TWINING HALL

Nursing Home Inspector

280 MIDDLE HOLLAND ROAD
HOLLAND, PA 18966
Bucks County
Phone: 215-322-6100
Provider Number: 395432
Last Inspection: 11/17/2016

About the Nursing Home

Number of Beds: 82
Number of Residents: 45
Beds Available: 37
Percent Occupancy: 55%
Insurance Accepted: Medicare
Types of Councils: Both
Ownership: Non profit - Corporation
Within Hospital?: NO

About State Inspection Deficiencies

Nursing Homes that are Medicare and/or Medicaid certified are licensed by the state and are required to comply with rigid standards enforced by regular facility inspections and extensive evaluations.

The state inspection deficiencies provided here are accounts reported by state inspectors of every discrepancy found where the home failed to meet the minimum standards set forth by state and federal regulations. If a home does not show any deficiencies, it has met the minimum standards required.

Please note: Findings in these inspections do not present a complete picture of the quality of care provided. Information in this database should be interpreted carefully and used in conjunction with other sources, as well as a visit to the nursing home.


Deficiency Ratings

Our nursing home inspector tool compares the severity of deficiences rather than the number of deficiences. We calculate the severity of each deficiency using the formula:

Severity Rating = Scope + Level of Harm.

Deficiency Rating= Sum of ALL Severity Ratings

Severity Scope Level of Harm
2 1-Isolated 1-Potential for minimal harm
3 2-Pattern 1-Potential for minimal harm
3 1-Isolated 2-Minimal harm or potential for actual harm
4 3-Widespread 1-Potential for minimal harm
4 2-Pattern 2-Minimal harm or potential for actual harm
4 1-Isolated 3-Actual harm
5 3-Widespread 2-Minimal harm or potential for actual harm
5 2-Pattern 3-Actual harm
5 1-Isolated 4-Immediate jeopardy to resident health or safety
6 3-Widespread 3-Actual harm
6 2-Pattern 4-Immediate jeopardy to resident health or safety
7 3-Widespread 4-Immediate jeopardy to resident health or safety

Deficiency Ratings
By Region

Lower Numbers Are Better

 

32

Facility
16

County
23

PA
20

USA

Deficiency Ratings
By Year

Lower Numbers Are Better

 

32

2016
10

2015
8

2014

Medicare Ratings

Overall Rating: Overall Rating
Health Rating: Health Rating
Staff Rating: Staff Rating
Quality Rating: Quality Rating

 

Details by Inspection Date

11/17/2016 Inspection

 
Deficiency Description Scope : Level of Harm 1 -- Rating -- 7 Corrected
Failed To: 1) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. Isolated : Minimal 3 1/13/2017
 
Failed To: Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. Pattern : Minimal 4 1/13/2017
 
Failed To: Provide necessary care and services to maintain or improve the highest well being of each resident . Isolated : Minimal 3 1/13/2017
 
Failed To: Have a program that investigates, controls and keeps infection from spreading. Widespread : Minimal 5 1/13/2017
 
Failed To: Provide care for residents in a way that maintains or improves their dignity and respect in full recognition of their individuality. Pattern : Minimal 4 1/13/2017
 
Failed To: Have a detailed, written plan for disasters and emergencies, such as fire, severe weather, and missing residents. Pattern : Minimal 4 1/13/2017
 
Failed To: Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature. Widespread : Minimal 5 1/13/2017
 
Failed To: Keep accurate, complete and organized clinical records on each resident that meet professional standards. Pattern : Minimal 4 1/13/2017
 

10/1/2015 Inspection

 
Deficiency Description Scope : Level of Harm 1 -- Rating -- 7 Corrected
Failed To: Provide routine and emergency drugs through a licensed pharmacist and only under the general supervision of a licensed nurse. Isolated : Minimal 3 11/18/2015
 
Failed To: Ensure each resident receives an accurate assessment by a qualified health professional. Pattern : Minimal 4 11/18/2015
 
Failed To: Keep accurate, complete and organized clinical records on each resident that meet professional standards. Isolated : Minimal 3 11/18/2015
 

11/5/2014 Inspection

 
Deficiency Description Scope : Level of Harm 1 -- Rating -- 7 Corrected
Failed To: Keep accurate, complete and organized clinical records on each resident that meet professional standards. Isolated : Minimal 3 12/19/2014
 
Failed To: Store, cook, and serve food in a safe and clean way. Widespread : Minimal 5 12/19/2014
 

Complaint Investigation Deficiencies

These deficiencies resulted from complaints investigated by the state inspectors and substantiated.

4/7/2017 Investigation

 
Deficiency Description Scope : Level of Harm 1 -- Rating -- 7 Corrected
Failed To: 1) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. Isolated : Minimal 3 5/1/2017
 
Failed To: Provide necessary care and services to maintain or improve the highest well being of each resident . Isolated : Minimal 3 5/23/2017
 

11/30/2015 Investigation

 
Deficiency Description Scope : Level of Harm 1 -- Rating -- 7 Corrected
Failed To: Provide necessary care and services to maintain or improve the highest well being of each resident . Isolated : Minimal 3 1/22/2016
 

About The Staff

(Higher Numbers Are Better)

Staffing Hours Per Day Per Resident... This Facility County Avg PA State Avg
Number of Residents 45 101.50 110.03
Registered Nurses 1.52 1.07 0.94
Licensed Practical / Vocational Nurses 0.82 0.71 0.85
Certified Nursing Assistants 2.57 2.25 2.26
Total Staff Hours 4.91 4.03 4.05

 


About the Residents

(Lower Numbers Are Better)

Percent of Residents... This Facility% County Avg% PA State Avg%
of high risk long-stay residents with pressure ulcers 3 5 5
of long-stay residents assessed and appropriately given the pneumococcal vaccine 98 96 94
of long-stay residents assessed and appropriately given the seasonal influenza vaccine 90 96 95
of long-stay residents experiencing one or more falls with major injury 3 2 3
of long-stay residents who have depressive symptoms 0 2 2
of long-stay residents who lose too much weight 7 7 7
of long-stay residents who received an antianxiety or hypnotic medication 21 24 22
of long-stay residents who received an antipsychotic medication 18 15 15
of long-stay residents who self-report moderate to severe pain 0 5 6
of long-stay residents who were physically restrained 0 0 0
of long-stay residents whose ability to move independently worsened 23 21 20
of long-stay residents whose need for help with daily activities has increased 15 19 15
of long-stay residents with a catheter inserted and left in their bladder 1 1 1
of long-stay residents with a urinary tract infection 3 2 3
of short-stay residents assessed and appropriately given the pneumococcal vaccine 91 60 56
of short-stay residents who had an outpatient emergency department visit 8 86 83
of short-stay residents who made improvements in function 42 11 10
of short-stay residents who newly received an antipsychotic medication 1 63 64
of short-stay residents who self-report moderate to severe pain 3 2 1
of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine 70 12 15
of short-stay residents who were rehospitalized after a nursing home admission 25 81 82
of short-stay residents who were successfully discharged to the community 64 22 20
of short-stay residents with pressure ulcers that are new or worsened 0 53 52