Following a 23-month-stretch of not a single citation from the Pennsylvania Department of Health, the Charles Morris Nursing and Rehabilitation Center was recently found in noncompliance with several long-term care requirements of the state.
Noncompliance found at Charles Morris by the Department of Health can often be attributed to agency nurses rather than the facility’s regular employees, according to David Gritzer, president and CEO of the Jewish Association on Aging.
“If we get an agency nurse that does not work up to our standards, we release them and have them never come again,” he said.
The noncompliances, which were found in an inspection dated Oct. 7, included an isolated incident of failure to implement proper infection control measures during blood glucose monitoring on one nursing unit, failure to ensure timely physician visits for one patient and failure to provide complete neglect and abuse training for some of its employees.
The Department of Health report states that five employees did not have mandated abuse and neglect training concerning involuntary seclusion of residents.
The nurses who did not receive abuse training were not regular employees of Charles Morris, but were temporary nurses from an agency, according to Jerry Pannell, administrator of Charles Morris. They will be sufficiently trained in the future, he said.
“Our regular employees have had the training,” Pannell said. “We have now updated our written training material for our agency nurses to include involuntary seclusion.”
The Department of Health also found that the facility failed to ensure that physician visits were timely for one of its residents.
While the facility’s physician services policy indicated that a resident must be seen by a doctor at least every 30 days for the first 90 days after admission, and at least every 60 days thereafter, clinical records indicated that the resident in question had been seen only at four and five month intervals.
The vast majority of residents at Charles Morris have documented, regular visits from their physicians, according to Gritzer.
“The Department of Health had access to over 500 medical records for them to review,” Gritzer said. “They found a violation of only one patient, with one doctor.”
According to Pannell, that physician did, in fact, see his patient as per the mandated schedule, but failed to record the progress notes reflecting those examinations.
The Department of Health also found that a Charles Morris employee failed to clean and disinfect an instrument after checking a resident’s blood sugar level, and that the employee stated during an interview: “I’m not aware of any policy for cleaning it.”
Charles Morris has taken action to ensure the problem is corrected, according to Pannell.
“This was an isolated incident with the glucometer,” Pannell said. “We now have a plan of correction developed. All licensed nursing staff were in-serviced on infection control techniques.”
To monitor the concerns of patients and their families, Charles Morris convenes a resident advocate subcommittee, which meets three times a week.
“The committee consists of the director of nursing, the administrator, a registered nurse unit manager, a social worker and our resident liaison,” Pannell said. “The purpose of the committee is to review all concerns that are brought by the residents, their families or our staff.”
Each concern is reviewed with the staff member involved.
“We hear all parties’ concern with whatever the incident is; then we put a plan of action together to fix the concern,” Pannell said.
Most concerns brought to the committee are “missing sweaters, wrinkled laundry, things like that,” said Pannell. “Sometimes somebody has a food issue.”
Charles Morris also employs a patient advocate, Sharyn Rubin, to address issues before they become problems, according to Gritzer.
The facility admits and discharges 35 to 40 people a month, Gritzer noted.
“We have an outstanding rehabilitation program,” he said. “People want to come here.”
(Toby Tabachnick can be reached at firstname.lastname@example.org.)