Report Slams State Veterans Agency in Covid-19 Response

By Walter F. Roche Jr.

A 116-page report concludes that state officials and managers at a state veterans home share responsibility for an outbreak of Covid-19 that took the lives of 42 residents of a state run veterans nursing home.
The report, which was commissioned by Pennsylvania Gov. Thomas Wolf, cited three crucial decisions that resulted in the deadly caronavirus spreading like wildfire through the 292 bed facility in Chester County.
Those findings include the failure of managers at the Southeastern Veterans Center to quickly end communal dining even as the outbreak was becoming apparent.
Those same managers misunderstood guidance from health officials about separating those patients who had been exposed to the virus and those who had tested negative. As a result dozens of residents who were free of the virus were needlesly exposed to the virus.
A third deficiency was the failure of the facility's management to utilize a vacant 32 bed unit to separate the infected residents from those free of the virus. Instead the vacant unit was set aside for a few employees to occasionally spend the night.
While much of the report focuses on the failures of the home's administrator, Rohan Blackwood and Director of Nursing Deborah Mullane, the report faults officials of the state Department of Military and Veterans Affairs(DMVA) for failing to provide adequate oversight.
"DMVA failed to exercise sufficient authority" over the Chester County facility," the report states.
In fact the panel concluded DMVA failed to provide sufficient oversight for all six state veterans homes.
And, the report continues, Blackwood and Mullane, who ultimately were fired, "managed by intimidation and dictate." The attorney for Blackwod and Mullane issued an extensive rebuttal of the report, charging that they were being scapegoated when the blame belonged to DMVA officials. Citing a culture of a lack of accountability both at the facility and the DMVA, the report states,"Ultimately the buck seems to have stopped nowhere."
The panel noted a lack of experience among DMVA managers in medical matters or the administration of long term care facilities.
The report praises the frontline workers at the facility for trying to perform their duties despite an openly hostile work environment and the lack of Personal Protective Equipment.
The report also cites the home management for the widespread and apparently indiscriminate use of a cointroversial drug, hydroxychloroquine, on patients diagnosed with Covid-19 or suspected of being infected.
The report states that the drug was used on patients despite warnings that it could have severe adverse effects on patients with coronary conditions. And, the report stated, the drugs were administered without proper disclosure either to the patients themselves or their families.
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UPMC Ordered EMTs to Move Patient

By Walter F. Roche Jr.

An emergency department nurse at a York County hospital ordered ambulance paramedics to take back a patient they had just delivered stating that there were no available beds, according to a report from the state Health Department.
The report on the October incident at UPMC Memorial Hospital, which was just made public, states that the nurse first ordered the EMTs (Emergency Medical Technicians) to take back the patient and then ordered them to take the patient for a CAT scan and X-rays. The patient had been taken to the hospital after a fall at home.
The ambulance crew "was advised by hospital staff that they had no beds available to transfer the patient off the ambulance litter," the report states.
The EMTs responded by stating that the patient was now under the care of the hospital and "the transfer of care was complete."
The nurse, according to the report, then stated that "Nursing did not and will not sign a transfer."
The EMTs then transferred the patient back to their stretcher and ended up waiting an hour before the patient was finally transferred to a hospital bed.
The report notes that except in emergency situations paramedics are limited to the emergency room.
"UPMC failed to assume the care of an emergency department patient that presented via ambulance... leaving the patient in the care of EMS(Emergency Medical Services)," the report states.
In a plan of correction filed with the state in response to the inspection report UPMC implemented an action plan to "create a better experience for our EMS colleagues."improve the experience of paramedics" on their trips to the 98-bed facility.
The hospital response also indicated the charge nurse in question had her charging duties removed.
UPMC Memorial officials did not respond to a series of questions about the incident but did issue a brief statement.
"UPMC Memorial cooperated with state officials and implemented a corrective action plan to address the issues in the complaint. The plan has been reviewed and accepted by the state Department of Health," said hospital spokeswoman Kelly McCall.
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UPMC Failed to Ensure Sterility of Surgical Instrument

By Walter F. Roche Jr.

A worker at a Williamsport hospital failed to adequately cleanse a surgical insrument and bacterial matter fell into a patient's surgical field while undergoing laparoscopic surgery, according to a report from the state Health Department.
The report, which was just made public, concludes that UPMC Williamsport, a 224 bed hospital, failed to ensure staff followed approved procedures for the cleansing and disinfection of surgical equipment.
According to the report a trocar which was being used in a Sept.9 laparoscopic procedure had not been properly cleaned and "bioburden fell from the distal end of the trocar into the patient's surgical field."
"The bioburden was retrieved and the surgical field was flushed," the report continues, adding that additional antibiotics were added to the patient's post operative orders.
The facility was also cited for failing to properly report the incident.
"The facility failed to document a surgical complication in the medical record," the report states, adding that the incident was not noted in the surgeon's operative or progress notes. The report states that a review of records showed there was no documentation of the disclosure of the incident to the patient on the day after the surgery.
Tyler Wagner, a hospital spokesman wrote in an email response to questions, that the hospital was cooperating with state health officials and has adopted a corrective action plan to address the issues in the complaint.
"The plan has been reviewed and accepted by the Pennsylvania Department of Health," Wagner wrote.
In the same report, state health surveyors failed to properly respond to patient grievances. in some cases the patients were not provided either an interim or final report on the findings on the complaints.
In another finding the state said records showed patients were discharged from a recovery room without written orders from a physician. Some patient records lacked required signed informed consent forms, the surveyors reported.
The hospital filed plan of correction in which it detailed steps taken to correct the errors and prevent any recurrence. Staff, according to the plan, were re-educated on the proper way to clean and sterilize surgical equipment.
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Four Pittsburgh Patients Off Cardiac Monitors

By Walter F. Roche Jr.

It took six hours for staff at a Pittsburgh hospital to realize a critically ill patient was no longer on a physician-ordered continuous cardiac monitor.
Not only that there were three other such incidences at UPMC Presbyterian Shadyside over a six month period, according to a report from the state Health Department, which was recently made public.
The latest incident prompted state Health officials to declare a state of "immediate jeopardy" which forced hospital officials to come up with an immediate correction plan.
Under that plan the hospital agreed to have 24/7 coverage of monitors showing the current stste of all working cardiac monitors.
"A monitor manager is located in the unit nursing station on each individual unit," the report states.
The immediate incident which triggered the state visit occurred on Oct. 25 and Oct. 26. The unnamed patient's monitor stopped functioning at 10:13 p.m. but the patient was not found unresponsive until 4:14 a.m. the next day.
The state report dated Nov. 2 states that three prior "serious events" reported at the facility over a six month period were for the same issue; patients on physician ordered cardiac monitors found unresponsive and off monitors.
None of the three patients survived," the report states.
The report does not indicate whether the October patient, who was off moitor for some six hours, survived.
In the most recent case the surveyors found that the same patient had been found with evidence of internal bleeding but staff failed to inform the physician of the change in condition.
The report faults the hospital management, including the chief executive officer, the nursing staff and the hospital's governing body for the multiple failures.
UPMC filed a plan of correction in response to the latest incident which includes staff re-education and audits. Hospital officials did not respond to requests for comment.
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NECC Defendant Renews Jail Release Plea

By Walter F. Roche Jr.

A former pharmacist convicted of racketeering in the wake of a deadly fungal meningitis outbreak is asking once again for release from prison citing the current pandemic and an undisclosed medical condition.
In a 15-page petition filed today in U.S. District Court in Boston, Mass., the lawyer for Gene Svirskiy is asking the court to allow him to complete his 30 month sentence under home confinement.
The petition and attached exhibits show Svirskiy plans to return to work as a compounding pharmacist, the sme role he played at the New England Compounding Center, the company blamed for the deadly 2012 outbreak.
In the petition Svirskiy states that he recently uncovered medical records showing that he has a medical condition that makes him susceptible to a severe form of Covid-19. Record relating to that condition were filed under seal with the approval of U.S. District Court Judge Richard G. Stearns.
The petition alsao cites Svirsky's history of smoking and a diagnosis of asthma.
"The personl health risks to Svirskiy are real," the petition states, citing guidelines from the U.S. Centers for Disease Control and Prevention.
Svirskiy was one of 14 people connected to NECC who were indicted in late 2014 after a two year probe of the fungal meningitis outbreak which took the lives of dozens of patients and sickened hundreds of others.
He was convicted of racketeering, racketeering conspiracy, mail fraud and violations of the Food Drug and Cosmetic Act.
A prior petition for early release was denied by Stearns who said he did not have the legal authority to grant the request.
In the new petition Svirskiy argues that Stearns does have that power and the new evidence shows "extraordinary and compelling reasons" why he should be released.
Stating that Svirskiy has now exhausted all possible administrative remedies, including appeals to the warden at the prison in Central Masachusetts where he is confined, the petition calls on Stearns to grant his request.
The petition acknowledges, however, that the Covid-19 outbreak at his prison has eased, although eight staffers have tested positive for the virus.
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Multiple Covid Deaths in PA State Facilities

By Walter F. Roche Jr.

