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401 SAWYER RD

KENDALLVILLE, IN 46755

PHYSICAL ENVIRONMENT

Tag No.: A0700

Parkview Noble Hospital was found not in compliance with Requirements for Participation in Medicare/Medicaid, 42 CFR Subpart 482.41(b), Life Safety from Fire and the 2000 Edition of the National Fire Protection Association (NFPA) 101, Life Safety Code (LSC).

Parkview Noble Hospital's main building, Building 06, a two story fully sprinklered building of Type I (332) construction with a basement and a fire alarm system with smoke detection in the corridors; patient rooms and spaces open to the corridors was surveyed with Chapter 18, New Health Care occupancies. Building 06 provides overnight care. Building 06 has a capacity of 31 and had a census of 29 at the time of this survey.

Based on LSC survey and deficiencies found (see 2567L), it was determined that the facility failed to ensure the elevator equipment in 2 of 2 elevator equipment rooms was provided with a shunt trip in the main building, Building 06 (see K 161).

The cumulative effect of these systemic problems resulted in the hospital's inability to ensure that all locations from which it provides services are constructed, arranged and maintained to ensure the provision of quality health care in a safe environment.

LIFE SAFETY FROM FIRE

Tag No.: A0709

Based on interview and record review, the facility failed to ensure the elevator equipment in 2 of 2 elevator equipment rooms was provided with a shunt trip in the main building, Building 06.

Findings:

Building 06:
1. In interview with MSS1 on 04/30/13 at 12:03 and 12:15 p.m., it was said that a shunt trip, which is designed to automatically disconnect power to the affected elevator, had not been installed on the elevator equipment in the two basement elevator equipment rooms. The facility's sprinkler contractor company had stated a shunt trip was not required per code.

2. Record review with MSS1 and QAS1 at 12:15 p.m. indicated the waiver request documentation submitted by the facility included the comment "This quote does not include the additional cost of electrician labor needed to install shunt trips prior to activation."