Inspection·November 14, 2024

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm Based on clinical record reviews, interviews with staff and and policy and procedure review, it was determined that the facility failed to ensure that physician's orders were follow for one of ten residents reviewed. (Resident R1) Residents Affected - Few Findings include: A review of the facility policy titled administering medications August 18, 2022 revealed that medications and treatments were to be administrated in a safe and timely manner as prescribed by the physician. The policy also indicated that medications and treatments must be administered in accordance with the physician's orders, including any required time frame or parameters as specified by the physician. This policy said that if the drug was withheld the individual administering the medication was responsible to use the correct documentation on the MAR (Medication Administration Record) space provided for that drug. The policy indicated that the person administering the medication was responsible for recording the date and time of administration. A review of the policy titled physicians' medication orders dated August 18, 2024 revealed that a medication or treatment was to be administered upon a physician's order by a person licensed to prescribed medications and treatments in the State. The policy also said that verbal orders for treatments and drugs were to be received by licensed nurses. Review of Resident R1 was readmitted to the nursing facility on August 16, 2024 with a diagnosis of replaced dislodged DOB Hoff tube (used for enteral feedings and medications for residents with swallowing problems), aspiration pneumonitis, and respiratory failure. Review of physician's orders for August, 2024 revealed a physician's order for Metoprolol tartrate (drug therapy for angina) 25 milligrams (mg) to be given every 12 hours and hold for systolic blood pressure less than 100 or heart rate less than 60. Continued review of physician's orders revealed an order for Midodrine (drug therapy for high blood pressure) 10 mg three times a day and hold for systolic blood pressure greater than 130. Review of Resident R1's August 2024 Medication Administration Record (MAR) revealed than on August 17, 2024, at 5:00 a.m., the resident's blood pressure was 132/74 and the nurse responsible failed to hold Midodrine 10 mg and administered medication to Resident R1. Continued review of August 2024 MAR revealed that on August 18, 2024 the nursing staff member documented holding Midodrine 10 mg at 9:00 a.m., however the resident's blood pressure was 109/49. The nurse responsible for administering medications documented that the medication was held; which was not (continued on next page) 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 Page 1 of 4 Event ID: 395019 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 395019 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/14/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Aristacare at Meadow Springs 845 Germantown Pike Plymouth Meeting, PA 19462 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)