At least 54 persons have died from Covid-19 in facilities run by the state of Pennsylvania and most of the deaths have come in state correctional institutions.
Data posted by Pennsylvania agencies shows deaths from the coronavirus have occurred in state hospitals, state centers for the intellectually disabled and state prisons in nearly all parts of the state.
A total of 40 deaths have been recorded in state correctional institutions with the most, 9, coming at the state prison in Laurel Highlands. Six inmates died from the virus at the prison in Dallas. Four Covid deaths were reported at the Chester facility and five at the prison in Huntingdon.
The state Corrections Department has reported that systemwide 2,849 inmates have been diagnosed with Covid-19.
At least 11 residents have died at state hospitals. Ten of those deaths were at Norristown State Hospital. At Wernersville State Hospital officials reported that less than five deaths were recorded. (Under she state's reporting system facilities with one to four deaths don't disclose the exact number).
The facility at South Mountain also reported less than five deaths.
Covid-19 cases have been reported at three of the state's youth services facilities, but there have been no deaths.
At the four state centers for those with intellectual disabilities a total of 138 residents have been diagnosed with Covid-19. At the facility in White Haven, officials reported less than five deaths.
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Bryn Mawr Hospital Left Patients Without Monitors

By Walter F. Roche Jr.

Physician ordered cardiac monitors were not provided to five patients at the Bryn Mawr Hospital and one of the five was critically ill and in need of immediate attention, according to a state Health Department report.
The 287-bed hospital, part of Main Line Health, also failed to assign registered nurses to accompany the emergency room patients, who were awaiting further testing.
The hospital, the report states, "failed to maintain a safe environment for Emergency Department patients ordered to receive continuous cardiac monitoring."
"Continuous cardiac monitoring, no exceptions," the physician's Sept. 19 admission order stated.
"I guess I should have looked closer at the physician's admission orders," a staffer said when asked by surveyors about the lack of a monitor.
The report details the handling of the critically ill patient including the failure of staffers to respond to test results showing the patient's potassium levels were nearly double the normal level.
When state surveyors interviewed staffers involved in the case they acknowledged mistakes were made, including the failure to notify the physician about the potassium levels.
Instead they mistakenly assumed the sample had become contaminated and debated whether to do a re-test.
"In hindsight if I had this to do all over again I would have called the physician and/or the physician's assistant for a final decision about the test results," one hospital employee told the state inspectors.
Another employee told inspectors they assumed the test result was wrong because that level of potassium was "not compatible with life."
Main Line Health officials did not respond to a series of questions about the report including whether the patient survived.
Instead they issued a statement asserting that all the issues adressed in the report had been adressed.
"We are confident that our action plan addresses the issues identified, and demonstrates Bryn Mawr Hospital’s ongoing commitment to a culture of safety and highly reliable, quality care," Megan Call, a Main Line spokeswoman wrote in an email.
She said a corrective action plan had been submitted to the state, although the state report says an approved plan is not on file.
According to the state report, a review of hospital records showed incorrect information about the patient's heart rhythm had been entered.
The report also faults the hospital for failing to record a baseline cardiac rhythm and failure to raise his triage level, condition srable, despite the test results.
"The facility failed to ensure emergency department patients received an acceptable standard of nursing care," the report states.
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Deaths Recorded at PA Assisted Living Facilities

By Walter F. Roche Jr.

Though the focus has been on Covid-19 deaths in nursing homes, data collected by the Pennsylvania Health Department shows multiple coronavirus deaths have also been reported in assisted living facilities.
According to the latest data posted this week by the state the most Covid-19 deaths were reported at Arden Courts of Yardley where 27 reesidents succumbed to the virus. Covid-19 deaths were also recorded at five other Arden Court facilities with 14 at King of Prussia and 12 at Allentown.
A total of at least 56 Covid deaths were reported at six Arden Court faciliies.
Other facilities with 12 or more Covid deaths include Country Meadows in Wyomissing with 14, Residence at Glen Riddle 16, Above and Beyond Mountain View 15, Bellingham Retirement Living 14 and Arbor Terrace in Willistown 12.
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Connellsville Hospital Faces Multiple Citations

By Walter F. Roche Jr.

A 64-bed hospital in Fayette County has been cited by state Health Department surveyors for an assortment of violations including a lack of environmental controls and improper storage of surgical supplies.
The citations were issued as part of a Medicare recertification review for the Highlands Hospital. The review was conducted from Sept. 21 to Sept. 23.
The report recently made public also faults the facility for failing to notify the state when it instituted a new service under a contract with a third party, Suburban Imaging Associates LLC.
In addition, according to the report, the hospital failed to notify the state that the facility had received a notice that its water service was being terminated.
The hospital did file a plan of correction in which it promised to correct the deficiencies, including the replacement of missing or damaged floor and ceiling tiles in the pharmacy area.
Hospital officials did not respond to questions about the report. The hospital "failed to maintain the facility in a safe and sanitary condition for pharmacy workers," the report states.
another deficiency was actually witnessed by a state surveyor: an employee administered an injection to a patient's left buttock without wearing gloves.
The hospital also failed to conduct required annual reviews of contracted services and failed to document that patients were given copies of the hospital's Patients Bill of Rights.
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Unqualified Staff Administered Anesthesia

By Walter F. Roche Jr.

After the credentialed staff literally walked away, unqualified staff at an East Stroudsburg Hospital were left to administer anesthesia to an unidentified patient suffering a severe asthma attack.
That was the conclusion of officials from the Pennsylvania Health Department after conducting interviews and reviewing rcords at the 237-bed Lehigh Valley Hospital-Pocono.
According to a report recently made public the incident occurred on Oct. 14 when the patient had difficulty breathing and nursing staff sought assistance from the anesthesia department.
Though two qualified anesthesia staffers came to the Intensive Care Unit and brought a anesthesia machine with them, they then left.
"CF5 and CF6 refused to stay with MR1 (the patient), the report states. "They left the ICU."
The state surveyors found that the treatment of the patient resulted in multiple violations of hosital policy and accepted treatment standards. Those included failure to have a written physician's order for anesthesia and failure to perform a pre-anesthesia evaluation of the patient.
The hospital "failed to ensure a qualified practitioner monitored a patient receiving a general anesthetic," the report states.
The hospital did file a plan of correction in which they promised to re-educate staff on the required standards for anesthesia administration, including the requirement for a written order from a qualified physician.
Hospital officials did not respond to a request for comment.
After CF5 and CF6 walked away, the patient's primary nurse refused to administer the anesthesia leaving CF2 and CF3 to oversee the anesthesia administration which extended from 6:57 p.m. to 1:32 a.m.
"CF2 and CF3 did not have privileges to administer general anesthesia," the report states.
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Woman Administered Wrong Medication

By Walter F. Roche Jr.

A woman who went to a Pittsburgh hospital for a Cesaerean section was "inadvertently" given the wrong medication, according to a report from the state Health Department.
The woman was admitted to the West Penn Hospital in early August for the C-section and a tubal ligation, state surveyors found.
The patient was inadvertently given 450 micrograms of an intravenous preparation containing digoxin into her central spine fluid which was followed by 15 miligrams of lidocaine.
Two physicians responsible for the error failed to follow the hospitals policies relating to "the administration and automated dispensing of medications," the Oct. 8 report states.
The report does not indicate what effect the error had on the patient. "We are confident that the steps we have taken to address these issues will prevent future such events from occurring," said hospital spokesman Dan Laurent.
He said patient privacy rules bar the discloure of specific case details.
In a plan of correction, the hospital said it would institute a re-education program for anesthesia staff and monitor inventory to detect any errors.
The same hospital was cited a day earlier for failing to re-assess the conditions of three patients who had been placed in restraints at least once every two hours. The three patients were among five patient records reviewed by the Health Department inspectors.
The hospital's plan of correction calls for staff re-education on the proper use of restraints and a daily review of records to ensure compliance.
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Death Toll Rises in PA Veterans Homes

By Walter F. Roche Jr.

The death toll from the Coronavirus has climbed to 69 in six nursing homes for veterans run by the state of Pennsylvania and only one of the six has avoided any deaths.
Data supplied today by a spokeswoman for the state Department of Military and Veterans Affairs show that in addition to the 42 deaths already disclosed at a Chester County facility Covid-19 deaths have occurred in state run homes from Erie to Pittsburg to Philadelphia.
Joan Nissley, the agency spokeswoman said 13 residents at the Delaware Valley Veterans Center died from the virus while nine died at the veterans center in Hollidaysburg.
Three died at the Southwestern Veterans Center in Pittsburgh while two died from the virus at the Pennsylvania Soldiers and Sailors Veterans Center in Erie.
Only the Gino J. Merli Veterans Center in Scranton has avoided any Covid-19 deaths "We take every case of COVID-19 very seriously as our No. 1 priority is the health and safety of our residents and the staff who serve them," Nissley said.
She noted taken since the pandemic began a number of steps have been taken to improve safety including restricting visitors, cancelling outings, discontinuing group activities, ceasing the use of volunteers, conducting daily health screenings for employees, more frequent cleaning of commonly touched objects, and putting new admissions on hold.
She also cited the fact that inspections at all the facilties by state Health Department surveyors found them in compliance with state and federal Covid-19 requirements. Contact: wfrochejr999@gmail.com

Covid-19 Hits Another PA Vet Home.

By Walter F. Roche Jr.

The coronavirus has hit another Pennsylvania veterans home pushing the total of Covid-19 deaths in the six facilities to at least 46.
A report posted today by the state Health Department lists five deaths at the Hollidaysburg Veterans Center, a 257-bed facility in Blair County.
Previously 43 Covid-19 deaths had been reported at the Southeastern Veterans Center in Spring City Chester County.
There has also been at least one Covid-19 death at the Southwestern Veterans Center in Pittsburgh. (Under the Health Department system nursing homes report 1 to 4 deaths with an asterisk.)
The deaths at the Chester County facility has prompted calls for an investigation. Two top officials at the facility were removed.
At the Hollidaysburg facility the Health Department report states that there are currently 185 patients at the 257-bed nursing home. Twenty-one residents have tested positive for the virus along with 22 employees.
In the immediately prior report issued last week no deaths were reported while nine patients had tested positive along with 13 employees.
In the most recent inspection of the Blair County home state Health Department surveyors concluded that a Covid-19 focused inspection in mid-July found no deficiencies.
The new data on the state veterans homes come as other state health data shows a resurgence of infections and Covid-19 deaths is happening in many of the state's nursing homes.
In a press briefing today Philadelphia Health Commissioner Dr. Thomas Farley reported that after a lull, Covid-19 cases in nursing homes were once again on the rise.
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CHOP Doubled Up NICU Patients

By Walter F. Roche Jr.

