Pennsylvania Department of Health
HAVEN CONVALESCENT HOME INC
Building Inspection Results

Note: If you need to change the font size, click the "View" menu at the top of the page, place the mouse over the "Text Size" menu item, and select the desired font size.

Severity Designations

Click here for definitions Click here for definitions Click here for definitions Click here for definitions
Minimal Citation - No Harm Minimal Harm Actual Harm Serious Harm
HAVEN CONVALESCENT HOME INC
Inspection Results For:

There are  37 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.
HAVEN CONVALESCENT HOME INC - 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 January 17, 2024, at Haven Convalescent Home, Inc., 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 #081102
Component 01
Main Building

Based on a Medicare/Medicaid Recertification Survey completed January 17, 2024, it was determined that Haven Convalescent Home, Inc. 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 483.70(a).

This is a one-story, Type II (222), protected, non-combustible building, with a partial basement, that is fully sprinklered.




 Plan of Correction:


NFPA 101 STANDARD Sprinkler System - Maintenance and Testing:Least serious deficiency but affects more than a limited number of residents, staff, or occurrences. This deficiency has the potential for causing no more than a minor negative impact on the resident but is 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, the facility failed to meet sprinkler system testing and maintenance requirements for one of over twenty sprinkler heads.

Observation on January 17, 2024, at 9:17 a.m., revealed room 212 lacked a sprinkler escutcheon.

Interview with the administrator and maintenance supervisor on January 17, 2024, at 9:17 a.m., confirmed the resident room lacked a sprinkler escutcheon.



 Plan of Correction - To be completed: 01/18/2024

Sprinkler escutcheon was installed on sprinkler head in room 210. All other sprinkler heads in the building were checked by maintenance to ensure that sprinkler escutcheons were present where needed.
Maintenance to monitor sprinkler heads at least once a month to ensure that sprinkler escutcheons are present where needed. Monitoring to be ongoing until deemed appropriate by facility QA Committee.
NFPA 101 STANDARD Electrical Systems - Essential Electric Syste: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.
Electrical Systems - Essential Electric System Maintenance and Testing
The generator or other alternate power source and associated equipment is capable of supplying service within 10 seconds. If the 10-second criterion is not met during the monthly test, a process shall be provided to annually confirm this capability for the life safety and critical branches. Maintenance and testing of the generator and transfer switches are performed in accordance with NFPA 110.
Generator sets are inspected weekly, exercised under load 30 minutes 12 times a year in 20-40 day intervals, and exercised once every 36 months for 4 continuous hours. Scheduled test under load conditions include a complete simulated cold start and automatic or manual transfer of all EES loads, and are conducted by competent personnel. Maintenance and testing of stored energy power sources (Type 3 EES) are in accordance with NFPA 111. Main and feeder circuit breakers are inspected annually, and a program for periodically exercising the components is established according to manufacturer requirements. Written records of maintenance and testing are maintained and readily available. EES electrical panels and circuits are marked, readily identifiable, and separate from normal power circuits. Minimizing the possibility of damage of the emergency power source is a design consideration for new installations.
6.4.4, 6.5.4, 6.6.4 (NFPA 99), NFPA 110, NFPA 111, 700.10 (NFPA 70)
Observations:
Name: MAIN BUILDING 01 - Component: 01 - Tag: 0918

Based on document review and interview, the facility failed to meet essential electric system testing and maintenance requirements for one of one generator.

Document review on January 17, 2024, at 9:00 a.m., revealed the facility lacked monthly conductance testing documentation at the time of the survey.

Interview with the administrator and maintenance supervisor on January 17, 2024, at 9:00 a.m., confirmed the facility lacked the testing documentation.




 Plan of Correction - To be completed: 01/24/2024

Maintenance will perform a monthly conductance test on Maintenance Free Generator Batteries. Monthly results will be documented, and Maintenance Free batteries will be replaced as needed.
Administrator will review monthly results with maintenance until deemed as appropriate by facility QAPI Committee.

Back to County Map


  
Home : Press Releases : Administration
Health Planning and Assessment : Office of the Secretary
Health Promotion and Disease Prevention : Quality Assurance



Copyright © 2001 Commonwealth of Pennsylvania. All Rights Reserved.
Commonwealth of PA Privacy Statement

Visit the PA Power Port