Fairview Care Center Of Bethlehem Pike (November 3rd)
Based on facility policies and procedures, interviews with staff, and review of clinical records, it was determined that the nursing home failed to notify the physician of a resident’s refusal of medical treatment for one of the 25 residents reviewed. The findings included the following: In review of Resident R26’s clinical record it was revealed that the resident was admitted to the facility with an undisclosed diagnosis. In further review of Resident R26’s clinical record it indicated that that the resident was followed by an ophthalmologist for periodic intravitreal treatments. The resident had an intravitreal treatment on August 2, 2011, and was scheduled to have a subsequent follow up in about one week. In an interview with Employee E7, unit manager on November 2, 2011 it was revealed that the resident refused eye injections because of the pain. Additionally, Employee E7 confirmed there was no documentation of Resident R26’s treatment refusal in the clinical record. In review of facility policy, Refusal of Treatment, dated and revised on April 1, 2003, it was revealed that a physician must be notified promptly of the resident’s refusal of treatment and all discussions with the patient, physician, and other involved persons are documented by clinical records. In an interview with Employee E7, unit manager, on November 2, 2011, at 3:40 p.m., it was confirmed that facility staff had not followed facility policy regarding Resident R26’s treatment refusal.
Based on review of personnel records, interviews with staff, facility policies and procedures, it was determined that the facility failed to obtain a timely Federal Bureau of Investigation background check for employees as required, for one of 13 personnel records reviewed. The findings included the following: In a review of the personnel record for Employee E4 it indicated that the employee’s initial date of hire was January 17, 2011 and that the employee had resided outside the Commonwealth during the previous two years. In further review of the personnel record revealed that a Federal Bureau of Investigation background check was completed on October 24, 2011, approximately nine months after Employee E’s hire with the nursing home. In another review of facility policy, Background Investigations, dated and revised April 1, 2003, it was revealed that criminal conviction investigation checks will be conducted on all personnel who apply for employment at the facility to assure that all appropriate individuals are employed by the facility. In an interview with the Administrator on November 3, 2011, at 12:00 p.m., it was confirmed that the FBI background check had not been performed in a timely manner to ensure that Employee E4 was eligible for employment in a long term care facility.
Based on observation, clinical record review, review of facility documentation and staff interviews it was determined that the facility did not provide personal care in a manner that maintained the resident’s dignity for one of 25 residents reviewed. The findings included the following: In an interview with the administrator during the entrance conference on October 31, 2011, at 9:00 a.m., it was confirmed that all residents are advised their rights upon admission to the facility. In review of facility document Resident Rights, dated 1992, it was revealed that each resident has the right to be treated with dignity and respect in full recognition of their individuality. In review of Resident’s R116’s clinical record revealed that the resident was admitted to the facility at an undisclosed date.An MDS revealed that the resident had cognitive impairments and required staff assistance for completing personal hygiene and was totally dependent upon staff for bathing. In observation of the resident revealed the resident lying on a shower gurney in the hallway outside of the shower room crying.