PA. Veterans Home Cited on Narcotics

By Walter F. Roche Jr.

A Pennsylvania health facility for veterans has been cited for mishandling of narcotic drugs including the apparent theft of opiods by staff members.
The violations of drug handling and other regulations at the Gino J. Merli Veterans Center were included in a report recently made public by the state Health Department. Other violations uncovered in a Dec. 7 inspection include failure to implement a correction plan from a prior inspection and multiple violations of sanitary requirements in food preparation areas.
The facility "failed to demonstrate effective corrective action plans," the report states, noting that mishandling of drugs had been cited in a prior report.
Both inspections were to re-certify the licensed nursing home for participation in the federally funded Medicaid program.
As the report notes the facility has had a history of problems with the handling of narcotic drugs. A licensed practical nurse employed at the facility was investigated in April of 2017 for mishandling of drugs and was no longer employed at the center, according to the report.
Officials of the state Department of Military and Veterans Affairs, which run state veterans homes, did not reply to requests for comment.
In the new report, surveyors found that in the review of 33 residents' records, nine were found deficient.
The report cites the "potential misappropriation of residents' property by drug diversion."
The state inspectors reviewed drug dispensing records and individual patient records and found that in many cases there was no verification that the drugs dispensed were actually administered to the patients as prescribed.
In one specific case a nurse incorrectly transcribed a doctor's prescription resulting in the patient getting incorrect dosages.
A review of surveillance videos showed a licensed practical nurse pouring medication from two different containers on 13 occasions, the report states. And there was no documented evidence the drugs were actually administered to the appropriate patients.
A further review of drug dispensing records showed staffers routinely taking two pain killing pills when only one pill had been prescribed.
The report states that when questioned about the double doses , a staffer "stated that he would give Resident 51 more thn the physician prescribed." That staffer resigned Aug. 7
A second staffer who mishandled narcotic drugs was "no longer employed by the facility," the inspectors reported..
In yet another violation, the report states that inventories of narcotic drugs required at the end of each shify were not always conducted.
The report cites the home for sanitation violations in a food preparation areas including a "build-up of thick black grime on a hand-washing area.
The facility failed to maintain two food preparation areas in a manner to prevent the potential for microbiological growth.
Contact: wfrochejr999@gmail.com

RN Photographs Bared Patient

By Walter F. Roche Jr.

A nurse manager at a Western Pennsylvania hospital photographed and then displayed a photo of a patient's bared bottom and threatened employees with the loss of their jobs if they disclosed what she had done.
Three employees at the Highlands Hospital in Fayette County related the incident to a surveyor from the state Health Department, which recently made public a report on the matter.
The report cites the hospital for failing to treat a patient with "respectful care given by competent personnel."
According to interviews with hospital personnel the incident occurred when the nurse supervisor spotted the bared bottom patient on a monitor. The patient, whose scrotum was also visible, was in a seclusion room and was being monitored by camera.
"I was sitting with a behavioral health patient," one hospital staffer told the state inspector. "The manager was making the rounds. The manager stood to the side and looked at the monitor. The patient's buttocks were showing." the report states, recounting the description given by the hospital employee.
"The nurse manager laughed and said,"Picture is worth a thousand words," the report continued, adding that the manager then took out her cell phone and took a picture of the patient. "The nurse manager laughed and said 'You can't make this stuff up."
Other hospital employees described the nurse manager showing the picture to them along with threats.
One employee said the nurse manager showed the picture and then said, "If anyone finds out about this and I find out who did it, you will lose your job."
One of the employees interviewed said that she didn't say anything at the time because the supervisor was her boss.
"I just thought HIPPA, HIPPA, HIPPA," the employee said referring to the federal law (the Health Insurance Portability and Accountability Act)protecting patient privacy rights.
In a plan of correction filed by the hospital, facility administrators said they would initiate an employee retraining program and then monitor to ensure against any future violations. The plan did not indicate what if any action was taken against the nurse supervisor.
Contact: wfrochejr999@gmail.com

Crozer-Chester Cited for Ligatures

By Walter F. Roche Jr.
UPDATED

A state of "immediate jeopardy" was declared at a behavioral unit at the Crozer-Chester Medical Center when state health inspectors found loopable devices which could be used for suicide.
The report, just made public last week, cites a series of other violations of state and federal standards in the same unit including a non-working monitor and improper use of restraints.
The immediate jeopardy declaration forced hospital officials to prepare an immediate response to abate the risk to patients.
"Immediate jeopardy," the report states, is a situation in which a violation of standards "caused or is likely to cause serious injury, harm, impairment or death."
The violations were found in the hospital's Rejuvenation" program. A hospital spokesman said there were 20 beds in the unit for elderly behavioral patients.
The non-working monitor was one of several used to keep patients under constant surveillance. Though other monitors were working, staffers told state surveyors that they did not monitor the monitors.
"We are not required to monitor patient activity," one staffer told the surveyors.
Restraints, inspectors found, were kept in place for excessive periods and a physician failed to state the reason for the restraint in the record for one patient.
An examination of patient treatment plans showed some were not updated while others were not sign or initialized.
In the dietary area, the inspectors found that logs of temperatures on refrigerators were missing and unsanitary conditions, including human hair, were found in one refrigerator.
A hospital spokesman said the facility has been working with state health officials on development and implementation of a corrective action plan.
"We have made all of the upgrades required," said spokesman Rich Lenowitz.