Health inspection·September 18, 2025

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 review and staff interview, it was determined that the facility failed to ensure physicians' orders were implemented for two of 21 sampled residents. (Residents 8, 10)Findings include: Clinical record review revealed that Resident 8 had diagnoses that included congestive heart failure and hypertension (high blood pressure). On November 21, 2024, a physician ordered that staff weigh the resident daily because of her congestive heart failure. There was no documented evidence that staff weighed the resident on August 12 and 20, and September 2, 4, 12, 14, and 16, 2025. Clinical record review revealed that Resident 10 had diagnoses that included heart failure and atrial fibrillation (irregular heart rhythm). On May 22, 2025, the physician ordered that staff administer a blood pressure medicine (metoprolol succinate) once a day. Staff was not to administer the medication if the resident's heart rate was less than 55 beats per minute. Review of the Medication Administration Record for August and September 2025, revealed that staff administered the medication when the resident's heart rate was less than 55 beats per minute on August 25, and September 7, and 8, 2025. In an interview conducted on September 18, 2025, at 10:30 a.m., the Director of Nursing confirmed that the physician's orders were not followed for Residents 8 and 10. CFR 483.25 Quality of CarePreviously cited 10/24/24.28 Pa. Code 211.12(d)(1)(5) Nursing services. Residents Affected - Few 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 2 Event ID: 395117 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 395117 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/18/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lutheran Home at Topton, The One South Home Avenue Topton, PA 19562 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)