Nursing Investigation Results -

Pennsylvania Department of Health
GROVE AT NORTH HUNTINGDON, THE
Patient Care Inspection Results

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GROVE AT NORTH HUNTINGDON, THE
Inspection Results For:

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GROVE AT NORTH HUNTINGDON, THE - 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 June 21, 2022, it was determined that The Grove at North Huntingdon 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:


483.25(i) REQUIREMENT Respiratory/Tracheostomy Care and Suctioning: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.
483.25(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, observations and staff interviews, it was determined that the facility failed to make certain a physician order for oxygen use was in place for three of 4 residents (Resident R1, R2, and R3).

Findings include:
A review of facility policy "Oxygen Administration" dated 6/14/22, indicated that oxygen therapy will be provided when a resident needs oxygen at a concentration greater than room air, and will be ordered as appropriate.

A review of the clinical record indicated that Resident R1 was admitted 5/25/22, and sent out-to-the-hospital (OTH) on 6/1/22. A review of the Admission Minimum Data Set (MDS - periodic assessment of care needs) dated 5/31/22, indicated diagnosis of high blood pressure, chronic obstruction pulmonary disease (chronic lung disease), and depression. Further review of Admission MDS revealed that resident had been receiving oxygen therapy.

Review of the current recapitulation of physician orders for Resident R1, while residing at facility, did not include an order to administer oxygen.

A review of the clinical record indicated that Resident R2 was admitted to the facility on 1/30/22, with diagnosis of heart failure, high blood pressure, and peripheral vascular disease. A review of the Quarterly Minimum Data Set (MDS - periodic assessment of care needs) dated 5/26/22, indicated that these diagnoses remained current and that the resident was receiving oxygen therapy.

During an observation on 6/21/22 at 11:10 a.m., Resident R2 was observed in his wheelchair next to his bed with an oxygen concentrator running, wearing a nasal cannula.

Review of the current physician orders did not include an order to administer oxygen.

A review of the clinical record indicated that Resident R3 was admitted to the facility on 5/10/21, with diagnosis of high blood pressure, Alzheimer's disease, and depression. A review of the Quarterly Minimum Data Set (MDS - periodic assessment of care needs) dated 5/12/22, indicated that these diagnoses remained current and that the resident was receiving oxygen therapy.

During an observation on 6/21/22 at 11:15 a.m., Resident R3 was observed in her wheelchair next to her bed with an oxygen concentrator running, wearing a nasal cannula.

Review of the current physician orders did not include an order to administer oxygen.

During an interview on 6/21/22 at 2:00 p.m., the Regional Clinical Consultant Employee E1 and the Nursing Home Administrator confirmed that Resident R1, R2, and R3 did not have a physician order for oxygen therapy.

28 Pa. Code: 201.14(a) Responsibility of licensee.
Previously cited 2/10/21, 8/26/21, 2/23/22, 3/30/22, and 6/3/22

28 Pa. Code: 211.12(d)(1)(5) Nursing services.
Previously cited 8/31/20, 2/10/21, 5/7/21, 6/29/21, 7/14/21, and 8/26/21


 Plan of Correction - To be completed: 07/07/2022

Facility will ensure that all residents with a need for oxygen have a physician order in place. Residents R1, R2 and R3 will be assessed to evaluate the need for oxygen and a physician order will be obtained if appropriate to the residents current needs.
The facility will complete a house audit to validate that all residents who require oxygen have a current physician order.
The Director of Nursing or Designee will re-educate licensed nurses, including new hires and agency, on the facility policy and procedures for oxygen use detailing obtaining a physician order.
The Director of Nursing or Designee will complete an audit weekly for four weeks then monthly for three months to validate residents who require the use of oxygen have a physician order in place.
These audits will be forwarded to the monthly Quality Assurance and Performance Improvement Committee for review and frequency of audits.



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