For a little over a month the Childrens Hospital of Philadelphia doubled up the patients in the facilities neonatal intensive care unit in violation of state regulations.
State Health Department inspectors found that the doubling up began Sept. 2 and continued until Oct. 2 as workers at the facility were working on upgraded to the neonatal facilities..
In the report dated Oct. 2 the state surveyors cited a state regulation barring health facilities from admitting patients for which there was insufficient space.
"The number of patients admitted to any area of the hospital shall not exceed the number which the area is designed, equipped and staffed," the report states.
The hospital did not respond to questions about the report but in a plan of correction filed in response to the state report they reported that the remediation project had been completed and had passed a state inspection.
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Covid-19 Still Grows in PA Nursing Homes

By Walter F. Roche Jr.

Data collected by state health officials show deaths from Covid-19 have continued to grow in state licensed nursing homes even as attention has shifted to other victim groups including those in the 19-24 age group.
The data collected by the state Health Department shows 70 nursing homes have reported 20 or more deaths from the Coronavirus. The most deaths, 94, were reported at the Fair Acres Nursing Home in Lima Delaware County.
Overall some 3,850 patients have died from Covid-19 in Pennsylvania licensed nursing homes, according to the latest report dated Nov. 4 from the state agency.
That represents a substantial jump from the 3,200 deaths reported by Aug. 1. A review of the latest report compared to the one issued Oct. 27 shows that while most homes had no or modest increases in Covid-19 deaths, some reported substantial increases in a short period of time..
The Lafayette Redeemer Nursing Home in Philadelphia listed 25 Covid-19 deaths in its Nov. 4 report, but had reported no Covid-19 deaths Oct. 27.
The Manorcare Health Services home in Wallingford had reported no Covid deaths in late October but listed 34 a week later. The latest report shows nine Manorcare facilities had 20 or more Covid-19 deaths.
Many homes across the state were listed as providing no data on deaths in the late October report but listed substantial numbers on Nov. 4.
Those include the Saint Ignatius Nursing and Rehabilitation which reported no data in October and 23 Covid-19 deaths on Nov. 4. Saint John Neumann Center, also in Philadelphia listed no data in October and 37 Covid-19 deaths a week later.
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Philly Nursing Home Makes Corrections

By Walter F. Roche Jr.

Philadelphia health officials say they have corrected deficiencies at a city-owned nursing home that were uncovered following the suicide attempt of a despondent Covid-19 patient.
Agency spokesman James Garrow said the nursing home had submitted a plan of correction to the state Health Department and after the plan was approved by the state it was fully implemented.
The deficiencies at the more than 400-bed facility were cited in a detailed report on the suicide attempt by an unnamed male patient. Although a physician had made a referral for psychiatric help more than two weeks earlier due to the patient's suicidal ideations, none had been provided when the patient attempted suicide on Aug. 24.
The patient was found at 5:30 a.m. with a cord around his neck. He was hospitalized until Sept. 1 and then returned to the W. Girard Avenue facility.
A psychiatric referral only came after the suicide attempt.
Garrow said the agency, due to confidentiality rules, could not provide any information on the current status of the patient.
Garrow also declined to provide any information on the number of patients at the city nursing home who have been diagnosed with Covid-19 and how many have died from the virus.
Nonetheless reports filed with the state Health Department show 130 residents of the home have been diagnosed with the virus and 11 of them have died.
In its report on the incident, state Health Department surveyors concluded, "It was determined that the facility failed to maintain the highest practicable mental and psycho-social well being."
The nursing home's plan of correction included re-education programs for staff members on the proper treatment of suicidal patients and renewed efforts to identify patients who may be considering suicide.
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Philly Owned Facility Cited in Suicide Attempt

By Walter F. Roche Jr.

Officials at the city owned Philadelphia Nursing Home failed to get a physician ordered psychological consult for a despondent Covid-19 patient for more then two weeks resulting in an attempted suicide.
The patient was found at 5:30 a.m on Aug. 24 15 days after a physician ordered the psychology consult due to the patient's repeated suicidal ideations.
Details of the case are laid out in a complaint investigationn report from the state Health Department which concluded that the nursing home failed "to ensure that Resident 1 received the appropriate treatment and services, preventing the resident from trying to commit suicide."
In a plan of corection filed by the nursing home in reponse to the state report facility officials said the unnamed patient was finally referred for psychiatric services on the day of his suicide attempt and he was hospitalized until Sept. 1.
The plan of correction also calls for re-education programs for staff members on the proper handling of patients contemplating suicide.
Philadelphia Health Department officials did not respond to a request for comment.
According to the state report there were several warnings that the patient was considering suicide including a day when he pleaded to a staffer, "Suicide! Suicide me."
Another warning came when the patient underwent an annual assessment on Aug. 5 and the physician, citing an increase in episodes of anxiety as evidenced by panic attacks, recommended a referral to a psychiatrist.
"Resident states that he believes he is going to die," a staffer wrote in the patient's record.
When state surveyors questioned the director of nursing about the case the official acknowledged that "to date the psychology consults had not been completed as ordered by a physician."
"It was determined that the facility failed to maintain the highest practicable mental and psycho-social well being," the report states.
According to data from the state Health Department 11 residents of the city owned nursing home have died from Covid-19. A total of 130 residents at the 402-bed facility have been diagnosed with Covid-19.
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Temple Cited in Patient Suicide

By Walter F. Roche Jr.

Citing a discrepancy between hospital records and video surveilance tapes, state Health Department investigators have concluded that Temple University Hospital workers failed to properly monitor a suicidal patient allowing him to hang himself.
A report on the Sept. 7 suicide at the hospital's Episcopal Campus concludes that while hospital employees were supposed to check on the patient face-to-face every 15 minutes, video tapes showed no one went into the patient's room a single time during a critical more than one hour period.
Nonetheless hospital records stated that the 15 minute checks were dutifully performed.
"Documentation in the medical record showed that 15 minute checks were completed and documented by the mental health technician," the report states.
"The video tape review showed there was a long period of one hour and eight minutes when Patient One was not visualized by a staff member which was in contradiction to the required 15 minute visual checks to be conducted by the staff per hospital policy," according to the report.
"The facility failed to ensure patient monitoring was performed as required," the report states, adding that a registered nurse was ultimately responsible but failed to ensure that the 15 minute checks were actually being performed.
The investigation showed that the unnamed patient tore up a sheet and attached it to a shower curtain rod and then hung himself.
The hospital also was cited for failing to remove ligature risks (the curtain rods) from an area where suicidal patients were being treated. The report does state that the curtain rods in the unit were immediately removed while surveyors were conducting their review.
Further review of video tapes showed there were 17 missed 15 minute checks in the behavioral unit in a two day period including the day of the suicide.
"This placed 21 patients at risk for harm, serious injury or death," the surveyors concluded.
The hospital failed to file an acceptable plan of correction and did not repond to requests for comment.
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Multiple Covid-19 Violations at PA Hospital

By Walter F. Roche Jr.

State surveyors say multiple violations of Covid-19 care requirements were observed at a 149-bed behavioral hospital, including an employee, who had tested positive for the virus interacting with a patient without properly wearing a face mask.
The details of the September survey at the First Hospital of the Wyoming Valley were included in a report made public late last week. The violations of state and federal rules on care for Covid-19 cases were observed both in person and by viewing surveillance videos at the Kingston facility.
The surveyors visited the hospital on Sept. 4 and again from Sept. 8 to Sept. 10.
The violations ranged from failing to properly screen patients prior to admission to failure to provide oversight of nursing staff to ensure they were properly using Personal Protective Equipment.
Surveyors personally observed an employee using a cell phone, a prohibited practice, in a patient care area.
The facility policy required leaving personal cell phones in a first floor locker room, according to the Sept. 10 report.
The hospital is part of Commonwealth Health, which boasts of its system-wide measures to keep patients and visitors safe during the ongoing pandemic.
A hospital spokeswoman, Annmarie Poslock, said the facility "implemented a plan of correction accepted by the Pennsylvania Department of Health following the September inspection." She said directors and providers have been retrained on infection control protocols established by the Centers for Disease Control and Prevention including the appropriate use of personal protective equipment.
She said the hospital does not currently have any Covid-19 cases. The hospital also was cited for failing to properly screen patients prior to admission.
The report cites three patients who were not pre-screened and later tested positive for Covid-19.
In seven of seven patient records reviewed the hospital had failed to ensure patients were tested prior to admission.
Other screening steps were absent in 12 of 26 records reviewed. Those missing steps included asking patients about any recent elevated temperatures or for other symptoms prevalent in Covid-19 cases.
In its plan of correction the hospital said it would no longer admit patients with positive Covid-19 test results.
In reviewing videos the surveyors observed multiple cases of employees interacting with patients while not wearing masks or not wearing them of other Personal Protective Equipment properly.
As part of its plan of correction the hospital agreed to maintain a list of non-compliant employees.
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Stabbing Victim Waits 7 Hours for Doctor

By Walter F. Roche Jr.

