Lebanon Valley Brethren Home

In the surveyor’s words

From the most serious findings on record at Lebanon Valley Brethren Home, in the surveyor’s own words.

• No harm, potential for more than minimal, patternF812Apr 30, 2021

  Based on observation, policy review and staff interview, it was determined that the facility failed to properly store food to prevent potential foodborne illness in three of seven kitchen areas. ([NAME], [NAME] Haven, and [NAME] Haven Greenhouses) Findings include: Review of the facility policy entitled, Food and Supply Storage dated [DATE], revealed that all food, non food items, and supplies used in food preparation were to be stored in a manner to prevent contamination and to maintain the safety of the food. Foods past the use by, sell-by, or enjoy by date should be discarded. Observation of the [NAME] Greenhouse dry storage area and refrigerator on [DATE], at 10:15 a.m., revealed three apples and one lemon with a discard date of [DATE]. […]

• No harm, potential for more than minimal, isolatedF697Jan 11, 2024

  Based on clinical record review, resident interview, and staff interview, it was determined that the facility failed to ensure pain management was consistent with professional standards and failed to attempt non-pharmacological interventions to alleviate pain prior to the administration of pain medication prescribed on an as needed basis for one of 16 sampled residents. (Resident 18) Findings include: Clinical record review revealed that Resident 18 had diagnoses that included dementia, anxiety, and diabetes. There were physician's orders dated July 14, 2022, for staff to administer the narcotic pain medication, oxycodone, every four hours as needed for very severe pain, rating nine to 10 only. […]

• No harm, potential for more than minimal, isolatedF689Mar 24, 2022

  Based on clinical record review, review of incident reports, and staff interview, it was determined that the facility failed to provide adequate supervision for a resident who exhibited behaviors and failed to ensure that an assessed safety intervention was in place in order to prevent falls for one of eight sampled residents who were at risk for falls. (Resident 120) Findings include: Clinical record review revealed that Resident 120 was admitted to the facility on [DATE], with diagnoses that included dementia with behavioral disturbance, [CONDITION(S)], [CONDITION(S)], restlessness, and agitation. Review of the current care plan identified the resident was at risk for falls due to dementia and poor safety awareness. […]

• No harm, potential for more than minimal, isolatedF580Jun 21, 2021

  Based on review of facility policy, clinical record review and staff interview, it was determined that the facility failed to ensure that the attending physician was notified of a need for an alteration in treatment for one of four sampled residents. (Resident CL1) Findings include: Review of the facility policy entitled Notification of Changes, dated July 2020, revealed that staff were responsible to notify the physician timely of a significant change in treatment related to the health or safety of the resident. Clinical record review revealed that Resident CL1 was admitted to the facility on [DATE], with diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . […]

• No harm, potential for minimal, patternF623Apr 30, 2021

  Based on facility policy review, clinical record review, and staff interview, it was determined that the facility failed to notify the resident and resident's representative in writing upon transfer to the hospital for three of 20 sampled residents. (Residents 21, 44, 79) Findings include: Review of the facility policy entitled, Transfer and Discharge Requirements, dated August 2020, revealed that, the Community will notify the resident and the representative of the transfer/discharge and the reasons for the move in writing and in a language they understand. Clinical record review revealed that Resident 21 was admitted to the facility on [DATE], and had diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . […]