Philadelphia Nursing Home Cited for Violations

By Walter F. Roche Jr.

A disabled and delusional  patient at a city owned nursing home was allowed to sign herself out on multiple occasions including several in which she suffered multiple injuries while wandering city streets, according to a report by state health officials.
The report on the Philadelphia Nursing Home also cited the home for multiple violations of state and federal regulations some of which led to the injury of patients.
Surveyors from the state Health Department visited the facility to determine if it met the minimum standards for participation in the Medicare and Medicaid program. They concluded that it didn't.
The Medicare program gives the home a two-star or blow average rating in the inspection and quality categories. It is licensed for 402 beds and is run by Fairmount Long Term Care under a $35.7 million contract with the city.
The city is currently accepting proposals for a new contract.
In response to the report,  Fairmount filed a plan of correction detailing steps it has promised to take to ensure the violations are eliminated and not repeated. The home can remain in the Medicare and Medicaid programs as long as those corrections are implemented. 
According to the report, the patient confined to a wheelchair was allowed to sign herself out despite the fact that there was no authorization by a physician stating she was capable of taking care of herself,
Stating that the woman had "an extensive history of delusions" the report states that she had asserted that she had been shot in the head by her sister and that her granddaughter lived in a morgue.
The inspectors found that the same resident was found passed out in her wheelchair in a nearby neighborhood. On another excursion she ended up being treated in a hospital emergency room.
"The facility failed to the safety of one resident by failing to provide adequate supervision to prevent accidents," the report states.
Other violations cited in the lengthy report include leaving medicine carts unlocked and unattended in an area where patients had access.
Another severely impaired patient was injured when an an aide attempted to lift him without assistance and the patient landed on the floor. The patient required two staffers for safe movement, according to the report.
In yet another case the facility was cited for failing to fully investigate the cause when a patient was observed to have suffered five bruises on the return from a doctor's visit.
Also when the inspectors looked at the treatment notes left by a psychiatrist treating home patients, they found them to be completely illegible. Nursing home staffers were also unable to decipher the notes, the report states.
The home "failed to maintain complete and accurate clinical records," the inspectors wrote.
The inspectors observed the care being provided to a patient who was on isolation due to clostridium difficile and concluded proper procedures were nor being followed by nursing home personnel.
Unsanitary conditions were cited in food handling areas and food being stored was not dated to ensure it had not passed expiration dates.
In its plan of correction Fairmount said it revised procedures to be followed when a patient leaves the facility against medical advice and changed the type of lift to be used for the bedridden patient. The plan includes changes to address sanitation issues and provide for the dating of all stored foods.
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