A stabbling victim, whose case had been classified as urgent, had to wait nearly seven hours after arriving at a hospital emergency room before being examined by a doctor.
That was the finding of surveyors from the Pennsylvania Health Department performing a state licensure inspection of a Montrose hospital.
According to the report on the Endless Mountain Health System hospital the stabbing victim arrived at the hospital at 3:23 a.m. on March 1 with a stab would in the chest. Hospital staff had categorized the case as Level 3 Urgent.
Yet it wasn't until 10:09 a.m. when a doctor examined the patient and ordered a transfer to another hospital for surgery.
The physician "failed to evaluate the patient in a timely manner," the report states.
Hospital officials did not respond to a series of questions about the incident.
The Aug. 20 report also cited the hospital for failure to have a director of anesthesia and for a series of sanitation issues including dirt and dead bugs at the entrance to the emergency room.
The facility "failed to maintain a clean environment," the report states.
The hospital filed a plan of correction which included re-educating staff on triage policy and a monitoring program to ensure compliance.

Wrong IV Administered at Wilkes Barre Hospital

By Walter F. Roche Jr.

A patient at a Wilkes Barre hospital was given an IV prescribed for another patient and even after the error was uncovered the patient's doctor was not informed.
That was the finding of an August state licensure inspection at the PAM (Post Acute Medical) Specialty Hospital, a 36-bed facility located within the Wilkes Barre General Hospital.
The IV mixup was only one of several medication errors turned up in the five-day inspection of the hospital in early August. And the same facility was cited twice in 2019 for other violations including a lack of adequate staff.
In the recent report one patient had been prescribed a five percent dextrose in a saline solution at a rate of 100 milligrams per hour.
A second patient had been prescribed a 5 percent dextrose solution in water administered at 50 milligrams per hour.
On Nov. 4 of last year at a shift change at 10 p.m. a nurse discovered that the first patient was getting an IV with the second patients's information on it.
Hospital records showed the patient getting the wrong IV had been administered 80 milligrams of wrong IV before it was discovered.
The report states that despite a hospital requirement that serious medication errors had to be reported to the physician of the patient affected, the records showed no documentation that the notification took place.
In addition the error was not recorded in the patient's record.
In another case, the report states that a doctor's order to increase the dosage of a drug was not implemented. And again the patient's doctor was not informed, according to the report.
In the same inspection state surveyors found that a crash cart had three expired vials of sodium chloride.
The hospital filed a plan of correction calling for re-education of staff on the requirements for reporting medication errors "that have harmed or have the potential to harm the patient."
The hospital also implemented a plan to ensure that expired medications were removed from crash carts.
Hospital officials did not respond to questions about the report.
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Hospital Failed to Screen for Covid-19

By Walter F. Roche Jr.

A suburban Philadelphia hospital failed to follow state and federal requirements in screening some 91 visitors to the 371-bed facility for coronavirus, according to a report by state Health Department officials.
The report dated Aug. 11 but only made public this week, states that Saint Mary Medical Center "failed to ensure all visitors were actively checked for temperatures and docmented in a log."
A review of hospital records for the first 10 days of August showed that for 91 of 172 visitors there was no documented evidence that these visitors had their temperatures taken."
The facility was not in compliance with state and federal Covid-19 guidelines, the report states.
In a plan of correction filed by the hospital, Saint Mary officials said they implemented an education program for employees on proper screening and maintaining the required log.
The hospital was cited in a separate report for failing to get proper informed consent from another patient. State surveyors were told hospital employees were unable to get a patient signature due to the Covid-19 pandemic.
"The facility failed to follow their policy for obtaining consents during the Covid-19 pandemic," the report states.
In yet another finding state surveyors cited the hospital for giving improper discharge instructions to a patient.
The patient was instructed not to remove nasal packing until the next day when a visit with an eye, ear and throat specialist was scheduled. The patient, however, had no nasal packing.
Hospital officials did not respond to a request for comment.
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Hospital Cited for Turning Away ER Patient

By Walter F. Roche Jr.

A Clearfield County hospital has been cited for turning away a clearly distressed patient seeking care in the emergency room.
According to a report from the state Health Department the patient was told by a Penn Highlands Clearfield employee to go home and call for an ambulance. Ultimately an ambulance picked up the patient on the hospital grounds and then brought the patient to the emergency room.
In the report state Health Department surveyors cited a federal law, the Emergency Medical Treatment and Labor Act, which requires that a hospital with an emergency room must provide a prompt examination and treatment.
The hospital "failed to ensure that a medical screening examination was provided for one patient who presented to the emergency room," the report states.
The incident occurred on May 18 at 12:42 p.m. when the patient, accompanied by a relative, arrived at the hospital in the front passenger seat. The state surveyors reviewed hospital records and also viewed videotapes showing the patient's arrival.
"The patient was noted to be extremely upset, embarassed and crying," the report states, adding that the patient, who had suffered a fall, came to the hospital under a doctor's instructions.
"The patient was told by an employee they could not help because the patient was a fall risk," the report states.
Officials of the 50-bed hospital did not respond to requests for comment.
In addition to failing to make a required assessment of the patient, hospital employees failed to enter the patient's first visit into the emergency department log.
"The patient should have been entered into the log and then formally transferred," the report states.
The hospital filed a plan of correction calling for retraining of emergency room employees on the requirements of the federal law and also the handling of "patients of size."
The report also cites the hospital for failure to maintain the required physician-on-call list.
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Phila VA Official Indicted for Bribery

By Walter F. Roche Jr.

The head of environmental services at the Veterans Administration Hospital in Philadelphia was indicted today for solicting bribes from two Florida contractors to steer contracts to their firms.
In an 11-page indictment filed in U.S. District Court in Philadelphia Ralph Johnson, the head of environmental services at the Veterans Administration Medical Center, was charged with three counts of soliciting bribes.
In an affidavit filed in the case an FBI agent said that Earron and Carlicha Starks paid over $100,000 in bribes to Johnson who then steered a series of contracts to two Florida firms controled by the Starks.
In one instance Johnson steered an $84,000 tree trimming and removal contract to the Starks in return for a $3,000 payment. According to the indictment the work under the contract was actually performed by a subcontractor for $4,000.
According to the 12-page affidavit from Special Agent Brett Nelson Johnson steered conracts worth more than $2 milllion to two Starks companies.
Some of those contracts were awarded under a program setting aside contracts for businesses controlled by service disabled veterans, but the Stark companies were "not legitimate" service disabled businesses, the affidavit states.
According to the affidavit the Starks were wearing wires during two of their meetings with Johnson, one in Philadelphia on June 13, 2019 and the other on Aug. 14, 2019 at an Orlando hotel.
The Starks "traveled regularly to Philadelphia" to pay over $100,000 in bribes to Johnson.
Records show the Starks already have entered guilty pleas in Florida to a single count of conspiracy to commit health care fraud. They have yet to be sentenced.
If convicted, Johnson faces a possible sentence of 45 years imprisonment, 3 years supervised release, and up to a $750,000 fine.
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PA Hospital Faulted in Drowning

By Walter F. Roche Jr.

Staff at a Pennsylvania psychiatric hospital didn't notice for 20 minutes that a patient had not returned with 11 others from a pond located on the facility grounds.
That was one of the findings of state health inspectors investigating the July 24 drowning of a 46-year-old woman at the Wellspan Philhaven Hospital in Mt. Gretna.
The report made publc this week concludes that the hospital was out of compliance with state and federal licensing requirements because it failed to provide care in a safe setting. The report cites "substantial deficient practices related to the on-site investigation for a patient death."
According to the report the unnamed woman had previously told staffers that she wanted to kill herself.
"I wish I just had a big knife and could just cut myself and be done. I want to be put in a place and let go until I die," the patient was quoted as saying.
A review of records and interviews showed that the victim was one of 12 brought to a pond on the grounds of the hospital, but when the group was brought back to the living quarters just before 5 p.m., no one noticed that only 11 returned.
"The staff failed to notice that the patient did not return to the unit," the report states, noting that hospital protocols required staff to accompany clients on all off-unit activities.
After her absence was noted staff pulled her body from the pond and attempted resuscitation but the effort failed.
The state surveyors also noted that the hospital staff had never addressed the patient's swallowing issues.
She had told a hospital worker, I cannot eat or drink. I am very weak."
Although the hospital did install a temporary fence around the pond and promised to re-educate staff on patient safety checks, an approved plan of correction was not filed.
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PA Hospital Turned Patient Away

By Walter F. Roche Jr.

A Pennsylvania hospital has been charged with violating a federal law when it turned away a patient who had arrived in an ambulance with a police escort.
In a report just made public by the state Health Department, state surveyors found that a nursing supervisor at Washington Health System Greene told police to take a behavioral patient who had displayed violent behavior to another unnamed hospital "that was better staffed and equipped to manage patients with behavioral issues."
The 23-bed facility is the only acute care hospital in Greene County in the far southwest corner of the state. The hospital boasts of having 24-hour emergency care. Hospital officials did not respond to a request for comment.
The incident occurred on April 23 and the investigation initiated April 28, but the report was not issued till July 20, apparently due to Covid-19 pandemic.
The report cites the federal Emergency Medical Treatment and Active Labor Act which bars hospitals from turning away patients before a medical examination and assessment are performed.
"The patient did not have a medical screening prior to transfer," the report states, adding that employees confirmed that the facility failed to provide an appropriate medical screening examination."
The report notes that the hospital self reported the "non-compliance" and "was found in compliance at the time of the survey."
Despite reporting the incident, the hospital failed to file an approved Plan of Correction.
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Troubled PA Vet Home Cited Again

By Walter F. Roche Jr.

