City Nursing Home Has Staffing Woes

By Walter F. Roche Jr.

A city-owned nursing home has been hit with two critical reports from state health surveyors who found the facility understaffed, dirty and with one patient out-of-control and injuring a fellow patient.
In two recent reports on the 402-bed Philadelphia Nursing Home, state Health Department inspectors found numerous deficiencies. The first report dated Dec. 9 specifically focused on staffing levels and found that on more than half the days reviewed the facility failed to maintain state mandated staffing levels.
While the state requires a facility to provide 2.7 hours of nursing care per patient per day the surveyors found that on 11 of 21 days reviewed the facility failed to meet that standard.
In the second report dated Jan. 10, surveyors concluded the facility "failed to maintain a clean and homelike environment for one of eight nursing units."
That second survey, which was conducted to determine whether the facility met federal Medicare and Medicaid standards, concluded that it didn't.
A clutter of trash was found next to one patient's bed and dried food was caked to a patient's wheelchair.
There was no care plan developed for three patients and proper incontinence care had not been provided to other patients. One of those patients told surveyors that when she pressed her call light for assistance, it was ignored.
The tracheotomy equipment for another patient was dirty and overdue for maintenance. Other issues included "a mice problem" which one surveyor witnessed first hand and failure to arrange a psychiatric review for an Alzheimer's patient.
Another patient with psychiatric issues threw a bedside table at another patient. That patient was referred for a psychiatric review on Oct. 19 but did not get it until Nov. 12.
James Garrow, a city Health Department spokesman, said that the facility was holding job fairs and working with several different agencies in an attempt to fill vacant nursing home positions.
He said that current levels were at 3.38 hours of nursing care per patient per day, well above the state's minimum standards.
In it's plan of correction, which was accepted by the state, the nursing home reported it had cleaned up the clutter of trash and cleaned the food stained wheekchair.
The plan calls for audits to ensure care plans were developed for all patients. The overall plan also calls for psychiatric consults to be completed immediately and improvements in incontinence care.
Contact: wfrochejr999@gmail.com

Suicidal Patient Jumps to Death at Crozier

By Walter F. Roche Jr.

A shoeless psychiatric patient who had acknowledged having suicidal thoughts including plans to jump in front of an Amtrak train, was discharged unattended from an area hospital then climbed to an unsecured roof top access and jumped.
The fatal Nov. 16 incident at the Crozer Chester Medical Center was detailed in a recent 9-page report from the state Health Department.
"The facility failed to assist a patient at risk of suicide and failed to implement a plan to deal with withdrawal from alcohol," the report states.
The unnamed patient had been transported to the Upland hospital by an emergency medical team. He was rated as high risk for suicide after admitting to a plan to walk into a passing Amtrak train.
Asked if he had ever wished he was dead, the patient said, "Yes."
After being informed he was being discharged, the patient asked for shoes, but was told all of his belongings, including a wallet, had disappeared. When the hospital workers discovered they had no shoes that would fit him, he was given a second pair of socks.
Efforts to find a place in area shelter were unsuccesful.
When health department staffers reviewed the records they discovered a series of tests that should have been performed, but never were.
The facility failed to provide "a safe and detailed discharge," the report states.
The health department team also viewed surveillance videos shot during the discharge. "The last video shows the patient falling on the ground," the report states.
Crozer filed a plan of correction including new security measures to monitor the areas near the roof access point.
The plan also calls for the reassesment of patients for suicide risks and education of staffers, along with audits to ensure compliance.
The hospital did not respond to a series of questions about the incident and the state report.
Contact: wfrochejr999@gmail.com