Roosevelt Rehabilitation And Healthcare Center
Inspection Findings
F-Tag F0842
F 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
observation, review of facility policy, clinical record review and interview with staff and residents, it was determined that the facility did not maintain complete and accurate medical records for one of 12 records reviewed (Resident R1)Findings Include: Review of clinical record revealed that resident Resident R1 was admitted to the facility on [DATE REDACTED], with diagnoses including, but not limited to, low back pain, end stage renal disease, chronic pancreatitis, and osteoarthritis. The resident died in the facility on [DATE REDACTED].Review of physician orders for resident Resident R1 revealed an order for OxyCODONE HCl Capsule 5 MG Give 1 capsule by mouth every 4 hours as needed for Pain. The order was active from [DATE REDACTED], to [DATE REDACTED], when it was discontinued following her death.A nursing note for resident Resident R1 signed by employee E3, dated [DATE REDACTED], at 3:09 a.m. stated s/s (signs and symptoms) of pain. x1 prn (as needed) med oxycodone given. [Positive] result. Review of the narcotic reconciliation log revealed that an oxycodone was signed out on [DATE REDACTED] at 1:38 a.m. Review of the medication administration record (MAR) revealed that the dose was not signed out in the MAR.An
interview was conducted on [DATE REDACTED], at 2:00 p.m., with employees E1, the Nursing Home Administrator, and E2, the Director of Nursing. They confirmed that no dose of oxycodone was signed out on [DATE REDACTED], and that
it is the expectation of the facility that all narcotics be signed out both in the narcotics log and the MAR.
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date
these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE
TITLE
(X6) DATE
FORM CMS-2567 (02/99) Previous Versions Obsolete
Facility ID:
If continuation sheet
Event ID:
ROOSEVELT REHABILITATION AND HEALTHCARE CENTER in PHILADELPHIA, PA inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
Frequently Asked Questions
- What is an F-tag violation?
- F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
- Were these violations corrected?
- Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
- How often do nursing home inspections happen?
- CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
- What should families do about these violations?
- Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in PHILADELPHIA, PA, (5) Report new concerns to state authorities.
- Where can I see the full inspection report?
- Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from ROOSEVELT REHABILITATION AND HEALTHCARE CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.