Pennsylvania Department of Health
LINDEN HALL
Patient Care Inspection Results

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Severity Designations


Minimal Citation - No Harm	Minimal Harm	Actual Harm	Serious Harm

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LINDEN HALL - Inspection Results	Scope of Citation Number of Residents Affected By Deficient Practice

Initial comments:
Based on a State Licensure survey and Civil Rights Compliance survey completed on February 29, 2024, it was determined that Linden Hall was not in compliance with the following requirements of the 28 PA Code, Commonwealth of Pennsylvania Long Term Care Licensure Regulations as they relate to the Health portion of the survey process.

Plan of Correction:

483.25 REQUIREMENT Quality of Care:

§ 483.25 Quality of care
Quality of care is a fundamental principle that applies to all treatment and care provided to facility residents. Based on the comprehensive assessment of a resident, the facility must ensure that residents receive treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan, and the residents' choices.

Observations:

Based upon review of clinical documentation and interview, it was determined the facility failed to follow physician orders for two of eight residents reviewed (Resident 54 and Resident 104).
Findings include:
Review of Resident 54's physician's orders revealed an order dated March 12, 2025, for "OT [occupational therapy] eval [evaluation] of left neck area s/p (status post - after an event) bruise, possible new chair or neck collar".
Review of Resident 54's clinical record revealed no evidence that the OT evaluation was completed.
Interview with the Director of Nursing on April 17, 2025, at 9:52 a.m. confirmed that the OT evaluation was not done as ordered.
Review of Resident 104's diagnosis list revealed diagnoses including congestive heart failure (CHF - excessive body/lung fluid caused by a weakened heart muscle).
Review of Resident 104's physician ' s orders revealed an order dated March 2025 which stated obtain weight weekly on Wednesday morning prior to breakfast.
Review of Resident 104's vital signs flow sheet indicated one weight was obtained on March 4, 2025. No further weights were obtained for March 2025.
Review of Resident 104's physician ' s orders revealed an order dated April 2025 which stated obtain weight weekly on Wednesday morning prior to breakfast.
Review of Resident 104's vital signs flow sheet indicated one weight was obtained on April 3, 2025. No further weights were obtained for April 2025.
Interview with the Director of Nursing on April 17, 2025, at 10:00 a.m. confirmed that no additional weights were obtained for Resident 104 for March or April 2025 according to physician orders.
28 Pa. Code 211.12 (d)(1)(3)(5) Nursing services
Previously cited 2/29/2024

Plan of Correction - To be completed: 05/29/2025

Resident 54 no longer resides at the facility. Resident 104's physician order for weekly weights is being followed.

A 30 day look back of physician orders was done to ensure orders for OT evaluations and orders for weekly weights have been followed.

Licensed Nurses were re-in serviced by the Director of Nursing on following physician orders for OT evaluations and orders for weekly weights.

A weekly audit will be done for 6 weeks by the Director of Nursing/designee of physician orders for OT evaluations and weekly weights to ensure orders are followed.

Results of the 6-week audit will be reported to the Quality Assurance Performance Improvement Committee by the Director of Nursing/designee for review and recommendation.

483.60(i)(1)(2) REQUIREMENT Food Procurement,Store/Prepare/Serve-Sanitary:

§483.60(i) Food safety requirements.
The facility must -

§483.60(i)(1) - Procure food from sources approved or considered satisfactory by federal, state or local authorities.
(i) This may include food items obtained directly from local producers, subject to applicable State and local laws or regulations.
(ii) This provision does not prohibit or prevent facilities from using produce grown in facility gardens, subject to compliance with applicable safe growing and food-handling practices.
(iii) This provision does not preclude residents from consuming foods not procured by the facility.

§483.60(i)(2) - Store, prepare, distribute and serve food in accordance with professional standards for food service safety.

Observations:

Based upon observation, it was determined the facility failed to ensure the three-compartment sink located in the kitchen had sufficient sanitizer at over 50 PPM (parts per million) for sanitation.
Findings include:
Observation on April 17, 2025, at 10:20 a.m. and 11:30 a.m. of the three-compartment sink located in the kitchen revealed that the test strip inserted in the sanitizing compartment water failed to meet the appropriate level for sanitation. The test strip was observed to reveal less than 50 PPM.
Interview with the Director of Nursing on April 17, 2025, at 11:45 a.m. confirmed that the sanitization of the third compartment did not meet required levels.

Plan of Correction - To be completed: 05/29/2025

Appropriate levels of sanitizer – over 50 parts per million – are utilized in the third compartment of the 3-compartment sink in the kitchen as evidenced by test strip readings of the water.

Dietary staff will be re-in serviced on the appropriate sanitizing levels required, the use of test strips and if readings are below acceptable levels, to report to the supervisor immediately for correction before using the sink for sanitizing.

Random weekly audits will be done for 6 weeks by the Director of Dining Services/designee of sanitizing levels in the water in the 3-compartment sink prior to use to ensure levels are appropriate.

Results of the 6 week audit will be reported by the Director of Dining Services/designee to the Quality Assurance Performance Improvement Committee for review and further recommendation.

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