Quality Life Services - Grove City

Based on review of facility policy and clinical records, and staff interview, it was determined that the facility failed to comprehensively assess pressure ulcers/injuries (injury to skin and underlying tissue resulting from prolonged pressure on the skin) for one of four residents reviewed (Resident 1). Findings include: Facility policy Skin Integrity and Wound Management dated 6/20/25, revealed the implementation of an individual resident's skin integrity and wound management occurs within the care delivery process. Staff continually observes and monitors residents for changes and implements revisions to the plan of care as needed. Complete comprehensive assessment of the resident's needs prior to admission. Identify resident's skin integrity status and need for prevention intervention or treatment modalities through review of all appropriate assessment information. Perform skin inspection on admission and weekly by a licensed nurse. Document in PCC[ computer program]. Perform wound assessment and complete proper forms upon initial identification of altered skin integrity weekly,…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based upon review of facility policies, observations, and staff interviews, it was determined that the facility failed to monitor sanitization chemicals for one of one three-compartment sinks; failed to ensure that food was stored in accordance with standards for food safety for four of four kitchen refrigerators, one of one solarium refrigerators, and one of one kitchen freezers; and failed to label food brought into the facility with the resident's name and use by date in one of five refrigerators.Findings include: Review of facility policy entitled Cleaning Dishes - Manual Dishwashing, dated 6/18/25, revealed the facility will check the sanitation sink often using a test strip to assure the level of sanitization solution is appropriate and that the facility will test the sanitizing solution in the sink using the manufacturer's suggested test strips to assure appropriate level. Review of facility policy entitled Food Storage, dated 6/18/25, revealed Refrigeration temperatures should be thermostatically controlled to maintain food temperatures at or below 41 degrees Fahrenheit (F)…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on review of facility policy and clinical records, and staff interview, it was determined that the facility failed to provide evidence that non-pharmacological interventions (interventions attempted to calm a resident other than medication) were attempted prior to the administration of a PRN (as needed) psychotropic (affecting the mind) medication for one of six residents reviewed for unnecessary medications (Resident R10).Findings include:Facility policy entitled Behavior Standard dated 6/18/25, revealed that the facility will identify, address and eliminate or reduce underlying cause of distressed behaviors and will develop interventions that are specific to the resident's interest, abilities, strengths, and needs. Resident R10's clinical record revealed an admission date of 8/22/25, with diagnoses that included congestive heart failure (CHF - a long-term condition that happens when your heart can't pump blood well enough to give your body a normal supply causing blood and fluids collect in your lungs and legs over time), chronic obstructive pulmonary disease (COPD a…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on review of facility policies, and clinical records, and staff interview, it was determined that the facility failed to provide the Resident and/or resident representative with a written notice of the facility bed-hold policy (explanation of how long a bed can be held during a leave of absence and the cost per day) and failed to make certain that the necessary resident information was communicated to the receiving health care provider upon transfer to the hospital for two of four residents reviewed for hospitalization (Residents R5 and R11). Findings include: Facility policy entitled Notice of Bed Hold Policy at Time of Transfer Due to Hospitalization or Therapeutic Leave dated 6/18/25, revealed policy is provided to residents at the time of transfer of a resident for hospitalizations or therapeutic leave. Facility policy entitled Transfer of Resident To Another Care Community dated 6/18/25, revealed to promote continuity of care during transfer the facility will copy / prepare documents needed for transfer, including, but not limited to face sheet, advanced directive,…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on review of facility policies, observations, and staff interviews it was determined that the facility failed to appropriately date and discard outdated medications for one of two medication rooms reviewed (third floor medication storage room). Findings include: Review of a facility policy entitled Storage of Medications dated 6/18/25, indicated that when the original seal of the manufacturer's vial is initially broken, the vial will be dated. The nurse will place a date opened sticker on the medication and enter the date opened and the new date of expiration. The expiration date of the vial will be 30 days unless the manufacturer recommends another date. Review of manufacturer's guidelines revealed that an open vial of Tubersol (a solution used for tuberculosis testing upon admission and employment) should be discarded within 30 days after opening. Observation of drug storage on 9/24/25, at approximately 3:26 p.m. of the third floor medication storage room refrigerator revealed one open vial of Tubersol with no date indicating when the vial was opened. During an interview at…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on a review of facility policy and infection control guidelines, clinical records, observations, and staff interviews, it was determined that the facility failed to follow acceptable infection control practices regarding Transmission Based Precautions (TBP) during observation of a resident with COVID-19 for one of three residents reviewed for TBP (Resident R64).Findings include: Facility policy entitled Droplet Precautions with a policy review date of 6/18/25, indicated, droplet precautions should be used in addition to standard precautions for residents with infections that can be transmitted by droplets. Droplet transmission involves contact with the conjunctiva or mucus membranes of the nose or mouth of a susceptible person with large particle droplets containing microorganisms generated from a person who has a clinical disease or is a carrier of the microorganism. Droplets may be generated by the resident's coughing, sneezing, talking, or during the performance of procedures.Review of Pennsylvania Department of Health PAHAN dated 5/11/23, with a subject of Interim…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on review of facility policy, observation, and staff interview, it was determined that the facility failed to maintain a clean homelike environment for one of two resident neighborhoods (2nd Floor). Findings include: Review of a facility policy dated 2/22/24, entitled Wheelchair Cleaning Policy, indicated the facility will provide clean, functional, and safe resident and facility owned wheelchairs through at least monthly cleaning or as needed. Observation of the 2nd Floor on 10/09/24, between 11:13 a.m. and 11:20 a.m. revealed concerns with four resident