HospitalInspections.org

Based on observation and staff interview, it was determined that the facility has not maintained the interior finish for corridors. Findings include:

During a tour of the hospital on 3/12/12, the following was observed:

1. Ceiling tiles were either damaged or missing in the following area:
a. Door (81212)

This finding was confirmed by Maintenance Supervisor A at 12:50 PM on 3/12/12.

Based on observation and staff interview, it was determined that the facility has not maintained the interior finish of rooms and spaces. Findings include:

A. During a tour of the Cancer Care Center on 3/13/12, the following was observed:

1. Ceiling tiles were either damaged or missing in the following areas:

a. Networking Office
This finding was confirmed by Maintenance Supervisor A at 12:25 PM on 3/13/12.

(2000, NFPA 101:18/19.3.3)

B. During a tour of Nanticoke Diagnostic Imaging on 3/13/12, the following was observed:

1. Ceiling tiles were either damaged or missing in the following areas:

a. Environmental Services
This finding was confirmed by Maintenance Supervisor A at 2:11 PM on 3/13/12.

b. Ultra Sound 3 (including restroom)
This finding was confirmed by Maintenance Supervisor A at 2:19 PM on 3/13/12.

c. CT Room
This finding was confirmed by Maintenance Supervisor A at 2:40 PM on 3/13/12.

d. Break Room
This finding was confirmed by Maintenance Supervisor A at 2:42 PM on 3/13/12.

Based on observation and staff interview, it was determined that the facility has not maintained the corridor walls involving penetrations through corridor walls. Findings include:

During a tour of the hospital on 3/12 and 3/14/12, the following was observed:

1. Unprotected and non-sealed penetrations above the ceiling need sealing with rated materials in the following areas:

a. 2nd floor Smoke Doors by room 2020
This finding was confirmed by Maintenance Supervisor A at 11:25 AM on 3/12/12.

b. Fire door (81658)
This finding was confirmed by Maintenance Supervisor A at 11:21 AM on 3/14/12.

c. 4th floor elevator lobby
This finding was confirmed by Maintenance Supervisor A at 12:12 PM on 3/14/12.

d. 3rd floor Staff Lounge
This finding was confirmed by Maintenance Supervisor A at 1:42 PM on 3/14/12.

e. Fire door (81731)
This finding was confirmed by Maintenance Supervisor A at 1:50 PM on 3/14/12.

Based on observation and staff interview, it was determined that the facility has not maintained corridor doors to resist the passage of smoke. Findings include:

During a tour of the hospital on 3/12/12, the following was observed:

1. 3rd floor Ante room
This finding was confirmed by Maintenance Mechanic A at 10:55 AM on 3/12/12.

2. Patient sleeping room doors 3021 & 3022
This finding was confirmed by Maintenance Mechanic A at 10:58 AM on 3/12/12.

Based on observation and staff interview, it was determined that the facility has not maintained smoke compartmentation doors. Findings include:

During a tour of the hospital on 3/12/12, the following was observed:

1. Fire door (81777) in elevator lobby to patient floor not latching properly.
This finding was confirmed by Maintenance Supervisor A at 10:35 AM on 3/12/12.

2. Fire door next to Human Resources not latching properly.
This finding was confirmed by Maintenance Mechanic A at 11:47 AM on 3/12/12.

3. Fire door between 2nd floor elevator lobby and ICU access door not latching properly.
This finding was confirmed by Maintenance Supervisor A at 12:10 PM on 3/12/12.

Based on observation and staff interview, it was determined that the facility has not maintained hazardous areas. Findings include:

A. During a tour of the Cancer Care Center on 3/13/12, the following was observed:

1. Exit door from lower utility room difficult to open.
This finding was confirmed by Maintenance Supervisor A at 9:45 AM on 3/13/12.

2. 2nd floor office converted to storage must have proper separation and a rated door with a self-closing device.
This finding was confirmed by Maintenance Supervisor A at 12:55 PM on 3/13/12.

B. During a tour of Nanticoke Diagnostic Imaging on 3/13/12, the following was observed:

1. Ceiling tiles were either damaged or missing and penetrations need to be sealed in the following areas:

a. Mechanical Room
This finding was confirmed by Maintenance Supervisor A at 2:25 PM on 3/13/12.

b. IT Room
This finding was confirmed by Maintenance Supervisor A at 2:30 PM on 3/13/12.

C. During a tour of Nanticoke Occupational Health on 3/13/12, the following was observed:

1. Door to Soiled Utility Room needs to be rated.
This finding was confirmed by Maintenance Supervisor A at 3:25 PM on 3/13/12.

Based on observation and staff interview, it was determined that the facility has not maintained minimum exit access width. Findings include:

During a tour of the hospital on 3/12/12, the following was observed:

1. Exit access must be maintained in storage room by Mechanical Room D.
This finding was confirmed by Maintenance Supervisor A at 3:25 PM on 3/12/12.

