Nine months of hospital inspections Hospital of the University of Pennsylvania: January to September
HUP's Cedar Avenue campus was cited for multiple violations in the first nine months of the year.
The Hospital of the University of Pennsylvania was cited by the Pennsylvania Department of Health for issues including unsanitary conditions and inadequate standards for use of urinary catheters at its Cedar Avenue facility, which specializes in mental and behavioral health services.
The citations were among 13 times health inspectors visited the hospital’s main campus and Cedar Avenue outpost to investigate potential safety problems between February and October.
Here’s a look at the publicly available details:
Jan. 16: Inspectors cited the hospital for failing to properly oversee a nurse-in-training who treated a patient with a urinary catheter that was larger than necessary at the Cedar Avenue campus in September 2023. Hospital policy requires staff to use the “smallest viable” catheter size to reduce the risk of damage to the urethral lining and minimize discomfort. Inspectors found that the too-large catheter did not work properly and the patient complained of pain. Administrators met internally to discuss the incident prior to the health department’s investigation, reviewed staffing levels, and retrained staff on catheter care protocol.
Feb. 6: Inspectors came to investigate a complaint but found the hospital was in compliance. Complaint details are not made public when inspectors determine it was unfounded.
Feb. 20: Inspectors came to investigate a complaint but found the hospital was in compliance.
Feb. 24: Inspectors came to investigate a complaint but found the hospital was in compliance.
Feb. 24: Inspectors followed up on two November 2023 citations at the hospital’s Cedar Avenue campus and found the facility was in compliance. HUP - Cedar Ave was cited for failing to provide prompt emergency care after a patient was left to die on the floor while staff scrambled to figure out what to do. Later the same month, the facility was cited after a patient waited four days for staff to split and treat a broken wrist.
Mar. 5: Inspectors visited for a mental health monitoring survey at the hospital’s Cedar Avenue campus and found the hospital was in compliance.
Apr. 23: Inspectors came to investigate a complaint but found the hospital was in compliance.
May 15: Inspectors came to investigate a complaint but found the hospital was in compliance.
Jun. 11: Inspectors cited the hospital’s Cedar Avenue location for sanitation problems, including a cracked floor in a clean storage area, discolored and leaking ceiling pipes and hand sanitizer that expired in 2022. Inspectors also found catheters and other sterile equipment that had expired earlier in 2024. The hospital repaired the floor and pipes, cleaned up debris, and discarded expired supplies. Staff were retrained on maintenance protocol and administrators agreed to monitor cleaning logs for compliance.
Jul. 11: Inspectors came to investigate a complaint but found the hospital was in compliance.
Jul. 17: Inspectors came to investigate a complaint but found the hospital was in compliance.
Aug. 15: Inspectors came to investigate a complaint but found the hospital was in compliance.
Aug. 26: Inspectors visited for a special monitoring survey and found the hospital was in compliance.
Sept. 25: Inspectors came to investigate a complaint but found the hospital was in compliance.
Pennsylvania Department of Health routinely inspects hospitals to ensure the facility is safe for patients and that staff are following all safety protocols. Inspectors may also visit when a hospital staff member or patient files a complaint.
Not all safety violations spark an on-site investigation from inspectors. Hospitals are required to self-report the most serious safety violations and often work directly with the state to address them. Complaint details are not made public when inspectors determine it was unfounded.
The Inquirer tracks publicly available hospital reports related to a complaint, special monitoring, and general safety inspections. The Inquirer does not track inspections for new equipment or occupancy surveys, unless problems are identified.
Inspection reports are publicly available online and are released 40 days after the report is completed.
The Inquirer is publishing roundups of state inspection reports for Pa. hospitals in our coverage area.
