Monday, August 31, 2020

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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Friday, August 28, 2020

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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Thursday, August 27, 2020

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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Tuesday, August 25, 2020

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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Monday, August 24, 2020

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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Friday, August 21, 2020

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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Friday, August 14, 2020

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.

Friday, August 7, 2020

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.

Thursday, August 6, 2020

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.

Saturday, August 1, 2020

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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