The state run nursing home for veterans where 42 residents died in a Covid 19 outbreak has been cited for failing to properly monitor a patient who had told staffers he simply wanted to die.
A report on the Southeastern Veterans Center in Spring City concluded that the facility "failed to adequately monitor one of one residents reviewed who had expressed a death wish and had a history of suicidal ideation."
The 238-bed facility in suburban Philadelphia has been the subject of prior highly critical inspection reports based on the mishandling of the deadly Spring coronavirus outbreak.
The new report, dated July 23, states that the unnamed male patient had been re-admitted to the veterans center from a local hospital suffering from dementia and coronary artery disease.
The patient had "a documented history of expressing a desire to hurt himself," the report states, adding that a staff member reported that the patient had just stated a desire to hurt himself.
A review of facility records by state surveyors showed no documentary evidence that many of the 15 minute checks on the suicidal patient which had been ordered were actually performed.
No 15 minute checks were documented from 7:45 a.m. to 2:45 p.m. on July 12. The same was true from 3 p.m. to 11:45 p.m.on July 13. And on July 14 and July 15 the 15 minute checks were completely undocumented on all three shifts.
The facility administrators filed a plan of correction in which they stated that the patient had been re-evaluated by an outside consultant "and new orders were received. He has no suicidal ideations with a formulated plan currently."
The plan also calls for staff re-education on the requirements for a one-to-one watch on a suicidal patient.
The state Health Department surveyors, meanwhile, have made spot checks at the five other state veterans homes and found them in compliance with state and federal requirements for the handling of Covid-19 cases.
One other facility, the Delaware Valley Veterans Center in Philadelphia, has reported 13 Covid-19 deaths.
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Scranton Hospital Cited Again

By Walter F. Roche Jr.

A Scranton hospital has been cited for the second time in a month by state Health Department surveyors this time for failing to keep watch on a suicidal patient who was injured in a failed attempt.
In a report made public this week the Regional Hospital of Scranton was faulted in the care of a patient who arrived at the facility on March 7 acknowledged having suicidal thoughts. He also had "a history of cutting arms" and was regarded as a high risk for suicide.
The patient was taken to a bathroom by an employee assigned to provide a one-to-one watch, but once inside the bathroom the patient found a tongue depressor, broke it into pieces and then self inflicted an arm wound requiring two stitches.
"The facility failed to provide continuous observation of a suicidal patient that resulted in the patient lacerating themselves," the report states.
The report also faults the hospital for failing to report the incident within 24-hours as required by a state law.
The surveyors also cited the hospital for failure to eliminate suicide risks including a metal hook on the wall.
In its plan of correction hospital officials said suicidal patients will no longer be brought to bathrooms but provided with "a urinal and/commode. The plan also calls for a staff re-education program on the requirements for a one-to-one watch.
The Scranton facility was cited earlier this month for improperly transferring patients to another facility and failure to provide needed MRI services. An improper transfer also was noted in a prior report.
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State Resumes All Hospital Inspections

By Walter F. Roche Jr.

In March of this year, surveyors from the Pennsylvania Health Department visited a Scranton hospital and found multiple violations of state and federal law including the premature discharge of a seriously ill patient.
Nonetheless a report on those findings was not completed and made public until months later. The delay was one of about 65 hospital survey reports put on hold, according to state officials, because of an order from a federal agency, the Centers for Medicare and Medicaid Services.
Nate Wardle, state Health Department spokesman, said the delay from mid-March through July was the result of a CMS directive to limit survey activity and focus on Covid-19 preparations and operations.
He said the order was lifted and state surveyors were authorized to resume normal survey activities on July 3.
Wardle said any backlog has been erased and all survey activities are now ongoing and up to date.
"Any surveys related to complaints which indicated a potential risk to patients, including risk for serious injury, serious harm or death, were not put on hold and did occur with site visits," Wardle said in an email response to questions.
"The hospital surveys that were most impacted were licensure surveys and recertification surveys," Wardle added.
The recently released report on the Regional Hospital of Scranton, however, indicates that violations of state laws and regulations were put on hold for several months.
"The report was held due to a directive from CMS," the July 17 report states, adding that the report was triggered by two complaints.
In one case detailed in the report a patient was discharged with a major headache. In fact a hospital employee told state surveyors the patient should have been transferred to another hospital.
The patient's mother "felt the patient received a lack of care."
The report cites the records of several patients who needed MRIs, but had to be sent to another hospital for a diagnosis.
The state inspectors also cited the hospital for failing to provide proper transfer orders for the same patients.
A review of hospital records showed the facility couldn't perform the ordered MRIs due to a shortage of MRI technicians.
"The facility failed to provide MRI services" in six of six records, the report states.
Despite the multiple failures the hospital failed to report the "infrastructure" failures as required under the state Medical Care Availability and Reduction of Error Act.
Also cited was a federal law, the Emergency Medical Treatment and Labor Act, barring hospitals from discharging patients prematurely.
In addition to the patient with the serious headache, other improperly transferred patients cited in the report included a stroke victim and a patient who fell from a ladder while putting up an 85 inch high curtain and apparently eloped without treatment at either hospital.
State inspection records show delayed reports were not all negative. Delayed reports on UPMC Altoona and the First Hospital of Wyoming Valley concluded that the facilities were in compliance with state and federal laws and regulations.
A report clearing another hospital complaint states that a report dating back to April was finally concluded on July 17 once state inspectors were able to visit the facility.
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Temple Hospital Cited in ER Fire

By Walter F. Roche Jr.

Security personnel at Temple University Hospital"s Episcopal campus gave a cigarette lighter back to a bahavioral patient who subsequently lit a mattress on fire using that same lighter, according a state Health Department report.
The May 23 incident which triggered an emergency evacuation order at the facility was detailed in a June 9 report just made public.
The report concludes that the hospital "failed to provide care in a safe setting and put patients and staff "at risk for serious physical and emotional impairment."
According to the report the psychiatric patient was uncooperative, hallucinating and had a history of polysubstance abuse.
During a safety search, security personnel found a lighter, but it was given back to him by security. An employee told state inspectors that emergency department patients were allowed to have lighters and matches.
Hospital officials did not respond to a request for comment and the state report notes that the hospital had not filed an acceptable plan of correction. The hospital did however file a response to a state of "immediate jeopardy" declared when the surveyors first arrived on May 30.
The "immediate jeopardy" was lifted a day later when the hospital filed an interim plan to assess behavioral patients upon arrival, use of a metal detector and staff education.
After passing through security the patient, according to the surveyors, was placed in an examination room on a gurney which had an oxygen tank attached. A review of videotapes showed the patient was next seen manipulating the oxygen tank and then set the mattress on the gurney on fire with his lighter.
The unidentified patient already had barricaded the door to the examination room.
Surveyors found that ER personnel, despite the patient's hallucinations, substance abuse history and displayed abnormal psychiatric behavior did not order a one-to-one watch.
One ER employee told the state surveyors she was trying to transfer a Covid-19 patient and "I did not have time" to see that a one-to-one watcher was assigned" to the behavioral patient.
The hospital did not have a specific policy on how to handle patients suffering from hallcinations, the report states.
The report also questions why oxygen tanks were routinely attached to gurneys when oxygen already was piped into the examination rooms.
"In this incident, having the oxygen tank underneath the stretcher in exam room eight with this patient did create a potential hazard to the patient and to all in the emergency department," a Temple employee told the surveyors. Security personnel broke a window to the room to gain access while the patient came out of the room and at one point threw a chair into the nurses station. A Code Red was declared and patient evacuation initiated.
Police and fire personnel responded and the patient was placed under arrest and the fire extinguished.
The state surveyors weren't done. They inspected the emergency department and found numerous ligature risks, door knobs and other fixtures that could be utilized for suicide attempts. Records showed the department had not been assessed for suicide risks since Jan. 31, 2019.
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Multiple Deaths At Homes Using Unauthorized Drug

By Walter F. Roche Jr.

At least 115 Pennsylvania patients have died from Covid-19 at the same nursing homes where there was widespread and unapproved use of a controversial drug touted by President Trump but subsequently removed from an approved coronavirus treatment list by the U.S. Food and Drug Administration.
Reports issued by the Pennsylvania Health Department show the deaths occurred at two nursing homes at opposite ends of the state; the Brighton Rehabilitation and Wellness Center in Beaver and the Southeastern Veterans Center in Chester County.
Inspection reports on the two facilities show the drug hydroxychloroquine was in widespread use at both facilities. In fact 205 of 435 patients at the Beaver nursing home were treated with the drug without the required approval of the state Health Department.
Nor did Brighton officials get proper informed consent from patients or their legal guardians.
State Health Department reports show 42 patients have died at the Southeastern Veterans Center while 73 have died at Brighton, one of the highest totals in the state.
The use of the drug, which the FDA has warned can have serious, even fatal side effects on some patients, has drawn the attention of three Democratic U.S. Senators to call on three federal agencies to take action.
The letters to the FDA, the Centers for Disease Control and Prevention and the Inspector General in the Office of Health and Human Services cite the fact that the drugs were dispensed in apparent violation of state and federal laws and regulations.
The letters were sent by Ron Wyden of Oregon, Elizabeth Warren of Massachusetts and Bob Casey of Pennsylvania.
In the letter to the HHS Inspector General the senators cited the use of the drug on cognitively impaired patients in a Texas nursing home.
The FDA had issued an emergency use authorization for hydroxychloroquine on March 28, but then revoked that authorization on June 15. Trump had touted the anti-malarial drug as a "game changer."
In a recent state Health Department inspection report on the Brighton facility, state surveyors cited the fact that the drug was not an approved medical treatment. In addition the home failed to report the drug use as a medication error.
The Chester county state run veterans home was cited recently for delayed treatment for a patient with multiple ailments. The patient was being treated with hydroxychloroquine and orders for X-Rays were delayed. The patient's conditions included pneumonia and a temperature of more than 100 degrees, two of the symptoms of Covid-19.
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PA Vets Home Cited For Delayed Care

By Walter F. Roche Jr.