wheelchairs. Resident R8's wheelchair was observed to have dust and dried debris on the frame of his/her wheelchair. Resident R14's wheelchair was observed to have dried liquid and debris down the side of his/her wheelchair and on the frame of his/her wheelchair. Resident R55's wheelchair was observed to have dust and dried debris on the frame of his/her wheelchair. Resident R74 was observed to have a dried spaghetti noodle as well as other dried debris and dust on the edge of his/her wheelchair near and under the wheelchair…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on review of clinical record, observation, and staff interview, it was determined that the facility failed to ensure physician's orders were accurate and reflected the status and care provided to one of 21 residents reviewed (Resident R8). Findings include: Resident R8's clinical record revealed an admission date of 5/15/06, with diagnoses that included stroke, diabetes, and dementia (loss of cognitive functioning affecting a persona memory and behaviors). Resident R8's clinical record revealed a task dated 12/16/20, indicating Resident R8 was to wear a left upper extremity resting hand splint for up to four hours twice a day and to check skin integrity before and after splint wearing. Further review of Resident R8's clinical record revealed it lacked a physician's order for the left upper extremity resting hand splint. Observation of Resident R8 on 10/09/24, at approximately 11:50 a.m. revealed he/she was wearing a left resting hand splint. During an interview on 10/10/24, at 2:44 p.m. the Nursing Home Administrator confirmed that Resident R8 was utilizing a left resting hand…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on review of facility policy and clinical record, observations, and staff interview, it was determined that the facility failed to maintain proper care of respiratory equipment for one of two residents reviewed for respiratory services (Resident R35). Findings include: Review of a facility policy dated 2/22/24, entitled Oxygen Concentrator indicated to check inlet filter pad to be sure it is clean and in place and not to run the concentrator without a filter or with a dusty filter as this can cause damage to the concentrator and alter the oxygen concentration. Policy also indicated to remove, rinse, and pat dry the air intake filter weekly or more often if needed to keep clean and free of dust. Resident R35's clinical record revealed an admission date of 12/28/22, with diagnoses that included chronic obstructive pulmonary disease (COPD - a lung disease that results in difficulty breathing, cough, and mucus production), dementia (loss of cognitive functioning affecting a persona memory and behaviors), and high blood pressure. Resident R35's physician's order dated 12/28/22,…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on review of clinical records and staff interview, it was determined that the facility failed to ensure the presence of necessary documentation to support the specific reasons for discharge versus returning to the facility after an emergency transfer to an acute care facility for one of three residents reviewed (Resident R1). Findings include: Review of Resident R1's clinical record revealed an initial admission date of 12/07/23, with diagnoses that included edema (swelling), dysphagia (difficulty swallowing) and short bowel syndrome (malabsorption disorder caused by lack of functional small intestine). Review of a progress note, dated 12/09/23, and as a late entry, revealed that Resident R1 was displaying behaviors including verbal, throwing things, putting other residents at risk, interfering with resident care and participation in activities. Another nursing note at 1:00 p.m., revealed that Crisis was called and Resident R1 was transferred to an acute care facility on a 302 petition and evaluation. Review of Resident R1's clinical record revealed that there was no physician…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on review of clinical records and facility policy and staff interview, it was determined that the facility failed to provide the resident and resident representative of a Notice before Transfer/Discharge in writing for one of three residents reviewed (Resident R1). Findings include: Review of the facility policy entitled 30 Day Discharge Notice AR-29 revealed to ensure proper notice is given and to secure a safe discharge location per state regulations. Review of Resident R1's clinical record revealed an initial admission date of 12/07/23, with diagnoses that included edema (swelling), dysphagia (difficulty swallowing) and short bowel syndrome (malabsorption disorder caused by lack of functional small intestine). Review of Resident R1's clinical record revealed a progress note dated 12/09/23, at 1:00 p.m., which identified that Resident R1 was transferred to the hospital. The clinical record lacked documentation that Resident R1 and their representative was provided with a copy of a Notice of Transfer/Discharge as required. During an interview on 1/24/24, at 2:25 p.m. the…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on review of facility policy and clinical records, observations, and staff interview, it was determined that the facility failed to provide resident privacy and dignity regarding an exposed urinary catheter (a tube placed and held in the bladder to drain urine) drainage bag for two of five residents reviewed for catheters (Residents R88 and R47). Findings include: Review of a facility policy entitled, Indwelling Urinary Catheter dated 2/23/23, indicated .drainage bag should be placed in a position lower than the bladder , policy also indicated The catheter bag should have a privacy cover applied at all times Review of Resident R88's clinical record revealed an admission date of 10/9/23, with diagnosis that included, Obstructive and Reflux Uropathy (a condition that will not let the urine drain naturally), Diabetes (condition of inadequate insulin levels and blood sugar control), and Hypertension (high blood pressure). Review of Resident R88's foley catheter care plan revealed an intervention for position catheter bag and tubing below the level of my bladder, without kinks and…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on review of facility policy, observations, and staff interviews, it was determined that the facility failed to ensure that food was stored in accordance with standards for food safety in one of two refrigerators reviewed (third floor pantry). Findings include: Review of a facility policy entitled Food brought in from outside sources dated 2/23/23, indicated that items brought into the facility must be labeled with the resident's name and the date prepared. The policy also indicated condiment type foods may be kept for 2 months or until factory marked date whichever is first. Review of a facility policy entitled Food Storage dated 2/23/23, indicated that food is stored by methods designed to prevent contamination or cross contamination. Observations on 11/15/23, at approximately 10:30 a.m. a refrigerator in the pantry for resident use on the third floor revealed three bottles of Pepsi with no resident name, an open container of 2.0 Cal med pass (a supplement given to resident during medication administration) with no open date, an open half empty bottle of parmesan cheese with…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.