Nursing Home Oversight
are commonly referred to as nursing care facilities or long term care
facilities. Nursing homes are inspected annually by the Pennsylvania
Department of Health (Department). The Department of Health has been given the
responsibility of inspecting Pennsylvania’s nursing homes by the Centers
for Medicare and Medicaid Services, a branch of the federal
government. These inspections are called surveys. The
Department of Health conducts surveys in nursing homes to make sure they are
following state and federal regulations (rules). Nursing
homes that have a history of serious problems are inspected more
Nursing Home Inspection Process
Survey Team Selection
includes a registered nurse (RN) and may include a nutritionist or social
worker. The composition of the team is unique to each facility and
is determined by the facility history regarding past problems at the nursing
home. All surveyors, no matter what their professional background,
have been trained as generalists. This means that any of the team
members have the skill to determine how well the nursing home provides
services from all professions.
Survey Team Evaluation
Surveys usually cover
several days and can take place at any time of the day or
night. Surveys are not announced in advance so nursing homes do not
know when a survey might happen. The team does the following:
- examines how well the
nursing home ensures that its residents feel “at home.”
- evaluates how well the
nursing home provides care to its residents by meeting minimum regulatory
standards, including the following needs:
- spiritual; and
- uses tools to determine the quality of care and
quality of life of nursing home residents, including checklists and forms that guide what the surveyor observes, reads and
participates in while at the nursing home.
If you are at a
nursing home while a survey is in process, you might see surveyors doing some
of the following:
- observing how the staff and residents talk and interact with
- watching how the staff provides nursing care to residents;
- interviewing residents and family to see how they feel about the
care they are receiving;
- reviewing resident charts to see if necessary services are
identified and provided;
- touring the facility to see if the environment is comfortable
and safe for the residents;
- observing meals to assure the food is nutritionally balanced,
attractive, the right temperature and tastes good;
- observing nurses giving medications and providing treatment
- meeting with groups of residents such as resident councils to determine
if there are widespread problems in the nursing home; and
- meeting with staff and administrators to see if they have
developed ways of solving problems in the nursing home.
Survey Team Results
surveyors have made enough observations to complete the survey tasks, they will
talk to the administrator, staff and residents before leaving the
facility and discuss areas of concern that were identified
while they were at the facility. The surveyors then return to their
office to write the official report of their observations. For every
problem that they identify, the surveyors must decide how serious the problem
is for the residents. This is called “assigning scope and
severity.” It reflects both how serious and how often a problem
occurs in the nursing home. The surveyors write a description of the
problems, which is then called a “statement of deficiencies.” They
send a copy of their report to the nursing home requesting that it submit a
plan to correct the problems. The nursing home must submit
in writing its proposed solutions to the problems; this is called a “plan of
correction.” You can ask to see a copy of this report at any nursing
home. Nursing homes must have notices posted to tell you where the
survey results are kept. You can also view these reports on the
Department of Health’s website.
Depending on the seriousness of the deficiencies, different consequences may be given to the nursing home, which are referred to as enforcement actions.
The following are examples of enforcement actions:
- impose a ban on admissions and/or re-admissions;
- issue a provisional license;
- revoke a nursing facility's license;
- have the facility lose its right to participate in federal Medicare or state Medicade programs; or
- civil money penalty.
nursing homes with consequences for quality of care and quality of life
problems, the Department of Health strives to protect the health and safety of
our valued citizens. The survey process lets nursing homes know what
they need to do to make sure residents are receiving care and services to
maintain their functional abilities in their “home.”
Nursing care facilities sanction information for the most recent month may not reflect all sanctions issued that month due The Department of Health, Division of Nursing Care Facilities’ (DNCF) responsibility to ensure that the facility is aware of the sanction prior to posting sanctions on the website.
Nursing care facilities have the right to appeal a sanction up to 30 days from the sanction issue date. Nursing care facilities sanction information for the most recent month may not reflect whether or not the facility is appealing the sanction. Sanctions that are appealed may be changed or eliminated depending on the appeal result.
Nursing care facility sanction information for all months is updated each month with the most current data available to DNCF at the time of posting.
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