A Pennsylvania nursing home for veterans has been cited for delayed care for a patient during the beginning of a deadly coronavirus outbreak that took the lives of 42 residents in the Chester County facility.
In a report made public this week state Health Department surveyors found that employees at the Southeastern Veterans Center in Spring City failed to followup on an X-Ray order "resulting in a delay in treatment."
The patient, the inspection records show, had been prescribed hydroxychloroquine, an anti-malaria drug highly touted by President Trump as a Covid-19 treatment. The U.S. Food and Drug Administration has subsequently withdrawn approval for emergency use of the drug on Covid-19 patients and warned of potentially fatal side effects in some patients.
In the report dated July 16, state Health surveyors said a physician had ordered a series of chest X-Rays for the patient on April 16, but the order was not carried out and a second X-Ray order was issued on April 19.
There was no record the treating physician was informed of the delay, the report states. The patient had been prescribed an antibiotic and Plaquenil, a brand name for hydroxychloroquine.
The inspection report describes Plaquenil as an anti-malarial drug that sometimes provides relief for arthritis.
The patient also suffered from hypertension, Chronic Obstructive Pulmonary Disease and chronic kidney disease.
"The facility failed to follow-up in a timely manner resulting in a delay of treatment for Resident CL1," the report states.
Records show that the drug hydrochloroquine was in widespread use at the veterans center even as Covid-19 raced from patient to patient ultimately killing 42 of them.
According to a separate inspection of the 238-bed facility, two residents died on April 21, two days after delayed treatment began.
Officials of the state Department of Military Affairs did not respond Thursday to questions about the report including whether or not the patient, described only as CL1, survived.
In a response to the inspection report officials of the facility said that CL1 was no longer at the nursing home.
"CL1 no longer resides in the facility," the Plan of Correction states.
The response included a series of steps, includung audits, the nursing home promised to take to avoid future delays in treatment, particularly when X-Rays are ordered.
According to the report the unnamed patient was suffering from pneumonia, a partially collapsed lung and a lung condition called "patchy bibasilar."
The patient's records showed a rapidly escalating temperature peaking at 101.3 on the day the initial X-Ray order was written. Temperatures over 100 are a symptom of Covid-19
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Guthrie Cited By State Surveyors

By Walter F. Roche Jr.

Two Bradford County hospitals have been cited by state surveyors for failing to inform the state health department in advance of reductions in available services.
Cited were the Robert Packer Hospital and the Guthrie Towanda Memorial Hospital, both part of the Guthrie Medical Group.
According to an inspection report recently made public by the state Health Department, Towanda hospital officials failed to provide at least 60 days notice of plans to cease providing an existing health care service or reducing its licensed bed complement.
The report states that a hospital employee acknowledged to a health department inspector that only 10 patient beds were available, although the hospital was licensed for 35 beds.
A review of hospital records showed the patient census generally ranged from two to ten patients. The maximum amount was 14 and that was for a single day.
The hospital employee told the state surveyor that the decision to reduce the bed count was made on May 8 "and is not permanent."
According to the report the hospital employee also acknowledged that the hospital ceased performing outpatient pulmonary function tests on March 28 "at the beginning of the Covid-19 pandemic."
"Employee One confirmed the closure was related to the Covid-19 pandemic," the report states.
Towanda President Felissa Koernig issued a statement denying that the closure was related to the pandemic.
"While Guthrie Towanda has not decreased the number of licensed beds, the hospital has adjusted its staffing levels to better align with recently declining average daily census numbers," Koernig wrote.
"This is not related to Covid-19,"she continued, adding that the hospital "inadvertently" failed to notify the state Health Department.
She added that if at any time patient care "requires Guthrie Towanda to increase its number of staffed beds, the hospital is prepared to do so and would notify the Pennsylvania Department of Health."
At the 267 bed Robert Packer Hospital in Sayre, state surveyors cited officials for failing to notify the state of an "infrastructure failure" when it reduced the number of available beds in the Behavioral Science Unit.
According to the report the beds were cut to seven due to staffing issues. The hospital filed a plan of correction in which it said the required report was filed and any future infrastructure failures would be reported within 24 hours.
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Susquehanna Hospital Flunks Medicare Certification

By Walter F. Roche Jr.

A rural 83-bed Pennsylvania hospital has been cited for multiple deficiencies during a Medicare re-certifcation review in late May by surveyors from the state Health Department. The Barnes-Kasson County Hospital was found to be "not in compliance" during a four-day review ending on May 24.
Hospital officials did not respond to requests for comment.
According to the lengthy inspection report the hospital "failed to ensure re-usable equipment was cleaned and re-processed appropriately."
The surveyors found test strips used in the cleaning and reprocessing department were opened but undated as required.
In the dietary department inspectors from the state Health Department observed employees with unrestrained hair and failure to make food temperature checks.
Other deficiencies included the failure to post signs notifying patients that a licensed physician is not on duty 24 hours per day- seven days a week and the failure to properly inventory outdated narcotic drugs.
Outdated drugs cited in the report include oxycontin, morphine and fentanyl patches.
Surveyors also cited the hospital for failure to document proper supervision of nurse anesthetists and failing to properly review dozens of incident reports including 10 falls and a dozen medication errors.
The hospital filed a plan of correction that calls for staff re-education for employees involved in the areas cited by the surveyors. In the quality control department the hospital's corrective action plan calls for monthly reviews to ensure incident reports are reviewed.
The hospital plan also calls for checks to ensure expired narcotic drugs are handled properly.
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Covid-19 Deaths Reported in PA Vet Homes

By Walter F. Roche Jr.

Deaths from the coronavirus have now been reported in three Pennsylvania nursing homes for veterans and postive cases of the virus among patients have now been reported at five of the six state run homes.
Data supplied by the state Department of Military and Veterans Affairs show the deaths have occurred at state veterans homes in Philadelphia, Chester County and Pittsburgh.
At the Southeastern Veterans Center in Spring City 28 deaths from the virus have been confirmed. An additional 14 cases are presumed to be from the coronavirus.
Thirteen Covid-19 deaths have been reported at the Delaware Valley Veterans Center in Philadelphia.
Three coronavirus deaths have been reported at the Southwest Veterans Center in Pittsburgh.
Overall 55 veteran deaths at the state veterans facilties have been confirmed or presumed to be caused by Covid-19. At the Gino Merli Veterans Center in Scranton a single patient has tested positive for Covid-19.
Two patients have tested positive at the Hollidaysburg Veterans Center in Blair County.
Only the Pennsylvania Soldiers and Sailors Home in Erie has reported no patients infected with the virus.
The same data shows 80 employees at the state homes have tested positive for the virus" nineteen at the Philadelphia home, three in Scranton, one in Erie, 45 in Spring City and 12 in Pittsburgh. No employee Covid-19 deaths have been reported.
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Covid Money Goes To Covid Facilities

By Walter F. Roche Jr.
Some $245 million in federally funded Covid-19 aid for nursing homes has been distributed by Pennsylvania officials to dozens of health facilities that include several that are publicly owned and many that have seen dozens of their patients succumb to the pandemic.
The money, allotted by the federal government, has been distributed under the provisions of a Pennsylvania statute approved by the legislature and signed by Gov. Tom Wolf.
Recipients of the funds include a Beaver County nursing home where 73 patients have succumbed to the coronavirus.
A little over $1.8 million was allocated to the Brighton Rehabilitation and Wellness Center.
One of the highest single grants, a little over $2 million went to Cedarbrook Senior Care and Rehabilitation, a Lehigh County run facility with two locations. Data on the number of Covid-19 cases at the facilities were not immediately available.
The Fair Acres Geriatric Center in Delaware County has reported 81 Covid deaths. The grants to the facility total more than $2.5 million, the highest of any one facility.
According to state officials and the Pennsylvania Health Care Association (PHCA), which represents nursing homes, the $245 million was distributed under two separate allocation formulae.
Some 80 percent or $196 million of the total was distributed based on the number of days each facility provided to Medicaid recipients in the third quarter of 2019.
The remaining $59 million was distributed based on the number of beds in each eligible nursing home.
PHCA spokeswoman Shayna Varner said the full $245 million has been distributed to Pennsylvania nursing homes.
Erin James, spokeswoman for the state Department of Human Services, said nursing homes not participating in the Medical Assistance program also can qualify for funds by submitting required forms.
"I’m told some of those payments are in process," she added.
Other major recipients in the Medicaid category include the Conestoga View Nursing Home in Lancaster which was awarded $1.5 million from the two programs. Seventy-seven Conestoga patients have died during the ongoing pandemic.
Another public owned facility, Northampton County Home-Gracedale, which has reported 76 Covid-19 deaths has been granted $2.4 million through the two allocation systems.
Still other recipients include Parkhouse Rehabilitation and Nursing in Royersford where 52 deaths have been recorded. The facility got $1.3 million in coronavirus funding.
The city owned Philadelphia Nursing Home got more than $1 million in Covid funding. The facility has reported nine Covid deaths.
The Pleasant Acres Rehabilitation and Nursing Center in York, where 13 Covid deaths have been recorded, was allotted more than $1.1 million.

