Pennsylvania Department of Health
ACCELERATE SKILLED NURSING AND REHABILITATION PHILADELPHIA
Building Inspection Results

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Severity Designations


Minimal Citation - No Harm	Minimal Harm	Actual Harm	Serious Harm

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ACCELERATE SKILLED NURSING AND REHABILITATION PHILADELPHIA - 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 March 5, 2024, at Accelerate Skilled Nursing And Rehabilitation Philadelphia, 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 (ORIG. BLDG. & NEW ADD.) - Component: 01 - Tag: 0000

Facility ID #200402
Component 01
Main Building

Based on a Medicare/Medicaid Recertification Survey conducted on March 5, 2024, it was determined that Accelerate Skilled Nursing And Rehabilitation Philadelphia was not in compliance with the following requirements of the Life Safety Code for an existing Nursing 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 six-story, Type II (222), fire resistive building, with a basement, that is fully sprinklered.

Plan of Correction:

NFPA 101 STANDARD Egress Doors:

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.

Egress Doors
Doors in a required means of egress shall not be equipped with a latch or a lock that requires the use of a tool or key from the egress side unless using one of the following special locking arrangements:
CLINICAL NEEDS OR SECURITY THREAT LOCKING
Where special locking arrangements for the clinical security needs of the patient are used, only one locking device shall be permitted on each door and provisions shall be made for the rapid removal of occupants by: remote control of locks; keying of all locks or keys carried by staff at all times; or other such reliable means available to the staff at all times.
18.2.2.2.5.1, 18.2.2.2.6, 19.2.2.2.5.1, 19.2.2.2.6
SPECIAL NEEDS LOCKING ARRANGEMENTS
Where special locking arrangements for the safety needs of the patient are used, all of the Clinical or Security Locking requirements are being met. In addition, the locks must be electrical locks that fail safely so as to release upon loss of power to the device; the building is protected by a supervised automatic sprinkler system and the locked space is protected by a complete smoke detection system (or is constantly monitored at an attended location within the locked space); and both the sprinkler and detection systems are arranged to unlock the doors upon activation.
18.2.2.2.5.2, 19.2.2.2.5.2, TIA 12-4
DELAYED-EGRESS LOCKING ARRANGEMENTS
Approved, listed delayed-egress locking systems installed in accordance with 7.2.1.6.1 shall be permitted on door assemblies serving low and ordinary hazard contents in buildings protected throughout by an approved, supervised automatic fire detection system or an approved, supervised automatic sprinkler system.
18.2.2.2.4, 19.2.2.2.4
ACCESS-CONTROLLED EGRESS LOCKING ARRANGEMENTS
Access-Controlled Egress Door assemblies installed in accordance with 7.2.1.6.2 shall be permitted.
18.2.2.2.4, 19.2.2.2.4
ELEVATOR LOBBY EXIT ACCESS LOCKING ARRANGEMENTS
Elevator lobby exit access door locking in accordance with 7.2.1.6.3 shall be permitted on door assemblies in buildings protected throughout by an approved, supervised automatic fire detection system and an approved, supervised automatic sprinkler system.
18.2.2.2.4, 19.2.2.2.4

Observations:
Name: MAIN BUILDING 01 (ORIG. BLDG. & NEW ADD.) - Component: 01 - Tag: 0222

Based on observation and interview, it was determined the facility failed to maintain delayed egress doors, affecting one of eight levels in the facility.

Findings include:

Observation on March 5, 2024, at 10:20 a.m., revealed, on the fourth floor, the delayed egress door near resident room 413 failed to open after 15 seconds.

Exit interview with the Administrator and the Maintenance Director on March 5, 2024, at 11:15 a.m., confirmed the door failed to open.

Plan of Correction - To be completed: 04/22/2024

1. An outside vendor will be contracted to make door repairs to maintain delayed egress locking systems to be in accordance to open after 15 seconds on the fourth floor (near room 413).
2. The appropriate staff will be in-serviced to maintain delayed egress to open after 15 seconds by April 22, 2024.
3. The Environmental Service Director or designee will audit compliance weekly for four weeks and then monthly for two months.
4. The results of the in house audit will be reviewed at the QAPI meeting for three months.

NFPA 101 STANDARD Subdivision of Building Spaces - Smoke Barrie:

Subdivision of Building Spaces - Smoke Barrier Construction
2012 EXISTING
Smoke barriers shall be constructed to a 1/2-hour fire resistance rating per 8.5. Smoke barriers shall be permitted to terminate at an atrium wall. Smoke dampers are not required in duct penetrations in fully ducted HVAC systems where an approved sprinkler system is installed for smoke compartments adjacent to the smoke barrier.
19.3.7.3, 8.6.7.1(1)
Describe any mechanical smoke control system in REMARKS.

