Pennsylvania Department of Health
PROVIDENCE REHAB AND HEALTHCARE CENTER AT MERCY FITZGERALD
Patient Care Inspection Results

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PROVIDENCE REHAB AND HEALTHCARE CENTER AT MERCY FITZGERALD
Inspection Results For:

There are  203 surveys for this facility. Please select a date to view the survey results.

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PROVIDENCE REHAB AND HEALTHCARE CENTER AT MERCY FITZGERALD - Inspection Results Scope of Citation
Number of Residents Affected
By Deficient Practice
Initial comments:

Based on an Abbreviated Survey in response to a complaint, completed on February 15, 2024, it was determined that Providence Rehabilitation and Healthcare Center at Mercy Fitzgerald was not in compliance with the following requirements of 42 CFR Part 483, Subpart B, Requirements for Long Term Care and 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:This is a less serious (but not lowest level) deficiency and is isolated to the fewest 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.
§ 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 on clinical record reviews, interviews with staff and policy and procedure reviews, it was determined that the facility failed to ensure that cardiac medication was administered as ordered by the physician for one of three residents reviewed. (Resident CL1)

Findings include:

A review of the policy titled Administering Medications dated April, 2019 revealed that it was the licensed nursing staff who were responsible to ensure that medications were administered in a safe and timely manner as prescribed by the physician. The policy also indicated that medication administration was to enhance optimal therapeutic effect of the medication for each resident. The nurse administering the medication was responsible for verifying the resident, the right medication, right dosage, right time and right route of administration before giving the medication. The nurse administering the medication was also responsible for verifying vital signs as requested for each resident prior to administration of medication.

A review of the policy titled Charting and Documentation dated July, 2017 indicated that all services provided to the resident, progress toward the care plan goals or any changes in the resident's clinical, physical, functional or psychosocial condition shall be documented in the resident's clinical record. The clinical record was to be used to document the communication between the interdisciplinary team regarding the resident's condition and response to care.

Review of Resident CL1 clinical record revealed an admission Minimum Data Set assessment (MDS-an assessment of care needs) dated September 27, 2023, indicated that had diagnoses of coronary artery disease, deep vein thrombosis and hypertension (high blood pressure).

Clinical record review for Resident CL1 revealed that this resident had diagnoses of angina pectoris (chest pain or pressure caused by insufficient blood flow to the heart), hypertension (high blood pressure) and chronic embolism (blockage of the arterial or venous blood flow in the body). Systolic blood pressure was the pressure within the arteries while the heartbeats.

Review of Resident CL1's November 2023 physician orders revealed an order for Metoprolol 25 milligrams (cardiac medication) hold the medication if the resident's heart rate was below 60 and if the resident's systolic blood pressure was below 100mmHg.

Review of Resident CL1's November 2023 Medication Administration Record revealed that a Licensed nurse, Employee E2, administered Metoprolol 25 milligrams on November 18, 2023 with a documented blood pressure of 95 systolic.

Clinical record review revealed that a licensed nurse, Employee E2, administered Metoprolol on November 20, 2023 at 9:00 a.m. to Resident CL1, on November 20, 2023 with a documented blood pressure of 85 systolic/55 diastolic.

Interview with the Nursing Home Administrator, Employee E1, at 10:00 a.m., on February 15, 2024 confirmed that the Licensed nurse, Employee E2 failed to follow physican's orders and to clairfy the order with the physician related to the administration of Metoprolol.


28 Pa. Code 211.12(d)(1) Nursing services

28 Pa. Code 211.10(c) Resident care policies









 Plan of Correction - To be completed: 03/04/2024

The statements made in this Plan of Correction are not an admission to and do not constitute an agreement with the alleged deficiencies herein. To maintain compliance with all federal and state regulation, the facility has taken or will take the actions set forth in the following plan of correction. The following plan of correction constitutes the facilities allegation for compliance such that all alleged deficiencies cited have been or will be corrected by the date or dates indicated.

Resident CL1 is no longer in the center.
The facility has determined that residents on cardiac medications have the potential to be affected.
Licensed staff will be in-serviced on ensuring that cardiac medications are administered as ordered by the physician.
Director of Nursing/ Designee will conduct five random audits of residents on cardiac medications to ensure that the medications are administered as ordered by the physician. This audit will be conducted weekly for four weeks and monthly for three months. This plan of correction will be monitored at the monthly Quality Assurance Performance Improvement meeting until such time consistent substantial compliance has been met.



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