PA Nursing Homes Fail to Submit Covid-19 Data

By Walter F. Roche Jr.
Dozens of Pennsylvania nursing homes have failed to timely submit data on the number of patients and employees testing positive or dying from the Coronavirus.
A review of data collected and posted by the Pennsylvania Health Department shows Covid-19 data is missing for a little over 100 facilities and a department spokesman says the reason is the facilities failed to submit required data.
"A facility listing no data means that the facility is not reporting data to the department. Sometimes it is the result of incomplete or inaccurate data, but the majority of the facilities are not reporting data, as they are required to do," spokesman Nat Wardle said in an email response to questions.
Among those facilities listed with "No data" are the state owned Delaware Valley Veterans Home. The state Department of Military and Veterans Affairs, which runs the facility did provide the missing data in response to a reporter's request.
The Health Department statement brought a strong reaction from the Pennsylvania Health Care Association which represents nursing homes and other long term care facilities in the state.
Calling the various state reporting requirements "cumbersome," Zach Shamberg, who heads PHCA, said nursing homes are required to report detailed data in multiple categories to five different data reporting databases.
As a result, Shamberg added, hours of staff time that should be devoted to patient care, are spent trying to meet the multiple reporting requirements.
"PHCA," Shamberg concluded has advocated for a singular streamlined data reporting system. In addition to the Southeastern Veterans Center, long term facilities listed as reporting "no data" include nursing homes from Norristown to Mechanicsburg to McKeesport.
The list includes Abington Crest Healthcare and Rehabilitation in Erie, Towne Manor in Norristown, Wyndmoor Hills Rehabilitation and Nursing in Wyndmoor, UPMC in McKeesport. Also the Masonic Home in Warminster, Immaculate Mary Center in Philadelphia and the St. Ignatius Nursing Center in Philadelphia and Weston Rehabilitation in Hellertown.
As for the Delaware Valley Veterans Center in Philadelphia, the state Department of Military and Veterans Affairs reported that 32 residents tested positive for Covid-19 and 13 of those patients died. Seventeen employees tested positive but none of them died.

2nd PA Veterans Home Cited on Covid-19

By Walter F. Roche Jr.
A state run veterans home in Erie has been cited by health inspectors for failing to properly screen the two state inspectors checking on the facility's compliance with Covid-19 infection control requirements.
In a report just made public this week, state health surveyors reported that when they arrived at the Pennsylvania Soldiers and Sailors Home on June 23, an employee of the veterans home who was screening visitors did not screen the surveyor and said ,"Go ahead in."
The screener was supposed to take the visitor's temperature and have the visitor fill out a questionnaire.
"The facility failed to implement thorough infection control measures regarding the screening process of visitors as related to Covid-19 prior to entrance to the facility for one of two visitors," the report states.
The report comes just weeks after a highly critical report was issued on another state run veterans home at the opposite end of the state.
More than 40 residents of the Southeastern Veterans Home in Chester County died as Covid-19 ravaged the 238 bed facility.
The report on the Erie facility also cited the failure of the screener to change gloves and sanitize between visitors.
According to the report the screener told surveyors the instructions were to allow some people in without the usual checks.
State surveyors have been checking the four other state veterans homes for compliance with state and federal Covid-19 requirements. The other facilities have been found in compliance.

Covid 19 Remains in PA Nursing Homes

By Walter F. Roche Jr.

Although the pace has slowed records show Covid-19 continues to take lives in Pennsylvania nursing homes and that includes some of those homes which already had recorded 30 or more coronavirus deaths.
Overall records from the state Department of Health show some 3,000 patients have died from Covid-19 in Pennsylvania licensed nursing homes.
For instance at the Conestoga View Nursing Home in Lancaster which had recorded 75 Covid-19 deaths a month ago another two coronavirus deaths were recorded by July 28, the date of the last Health Department update.
At Wesley Enhanced Living at Stapley in Philadelphia 35 coronavirus deaths were reported in the July 28 report while 30 deaths had been reported in the prior report.
At the Northampton County Home-Gracedale, which reported 72 Covid deaths last month, 76 such deaths were reported in the latest update.
A four case death increase, from 50 to 54 also was reported at Allied Services in Scranton. One additional Covid death was reported at the Neshaminy Manor in Warrington, which had reported 47 deaths a month ago.
One additional coronavirus death also was recorded at Old Orchard Health Care Center in Easton, which had reported 33 Covid-19 deaths a month ago.
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TN Veterans Homes Report Covid-19

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The Tennessee agency that operates nursing homes for veterans, which had previously boasted that not a single resident or employee tested positive for Covid-19, has now reported that two patients and seven employees have tested positive for the virus.
The two patients and four of the staffers are at the state Veterans Home in Clarksville. An employee at the Humboldt Veterans Home and two staffers at the state Veterans Home in Murfreesboro have also tested positive.'
According to a statement posted on the agency website, the employees who tested positive were sent home. They are all asymptomatic.
Family members of the two residents who tested positive were informed, according to the agency announcement.
Weekly testing of staff will continue, according to the agency statement. And residents will be monitored daily for coronavirus symptoms.
Veterans homes in other states including Massachusetts and New Jersey, have reported multiple Covid-19 deaths.

Hospital Cited in Suicide Attempt

By Walter F. Roche Jr.

A Pennsylvania hospital has been cited for failing to keep a suicidal patient under constant watch enabling the patient to attempt suicide.
The report on the Geisinger Wyoming Valley Medical Center states that a sitter had been assigned to maintain a constant watch while the patient was showering but the employee did not have an unobstructed view.
At 2:39 p.m. on June 4 the patient was found slumped over in the shower.
The facility "failed to ensure staff had an unobstructed view of a suicidal patient," according to the report from the state Health Department.
Earlier the patient "verbalized thought of killing self," prompting a physician to order a one-to-one sitter.
Geisinger officials did not respond to questions about the incident including whether resuscitation efforts were successful.
According to the report the employee activated an alarm and staff subsequently attempted to resuscitate the patient including intubation and administering Narcan.
Hospital records showed that hospital employees subsequently found "the end cap of an intravenous" in the back of the patient's throat.
The same hospital was cited in a separate report for failure to document a patient assesment after the patient was exposed to urine and fecal matter due to an overflowing commode. The hospital filed plans of correction in response to both reports. Both plans call for staff education and monitoring to ensure compliance.

Deadly Covid Attack at State Veterans Home Detailed

By Walter F. Roche Jr.

The management of a state run nursing home for veterans placed 124 of 154 patients in immediate jeopardy when they failed to institute a proper infection control plan even as Covid-19 ravaged through the facility ultimately killing 42 residents.
The report on the Southeastern Veterans Center shows that even as state surveyors were inspecting the facility in early June, proper infection control procedures were not in place.
The report also provides a timeline of when patients began to get sick at the Chester County facility.
In fact the first sign of the impending disaster came when an employee tested positive for the coronavirus on March 31. At that point only employees were being tested
Two days later the first patient tested positive although no one on the staff was specifically trained on how to perform the test.
On April 13 and April 14 "resident deaths started occurring." On April 21 there were two more deaths, according to the report.
The commandant and the director of nursing did not effectively manage the facility the report states.
"The facility failed to consistently maintain an infection control program."
In fact the commandant, Rohan Blackwood, was replaced along with the nursing director.
Even as the inspection was underway, state surveyors observed violations including a nurse who hugged a patient without a mask.
The report also cites a nurse who worked in the regular and Covid-19 areas without a proper mask. Another employee told surveyors she removed her mask because it was hot.
Employees at the facility told the inspectors that they were not allowed to wear the proper protective equipment because management said it would scare the residents.
The employees also stated that testing was delayed because of arrogance.
"We will be fired for talking to you," one facility employee told the surveyors.
The report also faults the nursing home for placing a patient who tested negative for the highly contagious virus in a room with two patients who tested positive. In addition male and female patients were placed in the same room.
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Hospital Cited on Covid-19 Requirement

By Walter F. Roche Jr.

A Pennsylvania hospital has been cited for failing to screen visitors and patients entering the hospital or its emergency room for symptoms of Covid-19, as required under state and federal regulations.
The violation notice was issued on May 28 to St. Luke's Hospital Anderson Campus in Easton by surveyors from the state Health Department. The 108 bed hospital is apparently the first hospital in the state to be cited for failure to meet a coronavirus requirement. The report became public this week.
"All facilities will actively screen visitors by assessing for fever and signs and/or symptoms of respiratory infection and other criteria such as travel or exposure to Covid-19," a state Health Department report states.
Nate Wardle, a Health Department spokesman confirmed that state surveyors have been checking for compliance with both the state and federal requirements relating to Covid-19.
Hospital officials did not respond to a request for comment but in a plan of correction filed in response to the complaint the hospital said it is now screening all visitors from 5 a.m. to 9 p.m. Patients entering the emergency room will be screened 24/7.
The plan of correction also includes audits and monitoring along with staff education to ensure compliance.
"The data obtained is recorded in the visitors' log and retained by the organization," the plan of correction states.
A review of recent survey reports for other Pennsylvania hospitals shows state inspectors routinely note compliance with state and federal Covid-19 requirements.
"The facility was in compliance with the current Pennsylvania Department of Health, CMS (Center for Medicare and Medicaid Services) and CDC (Centers for Disease Control and Prevention guidelines as they pertain to Covid-19," one recent report states.
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Coronavirus Still Hitting PA Veterans Homes

Thiry-one patients at a Philadelphia nursing home for veterans have contracted the coronavirus and 13 of them have died, according to officials of the state Department of Military and Veterans Affairs.
The deaths at the Delaware Valley Veterans Center are in addition to the 42 reported at another state veterans facility in suburban Chester County.
At the Philadelphia facility 17 staff members also have tested positive for Covid-19.
At the 238 bed Southeastern Veterans Center in Spring City 105 patients became infected including the 42 who died. Forty-seven employees at the center have tested positive for the virus.
At the four other state homes for veterans any serious outbreaks have apparently been averted.
At the Southwestern Veterans Center in Pittsburgh nine employees tested positive.
The other state veterans homes are located in Scranton, Hollidaysburg and Erie.
State run veterans homes in other states like New York and New Jersey have seen multiple coronavirus deaths. A total of 146 deaths have been reported at New Jersey's three homes, including 81 at the Menlo Park home.
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VA Official Engaged in Unethical Conduct

By Walter F. Roche Jr.

