Pennsylvania Department of Health
SWEDEN VALLEY MANOR
Building Inspection Results

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Minimal Citation - No Harm Minimal Harm Actual Harm Serious Harm
SWEDEN VALLEY MANOR
Inspection Results For:

There are  40 surveys for this facility. Please select a date to view the survey results.

Surveys don't appear on this website until at least 41 days have elapsed since the exit date of the survey.
SWEDEN VALLEY MANOR - Inspection Results Scope of Citation
Number of Residents Affected
By Deficient Practice
Initial comments:Name: - Component: -- - Tag: 0000


Based on an Emergency Preparedness Survey completed on October 3, 2024, at Sweden Valley Manor, it was determined there were no deficiencies identified with the requirements of 42 CFR 483.73.




 Plan of Correction:


Initial comments:Name: MAIN BUILDING 01 - Component: 01 - Tag: 0000


Facility ID# 455402
Component 01
Main Building

Based on a Medicare/Medicaid Recertification Survey completed on October 3, 2024, it was determined that Sweden Valley Manor was not in compliance with the following requirements of the Life Safety Code for an existing health care occupancy. Compliance with the National Fire Protection Association's Life Safety Code is required by 42 CFR 483.90(a).

This is a one story, Type V (000), unprotected, wood frame building with a partial basement, that is fully sprinklered.



 Plan of Correction:


NFPA 101 STANDARD Sprinkler System - Maintenance and Testing: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.
Sprinkler System - Maintenance and Testing
Automatic sprinkler and standpipe systems are inspected, tested, and maintained in accordance with NFPA 25, Standard for the Inspection, Testing, and Maintaining of Water-based Fire Protection Systems. Records of system design, maintenance, inspection and testing are maintained in a secure location and readily available.
a) Date sprinkler system last checked _____________________
b) Who provided system test ____________________________
c) Water system supply source __________________________
Provide in REMARKS information on coverage for any non-required or partial automatic sprinkler system.
9.7.5, 9.7.7, 9.7.8, and NFPA 25
Observations:
Name: MAIN BUILDING 01 - Component: 01 - Tag: 0353

Based on observation and interview, it was determined the facility failed to maintain the automatic sprinkler system in one location, affecting one of one floor.

Findings include:

1. Observation on October 3, 2024, at 10:55 a.m., revealed the attic access panel/stair, located within the Clean Linen Room, failed to close, leaving an opening within the ceiling assembly.

Exit interview with the Facility Administrator on October 3, 2024, between 11:35 a.m., and 11:40 a.m., confirmed the automatic sprinkler system deficiency.



 Plan of Correction - To be completed: 11/22/2024

This plan of correction has been prepared and executed because the law requires it. This plan does not constitute an admission that any of the citations are either legally or factually correct. This plan of correction is not meant to establish any standard of care, contract, obligation, or position. Sweden Valley Manor reserves the right to raise all possible contestations and defenses in any civil, criminal, claim, action or proceeding. Please accept this plan of correction as Sweden Valley Manor credible allegation of compliance. All residents received appropriate care and services to meet their needs on the identified days and there was no direct correlation to an individual resident.

A: The b hall attic access panel/stair will be repaired to close completely by 10/18/2024
B: A whole house audit of all attic access points will be completed to ensure they all close properly by 10/18/2024
C: Education will be provided by NHA to ESS on NFPA 25, Standard for the Inspection, Testing, and Maintaining of Water based Fire Protection System by 10/18/2024
D: An audit will be completed by ESS or designee on attic access points to ensure proper closure weekly x 4 weeks and monthly x 2 months.
E: Results of the attic access point audits will be reported to the QAPI committee

NFPA 101 STANDARD Fire Drills:Least serious deficiency but was found to be widespread throughout the facility and/or has the potential to affect a large portion or all the residents. This deficiency has the potential for causing no more than a minor negative impact on the resident.
Fire Drills
Fire drills include the transmission of a fire alarm signal and simulation of emergency fire conditions. Fire drills are held at expected and unexpected times under varying conditions, at least quarterly on each shift. The staff is familiar with procedures and is aware that drills are part of established routine. Where drills are conducted between 9:00 PM and 6:00 AM, a coded announcement may be used instead of audible alarms.
19.7.1.4 through 19.7.1.7
Observations:
Name: MAIN BUILDING 01 - Component: 01 - Tag: 0712

Based on documentation review and interview, it was determined the facility failed to conduct one of twelve required fire drills, affecting one of two floors.

Findings include:

1. Observation on October 3, 2024, at 11:20 a.m., revealed the facility lacked a third shift fire drill, for the fourth quarter of calendar year 2023.

Exit interview with the Facility Administrator on October 3, 2024, between 11:35 a.m., and 11:40 a.m., confirmed the fire drill deficiency.





 Plan of Correction - To be completed: 11/22/2024

Fire drills are currently being scheduled by NHA to meet requirements and conducted by ESS.
Education will be provided by NHA or designee to ESS on fire drill requirements and planning to meet regulations by 10/18/2024
A monthly audit will be conducted by NHA or designee to monitor fire drills and their occurrence
Results of fire drill audit will be reported to QAPI committee

Initial comments:Name: THERAPY ADDITION - Component: 02 - Tag: 0000


Facility ID# 455402
Component 02
Therapy Addition

Based on a Medicare/Medicaid Recertification Survey completed on October 3, 2024, at Sweden Valley Manor, it was determined there were no deficiencies identified under the requirements of the Life Safety Code for a new health care occupancy. Compliance with the National Fire Protection Association's Life Safety Code is required by 42 CFR 483.70(a).

This is a one story, Type V (111), protected, wood frame building, that is fully sprinklered



 Plan of Correction:



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