Based on observation and staff interview, it was determined that the facility has not maintained exit and directional signs. Findings include:

During a tour of the hospital on 3/13/12, the following was observed:

1. Exit Sign/Emergency Light over south exit door was obstructed.
This finding was confirmed by Maintenance Supervisor A at 12:17 PM on 3/13/12.

Based on observation and staff interview, it was determined that the facility has not maintained the fire alarm signaling system in accordance with NFPA 70 and NFPA 72. Findings include:

A. During a tour of the Cancer Care Center on 3/13/12, the following was observed:

1. Open junction boxes for Fire Alarm Wiring in Preaction FSS Room need covers.
This finding was confirmed by Maintenance Supervisor A at 11:50 AM on 3/13/12.

2. Smoke detector in 2nd floor storage room too close to air discharge.
This finding was confirmed by Maintenance Supervisor A at 12:42 PM on 3/13/12.

B. During a tour of Nanticoke Diagnostic Imaging on 3/13/12, the following was observed:

1. Cover needed for Fire Alarm transformer box in IT Room.
This finding was confirmed by Maintenance Supervisor A at 2:30 PM on 3/13/12.

2. Install proper receptacle for Fire Alarm transformer box in IT Room.
This finding was confirmed by Maintenance Supervisor A at 2:30 PM on 3/13/12.

3. Install proper detector in Future MRI Room.
This finding was confirmed by Maintenance Supervisor A at 2:36 PM on 3/13/12.

4. Smoke detector in Lab Waiting area too close to air discharge.
This finding was confirmed by Maintenance Supervisor A at 2:50 PM on 3/13/12.

Based on observation and staff interview, it was determined that the facility has not maintained the automatic sprinkler system in accordance to NFPA 13 and NFPA 25. Findings include:

A. During a tour of the Cancer Care Center on 3/13/12, the following was observed:

1. Preaction FSS Room.

a. Verify with licensed fire suppression company that the pre-action sprinkler system has a "release" function for water to enter the piping system, a tag on the system noted nothing was found to do the release function.

b. Install ceiling tiles or change heads to uprights.

c. Replace corroded pipe nipple and reducer.
These findings were confirmed by Maintenance Supervisor A at 11:50 AM on 3/13/12.

2. Wires tied to sprinkler pipes in Electrical Room.
This finding was confirmed by Maintenance Supervisor A at 12:05 PM on 3/13/12.

B. During a tour of Nanticoke Diagnostic Imaging on 3/13/12, the following was observed:

1. Loaded sprinkler heads through the entire facility.
This finding was confirmed by Maintenance Supervisor A at 2:10 PM on 3/13/12.

C. During a tour of Nanticoke Rehabilitation on 3/13/12, the following was observed:

1. Loaded sprinkler heads through the entire facility.
This finding was confirmed by Maintenance Mechanic A at 2:12 PM on 3/13/12.

Based on observation and staff interview, it was determined that the facility has not properly maintained the storage of oxygen cylinders. Findings include:

During a tour of the hospital on 3/8/12, the following was observed:

1. Unsecured oxygen cylinder in 4th floor equipment storage room.
This finding was confirmed by Quality Manager A at 12:04 PM on 3/8/12.

Based on observation and staff interview, it was determined that the facility has not maintained electrical wiring and equipment in accordance with NFPA 70. Findings include:

A. During a tour of the Cancer Care Center on 3/13/12, the following was observed:

1. Install covers in the following areas:

a. Open electrical junction box in Electrical Room.
This finding was confirmed by Maintenance Supervisor A at 12:05 PM on 3/13/12.

b. Low voltage outlet box in Networking office.
This finding was confirmed by Maintenance Supervisor A at 12:25 PM on 3/13/12.

2. Follow installation instructions as per the requirements of NFPA 70 in the following areas:

a. Data lines in Electrical Room pinched between ceiling tile and grid.
This finding was confirmed by Maintenance Supervisor A at 12:14 PM on 3/13/12.

b. Data lines in Main Server Room pinched between ceiling tile and grid.
This finding was confirmed by Maintenance Supervisor A at 12:17 PM on 3/13/12.

3. Discontinue the use of multi-tap outlets in the following area:

a. Main Server Room
This finding was confirmed by Maintenance Supervisor A at 12:17 PM on 3/13/12.

B. During a tour of Nanticoke Diagnostic Imaging on 3/13/12, the following was observed:

1. Remove construction type lighting and wires in the future MRI room and install lighting in accordance to NFPA 70.
This finding was confirmed by Maintenance Supervisor A at 2:36 PM on 3/13/12.

C. During a tour of Nanticoke Occupational Health on 3/13/12, the following was observed:

1. Open splices in wiring above door to conference room need to be in back boxes.
This finding was confirmed by Maintenance Supervisor A at 4:05 PM on 3/13/12.