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Merakey Allegheny Valley School, 880 Poplar Street makes its best effort to operate in full compliance with both Federal and State Law. Nothing included in this Plan of Correction is an admission otherwise. Merakey Allegheny Valley School, 880 Poplar Street has submitted this Plan of Correction to comply with its regulatory obligation and does not waive any objections to its merits or form of any allegations contained herein. Please note that Merakey Allegheny Valley School, 880 Poplar Street may contest the merits and/or form of any deficiency or finding alleged below and take reasonable steps to appeal them.

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Merakey Allegheny Valley School, 880 Poplar Street will ensure staff are able to demonstrate the skills and techniques necessary to implement the individual program plans for each client for whom they are responsible.

All current supervisory and direct care staff will receive re-training on proper procedures in utilizing mechanical lifts as well as proper lifting/transferring techniques, provided by the Physical Therapist or designee by October 25th, 2024. Training will be verified by written documentation and signatures obtained on a Staff Attendance Sheet (SA).

In addition to re-training, all current supervisory and direct care staff will be expected to review the current positioning mobility client profiles by October 25th, 2024. Review of the positioning mobility client profiles will be verified by written documentation and signatures obtained on a Staff Attendance Sheet (SA). Updates to the individuals program plan (IPP), will be communicated via the standard distribution process. This process includes distributing a copy of the updated individual program plan (IPP) to the appropriate departments/sites and implementing as indicated. The positioning mobility client profiles will be updated by the Physical Therapist or Designee and distributed as well, for review. Review and acknowledgement of the updated positioning mobility client profiles will be verified by written documentation and signatures obtained on a Staff Attendance Sheet (SA).

In order to monitor that staff are following appropriate lifting and transferring techniques, beginning November 2024 observations will be conducted by the House Manager or Designee on each shift. Random observations will occur twice a week for three months, followed by once a week for three months for a total of thirty-nine observations. Completed observations will be documented on a designated tracking sheet. Any concerns noted during observations will be immediately addressed and referred to the Administrator or designee for further follow-up via standard disciplinary process.

Merakey Allegheny Valley School, 880 Poplar Street, makes its best effort to operate in full compliance with both Federal and State Law. Nothing included in the Plan of Correction is an admission otherwise. Merakey Allegheny Valley School, 880 Poplar Street has submitted this Plan of Correction to comply with its regulatory obligations and does not waive any objections to its merits or form any allegations contained herein. Please note that Merakey Allegheny Valley School, 880 Poplar Street may contest the merits and/or form of any deficiency or finding alleged below and take reasonable steps to appeal them.

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Merakey Allegheny Valley School, 880 Poplar Street will ensure that as soon as the interdisciplinary team has formulated a client's individual program plan, each client must receive a continuous active treatment program consisting of needed interventions and services in sufficient number and frequency to support the achievement of the objectives identified in the individual program plan.
The Qualified Intellectual Disabilities Professional (QIDP) or Designee will train the House Manager (HM) on goal plan development, implementation of goals and monitoring. The House Manager or Designee will then be responsible for training the Direct Support Professional(s) on goal plan implementation and goal plan documentation. The Administrator or Designee will implement the utilization of a goal plan update form. The purpose of this form is to document the progress of the goal plan and to track the last step, triggering the creation the next goal. Training on the goal plan update form provided by the Administrator or Designee will consist of orienting the House Manager to the form, including purpose and explanation as to how to accurately complete. All above mentioned training will be completed and documented on a staff Attendance Sheet (SA) by October 25th, 2024.

In order to monitor that the training was effective, the House Manager or Designee will be responsible for completing the goal plan update form beginning November 2024, once a week for a period of 6 months (November, December 2024, January, February, March, April 2025). Completed goal plan monitoring forms will be submitted to the Administrator or Designee to verify completion weekly. Any concerns identified will be addressed immediately via re-training or standard disciplinary process and the review period extended.

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Merakey Allegheny Valley School (AVS), Poplar Street makes its best effort to operate in full compliance with Federal and State Law. Nothing included in this Plan of Correction is an admission otherwise. Merakey AVS Poplar Street has submitted this Plan of Correction in order to comply with its regulatory obligation and does not waive any objections to the merits or form of any allegations contained herein. Please note that Merakey AVS Poplar may contest the merits and/or form of any deficiency or finding alleged below and take reasonable steps to appeal them.

DRUG ADMINISTRATION:
The system for drug administration must assure that all drugs are administered in compliance with the physician's orders.

At the time of each identified error noted during survey, the staff was counseled, reviewed and signed a Staff Attendance (SA) Sheet on Medication Administration protocol and any other trainings related to the error, and had a medication pass monitored by a nurse in the home.

The Nurse Educator will hold a Medication Administration training focusing on module 7 and 8 of the training with the house manager and all house manager aid staff in the home. This training will be completed no later than October 29, 2024 and documented on a SA sheet. Staff will also receive training on Merakey's Administration of Medication Protocol including the 5 Rights, identifying individuals who require medication administration during the shift to prevent omissions, double checking blister packs and med cups after dose has been removed from the card for administration to prevent wrong dose errors, proper review of the BM log with each of the individuals orders to ensure the correct medication is being given, and identifying that the correct individual is receiving the meds prior to administration so that all medications are administered in compliance with the physician's orders. These trainings will be documented on a SA sheet. Once the training of all staff in the home is completed, this will be reported to the Residential Director for SFRs and Director of Nursing. SA sheets will be sent to the Staff Development Coordinator to verify all staff have received training.

Monitoring of medication administration to ensure all staff in the home are administering all medications per the Physicians Orders will be completed by the nurse, Assistant HSS (AHSS) or HSS. This will be done by staff completing monthly skills demonstration and completing random med pass audits on varied days and shifts. Documentation of this monitoring will be kept on the Medication Pass Audit form. The Medication Pass Audit is a visual observation of the staff performing skills demonstration and/or administering medications and treatments. This visual process includes, but is not limited to, ensuring individuals receive the prescribed dose of each medication throughout the entire medication administration procedure as per physician's orders. Random skills demonstration and AM and PM audits will occur weekly for two months. If this monitoring reveals that staff are following the Medication Administration procedure correctly, then the monitoring will begin to be tapered to bi-weekly for two months, then monthly for a period of two months, and then as needed. Med Pass Audits will begin the week following the module 7 and 8 training.

If during this process, if it has been identified that the staff observed are not administering medications as per policy, retraining will be provided individually to that staff person and random audits will be increased in frequency. Staff who fail to follow policy will be referred to the ICF/SFR Administrator for corrective action.