 06/09/2026

Employees E1 and E5 have been re-educated on the facility policy entitled "Medication Labeling and Storage".

A one-time audit of 100% of medication carts has been completed to ensure all drawers were locked while unattended.

Current licensed staff will be re-educated on 5/15/2026 on the facility policy entitled "Medication Labeling and Storage" with emphasis on compartments containing medications and biologicals are locked when not in use and left unattended. The education has been added to agency orientation.

Facility Director of Nursing or designee will audit 2 medication carts per shift (1 on each unit) to ensure they are not left unlocked while unattended for five (5) days, weekly for three (3) weeks, monthly for two (2) months.

Results of audits will be reviewed with the Quality Assurance Performance Improvement (QAPI) Committee

§ 211.12(i)(2) LICENSURE Nursing services.:

(2) Effective July 1, 2024, the total number of hours of general nursing care provided in each 24-hour period shall, when totaled for the entire facility, be a minimum of 3.2 hours of direct resident care for each resident.

Observations:

Based on review of facility nursing staffing documents and staff interview, it was determined that the facility failed to provide the minimum number of general nursing care hours of 3.2 hours of direct resident care hours per resident in a twenty-four-hour period for six of 21 days reviewed (4/01/26, through 4/11/26).

Findings include:

Review of facility nursing staffing documents for the time period from 4/01/26 through 4/11/26, revealed that the hours of direct resident care were below the required 3.2 minimum per patient day (PPD) on the following days:

4/04/26 PPD 3.15
4/05/26 PPD 3.01
4/11/26 PPD 3.16
4/12/26 PPD 3.15
4/18/26 PPD 3.14
4/19/26 PPD 3.02

During an interview on 4/22/26, at 11:21 a.m. the Nursing Home Administrator confirmed that the facility did not meet the 3.2 minimum hours of direct resident care on the above dates.

Plan of Correction - To be completed: 06/09/2026

The facility is unable to retroactively correct the state general nursing hours for 4/4/2026, 4/5/2026, 4/11/2026, 4/12/2026, 4/18/2026, and 4/19/2026.

The facility will schedule nursing staff to the state required general direct care nursing hours per patient day (ppd) of 3.2.

Nursing Home Administrator (NHA) or designee will educate the scheduling coordinator on 5/11/2026 on the requirements of the state ppd of 3.2.

The facility is currently interviewing for the next nurse aide class, scheduled for 6/1/2026.

The facility is offering a sign-on bonus to assist with hiring additional NAs as well as a referral bonus to current staff to encourage assistance with recruitment.

The facility is utilizing four (4) separate staffing agencies to supplement facility staffing.

Call outs will be monitored by Nursing Home Administrator/Director of Nursing and/or designee. Staff will be offered bonuses and staffing agencies will be utilized to facilitate replacement/procurement of staff. A centralized staffing center will be utilized to assist with sourcing staff for call outs.

Audits of direct care nursing staff schedules will be completed by the NHA/designee to ensure the facility is meeting the required number of hours of general nursing care hours per patient day for five (5) days, weekly for three (3) weeks, monthly for two (2) months.

Results of audits will be reviewed with the Quality Assurance Performance Improvement (QAPI) Committee

35 P. S. § 448.809b LICENSURE Photo Id Reg:

Law amended July 11, 2022 Act 79 2022 HB 2604

(1) The photo identification tag shall include a recent
photograph of the employee, the employee's first name, the
employee's title and the name of [the health care facility or
employment agency.] any of the following:
(i) The health care facility.
(ii) The health system.
(iii) The employment agency.
(iv) The fictitious name of an entity under
subparagraph (i), (ii) or (iii) which is registered with
the Department of State under 54 Pa.C.S. Ch. 3 (relating
to fictitious names) or a successor statute.

(2) The title of the employee shall be as large as possible
in block type and shall occupy a one-half inch tall strip as
close as practicable to the bottom edge of the badge.

(3) Titles shall be as follows:
(i) A Medical Doctor shall have the title "Physician."
(ii) A Doctor of Osteopathy shall have the title
"Physician."
(iii) A Registered Nurse shall have the title
"Registered Nurse."
(iv) A Licensed Practical Nurse shall have the title
"Licensed Practical Nurse."
(v) All other titles shall be determined by the
department. Abbreviated titles may be used when the title
indicates licensure or certification by a Commonwealth
agency.

(4)A notation, marker or indicator included on an identification badge that differentiates employees with the same first name is considered acceptable in lieu of displaying an employee's last name.

Observations:

Based on review of facility policy, observations and staff interviews, it was determined that the facility failed to ensure that all employees were wearing photo identification (ID) tags that included all the required information for five of 16 employees observed.

Findings include:

Review of the facility policy entitled, "Identification Name Badges" dated 1/12/26, indicated that in order to promote safety and security measures established by our facility; each employee must always wear his/her identification name badge while on duty.

And included: 1) All personnel are required to wear ID name tags/badges during their work shift; 2) The ID name badge must be clearly visible and contain a picture of the employee, the employee's first name initial, last name and job title; 3) The personnel/human resources director, or designee, will be responsible for preparing the employee's ID tag/badge; department directors or supervisors will issue newly hired or reassigned employee his/her ID tag/badge upon reporting for work; 4) Employees will be responsible for maintaining their ID tags/badges and wearing them to work, and employees who chronically lose or forget their ID tags/badges may be subject to disciplinary action; and 5) Employees must report lost ID tags/badges to their supervisor so that replacement tags/badges can be issued.

Observations on 4/19/26, between 1:30 p.m. and 3:30 p.m. revealed Nurse Aide (NA) Employees E7, E8, and E10, and Licensed Practical Nurse (LPN) Employees E3, and E9 lacked a photo or other visual identification for staff, residents, and visitors to know what position he/she was in the facility.

Interview with NA Employee E7 confirmed he/she was an agency staff member, did not possess a facility photo ID badge and left his/her agency ID badge at home.

Interview with NA Employee E8 confirmed he/she forgot his/her badge.

Interview with NA Employee E10 confirmed that he/she lost their badge and that facility badge maker is on maternity leave.

Interview with LPN Employee E3 confirmed that he/she was an agency staff member and did not have a photo ID badge.

Interview with LPN Employee E9 confirmed that he/she broke their name badge holder and hasn't gotten a new one.

On 4/22/26, at 9:41 a.m. the Nursing Home Administrator confirmed the lack of photo identifications and that the NHA is currently responsible for the issuing of photo ID badges until the responsible staff return from leave.

Plan of Correction - To be completed: 06/09/2026

Employees E7, E8, E10, E2, and E9 have been provided with a new name tag.

Staff identified as not having a proper name tag have been provided with one.

Current staff will be re-educated by 5/15/2026 on the facility policy entitled "Identification Name Badges" with emphasis on wearing their provided name tags and notifying human resources/designee should they require a replacement name tag. Staff who do not follow the policy will be subject to the disciplinary process.

Facility Director of Nursing or designee will audit 10 staff to ensure they are wearing a proper name tag for five (5) days, weekly for three (3) weeks, monthly for two (2) months.

Results of audits will be reviewed with the Quality Assurance Performance Improvement (QAPI) Committee

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