INITIAL COMMENTS
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This report is a result of an on-site licensure renewal inspection conducted on May 29, 2024 by staff from the Bureau of Program Licensure. Based on the findings of the on-site inspection DS0L6701 Westminster Homes of Lehigh Valley was found to not be in compliance with the applicable chapters of 28 PA Code which pertain to the facility. Therefore, deficiencies were identified during this inspection and a plan of correction is required.
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Plan of Correction
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§ 717.23 LICENSURE Notification of decision to end residency
§ 717.23. Notification of decision to end residency.
(a) The licensee shall notify the resident in writing of a decision to end residency. The notice must include the reason and a timeframe for ending residency.
(b) The resident shall have an opportunity to request the licensee reconsider a decision to end residency before the decision to end residency takes effect.
(c) The resident may decide to end residency without providing a reason to the licensee.
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Observations
Based on a review of resident records, the recovery house failed to provide a written notification to the resident stating the decision to end residency.
In 2 out of 2 resident discharge files the recovery house failed to provide a written notification to the resident stating the decision to end residency.
These findings were reviewed with the recovery house staff during the licensing process.
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Plan of Correction
Westminster has not always been consistent with given resident a written notice to end residency. To remain in compliance, Westminster as of 6/30/2024 will give notification to end residency and if they refuse to sign that they reserved this notice, Westminster will have to note they refuse to sign.
Westminster Homes Of The Lehigh Valley
End of Residency Form
Notification to end residency.
This serves that you are being asked to leave the premises due to:
___ Continued use
___ Behavioral issues
___ Physical threats of violence
THE TIME FRAME FOR RESIDENT TO LEAVE: ___Immediately (45mins) _____ Days(max 7days)
Staff signature: ___________________________________________ Date: ________________
Resident Signature: _______________________________________ Date: _________________
Note: If a resident chooses not to sign the form, Manager's option is to then write "refuse to sign" in the Resident Signature spot.
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§ 717.27 LICENSURE Notification to family or emergency contact
§ 717.27. Notification to family member or emergency contact.
(a) The licensee shall develop and implement written policies and procedures that specify the methods and circumstances, including the resident ' s hospitalization or death, for notifying the resident ' s emergency contact with the resident ' s consent. The resident may revoke consent to provide notice to the emergency contact.
(b) The licensee shall make at least one attempt to notify the resident ' s emergency contact in accordance with subsection (a) immediately and in no event more than 12 hours after the resident decides to end residency or does not return to the drug and alcohol recovery house as expected. This subsection shall not apply if the licensee knows or has reason to know of allegations of domestic abuse on the resident by the emergency contact.
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Observations
Based on a review of resident records, the recovery house failed to make at least one attempt to notify the resident ' s emergency contact in accordance with subsection (b) immediately and in no event more than 12 hours after the resident decides to end residency or does not return to the drug and alcohol recovery house as expected.
Findings: In 1 out of 2 dishcarge files the recovery house failed to notify the emergency contact within 12 hours of resident departure.
These findings were reviewed with the recovery house staff during the licensing process.
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Plan of Correction
According to Westminster resident contract all residents sign a consent that they are aware that if they are discharge or go missing for whatever reason, Westminster has the consent to contact their Emergency Contact. As of 6/30/2024 Westminster will in force this rule from this point forward
EMERGENCY CONTACT INFORMATION
I acknowledge that Westminster Homes of the Lehigh Valley will attempt to notify my emergency contact if I decide to
end residency, the resident does not return to the house as expected, is hospitalized or deceased. |