A former top official in the U.S. Veterans Administration engaged in unethical conduct when he steered a $5 million contract to two friends, a contract that netted a $5 million loss to taxpayers.
That was the conclusion of the VA's Inspector General on a contract awarded to an unnamed contractor participating in a program established to benefit service disabled veterans.
The report concludes that Peter Shelby, the former Assistant Secretary for Human Resources and Administration, a Trump appointee who resigned under fire in July of 2018.
The report states that Shelby "ranted and raved" when VA employees raised questions about awarding the contract on a "sole source" basis to the company under the Service Disabled Veteran program.
The report states that the contract benefited Shelby's friend at the contracting firm and another friend at a subcontractor on the contract, Blanchard Training and Development.
VA employees interviewed by the IG said that Hoskins was "insistent and intimidating" as he demanded subordinates take the necessary steps to award the contract.
Stating that the contract resulted in a $5 million "resulted entirely in waste," the IG made a series of suggestions to avoid a repetition which the agency agreed to implement.
The report states that Shelby's resignation was triggered by an investigation into an unrelated issue, the IG concluded that Shelby engaged in unethical conduct to benefit two friends.
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3,000 Covid Deaths in PA Nursing Homes

By Walter F. Roche Jr.

Nearly 3,000 patients in Pennsylvania nursing homes have died from Covid-19, according to data compiled by the state Department of Health.
The data, which was updated this week, shows some 20 nursing homes had 30 or more deaths. The Conestoga View nursing home in Lancaster has reported 75 coronavirus deaths. A Beaver nursing home, the Brighton Rehabilitation and Wellness Center, reported 73 covid-19 deaths.
The Northampton County Home-Gracedale reported 72 Covid deaths.
The same homes reported multiple employees tested positive for the virus. The Beaver home, for instance, reported 109 employees were infected while the Lancaster home had 75 infected employees. The Northampton county home reported 53 employees were infected.
The exact state total of Covid-19 deaths in Pennsylvania nursing homes is likely much higher because the health department was unable to collect any data from dozens of nursing homes
Other homes with 30 or more Covid deaths include Brandywine Hall in West Chester reported 30 deaths, Abramson Residence in North Wales reported 34 deaths, Allied Services in Scranton reported 50 deaths, Chapel Manor in Philadelphia reported 34 deaths, the Neshaminy Manor Home in Warrington had 47 deaths and Parkhouse Rehabilitation and Nursing Center in Royersford reported 52 deaths.
Still others with 30 or more deaths include Shippensburg Health Care Center with 31, Southeast Veterans Center in Spring City with 42, Spring Creek Rehabilitation and Nursing in Harrisburg with 42, St.John Neumann Center for Rehabilitation and Healthcare in Philadelphia with 36 and Enhanced Living at Stapely in Philadelphia with 30.
Easton Gardens for Memory Care in Easton had 30 deaths, Green Meadows Nursing and Rehabilitation in Malvern had 36, Manorcare Health Services in Sinking Springs had 48, Mountainview Care and Rehabilitation in Scranton had 32, Old Orchard Health Care Center in Easton had 33, Rosewood Gardens Rehabilitation and Nursing Center in Broomall had 33 and Saunders House in Wynnewood had 38.
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VA Missed Two Warnings Before Patient Death

By Walter F. Roche Jr.

A primary care physician and a clinical pharmacy specialist at the Nashville Veterans Administration failed to take proper action on a patient who was later diagnosed with pancreatic cancer and died.
That was the conclusion of the VA's Inspector General in a 15-page report issued this week. According to the report the omissions resulted in a three month delay in the patient's diagnosis and treatment.
"The OIG was unable to determine if immediate action by the Clinical Pharmacy Specialist would have led to this patient receiving a prompt diagnosis and treatment," the report states.
According to the report the specialist failed to inform the patient, who was in his 60s, of an abnormal liver test result. He also failed to initiate a change in the patient's care plan, based on those abnormal results.
In addition a primary care physician who examined the veteran in 2018 failed "to acknowledge or assess" the patient's unintentional weight loss of 48 pounds in one year.
"Unintentional weight loss may be symptomatic of a disease process and must be further evaluated," the IG stated.
The physician, who is no longer with the VA could not be reached by IG investigators who visited the Nashville facility in 2019.
According to the report the pharmacy specialist told investigators that he did not recall the specific case, but said it was normal practice to take no action if the test results were considered insignificant.
"The OIG does not believe the laboratory results were clinically insignificant," the report states, adding that the minimum expected plan of care for the patient should have included repeat liver function testing within four to six weeks and communication of test results to the patient."
In addition, the IG stated, the patient should have been counseled on warning signs of a worsening condition.
According to the report the patient returned to the VA three months after the annual physical complaining of abdominal pain. He was subsequently diagnosed with pancreatic cancer and died in the spring of 2019.
The report also cites deficiencies in the VA's electronic health records which do not have a "fail safe" feature that could have triggered a reassessment of the patient's condition at an earlier date.
The report also faults the local facility's management for two inadequate responses to the initial inquiry.
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Three More PA Vets Have Covid-19

Three more patients in Pennsylvania nursing homes for veterans have tested positive for the coronavirus but the death toll in the six home system remains at 54.
According to the state Department of Military and Veterans Affairs the number of infected patients jumped from 132 late last week to 135 today.
Veterans homes in Philadelphia and suburban Chester County have been the hardest hit. Forty two patients at the Southeastern Veterans Center in Spring City have died from Covid-19. Twelve patients at the the Delaware Valley Veterans Center in Philadelphia have died.
Of the 54 deaths, 40 were confirmed cases of Covid-19, while 14 were classified as probable.
The department also reported that 65 employees at the six facilities have tested positive for the virus. Forty seven of those infected employees worked at the Southeastern Veterans Center.
State run veterans homes in New York, New Jersey and Massachusetts have also reported multiple coronavirus deaths. At one New York home on Long Island nearly 60 deaths have been reported.
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Covid Deaths Mount in PA Facilities

By Walter F. Roche Jr.

Deaths from the coronavirus in facilities licensed or run by the Pennsylvania Department of Human Services (DHS) have topped 100 and show no signs of slowing down.
Data compiled by the agency show the deaths have occurred in facilities ranging from community based residential homes for the intellectually disabled to substance abuse centers.
Ten covid deaths have also come in the state mental hospital in Norristown among 81 patients who tested positive.
With the exception of state mental hospitals, state Human Services officials, citing privacy concerns, have declined to name the specific entities where the deaths occurred. Instead they have provided updated figures by county.
"To protect the confidentiality of personal health information and the privacy of individuals, DHS is reporting this data by county rather than by program," the agency web site states.
"Some programs," the web site continues, "serve fewer than five individuals, and reporting information at this level potentially violates the department's obligation to protect individual privacy and personal health information."
For instance in the community based facilities for the intellectually disabled category, 64 covid deaths were recorded statewide while 18 of those deaths were in Philadelphia.
In Delaware county 16 deaths were reported out of 86 residents who were infected. In addition 117 staff members at Delaware county community based centers tested positive for covid-19.
In intermediate care facilities licensed by the state, deaths statewide were listed as "less than 28," while 227 staff members tested positive. In Philadelphia 125 patients were infected and nine died.
In licensed substance abuse treatment centers a total of 91 patients tested positive while five of those patients died. The state reported that 141 staffers at the treatment centers tested positive.
The DHS data is separate from coronavirus data compiled by the state Health Department on deaths and covid infections in licensed nursing homes. The latest total of nursing home deaths is 4,528.
Nor does the DHS data include covid deaths in Pennsylvania homes for veterans where 54 deaths have been recorded.
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54 PA Veterans Died from Covid-19

By Walter F. Roche Jr.

Some 54 veterans living in state run nursing homes in Pennsylvania have died with confirmed or probable diagnoses of the coronavirus, according to officials of the Pennsylvania Department of Military and Veterans Affairs.
Twelve of the deaths were at the Delaware Valley Veterans Center in Philadelphia while 42 died at the Southeastern Veterans Center in Spring City, in Philadelphia's suburbs.
Data provided by the Pennsylvania Health Department shows that an additional eight veterans died in personal care rooms at the Spring City facility. A spokeswoman for the state Department of Military and Veterans Affairs said those deaths were already included in the agency count.
The disclosure comes as veteran deaths have been reported in other states providing nursing home care to veterans. In a highly critical report issued Wednesday, officials of a Massachusetts veterans home in Holyoke were charged with substantial errors in the treatment of veterans infected with Covid-19.
Seventy-five patients at the facility died from the coronavirus.
At the Spring City, PA facility the administrator was recently placed on leave. Another longtime administrator was brought in as a temporary replacement.
According to the state agency 28 of the Southeastern deaths were confirmed cases of coronavirus while 14 were classified as probable coronavirus. A total of 101 residents tested positive for the virus.
At the Philadelphia facility 12 deaths were confirmed as coronavirus. Four were classified as probable. A total of 31 patients tested positive for coronavirus.
State run nursing homes for veterans in several other states including New Jersey and Alabama have also reported multiple coronavirus deaths over the past two months.