Observations:
Name: MAIN BUILDING 01 (ORIG. BLDG. & NEW ADD.) - Component: 01 - Tag: 0372

Based on observation and interview, it was determined the facility failed to ensure that smoke barrier walls were free of unsealed penetrations on one of five floors.

Findings include:

Observation made on March 5, 2024, at 10:59 a.m., revealed on the ground floor, above the doors outside of the men's staff locker room, above the ceiling, there was an unsealed penetration of the smoke barrier wall around an armor conduit.

Exit interview with the Administrator and the Maintenance Director on March 5, 2024, at 11:15 a.m., confirmed the penetration of the smoke barrier wall.

Plan of Correction - To be completed: 04/22/2024

1. The maintenance staff immediately corrected to ensure that smoke barrier walls are free of unsealed penetrations.
2. The maintenance staff will be in-serviced to ensure all penetrations are sealed on the ground floor of the smoke barrier wall around an armor conduit.
3. The Environmental Service Director or designee will audit compliance weekly for four weeks and then monthly for two months.
4. The results of the in-house audit will be reviewed at the QAPI meeting for three months.

NFPA 101 STANDARD Electrical Systems - Essential Electric Syste:

This is a less serious (but not lowest level) 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 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.

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 (ORIG. BLDG. & NEW ADD.) - Component: 01 - Tag: 0918

Based on document review and interview, it was determined the facility failed to maintain and inspect the emergency generator, affecting the entire facility.

Findings include:

Document review on March 5, 2024, at 8:30 a.m., revealed the facility could not produce documentation of an annual 90-minute load bank test.

Exit interview with the Administrator and the Maintenance Director on March 5, 2024, at 11:15 a.m., confirmed the lack of documentation.

Plan of Correction - To be completed: 04/22/2024

1. The maintenance director contacted the vendor on 3/21/24 to produce documentation of an annual 90-minute load bank inspection at the facility.
2. The maintenance staff will be in-serviced to ensure the documentation is readily available and maintained properly after inspections of the emergency generator's annual 90-minute load bank.
3. The Environmental Service Director or designee will audit compliance weekly for four weeks and then monthly for two months.
4. The results of the in-house audit will be reviewed at the QAPI meeting for three months.

NFPA 101 STANDARD Electrical Equipment - Power Cords and Extens:

Electrical Equipment - Power Cords and Extension Cords
Power strips in a patient care vicinity are only used for components of movable patient-care-related electrical equipment (PCREE) assembles that have been assembled by qualified personnel and meet the conditions of 10.2.3.6. Power strips in the patient care vicinity may not be used for non-PCREE (e.g., personal electronics), except in long-term care resident rooms that do not use PCREE. Power strips for PCREE meet UL 1363A or UL 60601-1. Power strips for non-PCREE in the patient care rooms (outside of vicinity) meet UL 1363. In non-patient care rooms, power strips meet other UL standards. All power strips are used with general precautions. Extension cords are not used as a substitute for fixed wiring of a structure. Extension cords used temporarily are removed immediately upon completion of the purpose for which it was installed and meets the conditions of 10.2.4.
10.2.3.6 (NFPA 99), 10.2.4 (NFPA 99), 400-8 (NFPA 70), 590.3(D) (NFPA 70), TIA 12-5

Observations:
Name: MAIN BUILDING 01 (ORIG. BLDG. & NEW ADD.) - Component: 01 - Tag: 0920

Based on observation and interview, it was determined the facility failed to ensure that the improper use of power strips was prohibited, affecting 1 of 5 floors.

Findings include:

Observation made on March 5, 2024 at 10:47 a.m., on the first floor, revealed inside the Admissions office near the lobby, a microwave oven was plugged into a powerstrip.

Exit interview with the Administrator and the Maintenance Director on March 5, 2024, at 11:15 a.m., confirmed the improper use of a powerstrip.

Plan of Correction - To be completed: 04/22/2024

1. The power strip was removed immediately upon completion of survey walk through on 3/5/2024.
2. The maintenance staff will in-service all staff to ensure acknowledgement that improper use of power strips are prohibited.
3. The Environmental Service Director or designee will audit compliance weekly for four weeks and then monthly for two months.
4. The results of the in-house audit will be reviewed at the QAPI meeting for three months.

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