Health inspection·November 15, 2024

F 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review and staff interview, it was determined that the facility failed to develop or implement a comprehensive care plan and/or interventions that addressed individual resident needs as identified in the comprehensive assessment for three of 27 sampled residents. (Resident's 15, 17, 21) Findings include: Clinical record review revealed that Resident 15 had diagnoses that included malignant neoplasm of prostate and Alzheimer's disease. Review of the current care plan revealed Resident 15 was at risk for skin breakdown with an intervention for staff to apply Geri-Sleeves (sleeves to protect skin from damage caused by friction and shearing) to bilateral arms in the morning and remove during provision of care. Multiple observations on November 12, 13, and 14, 2024, between 9:30 a.m. and 1:45 p.m., revealed Resident 15 sitting in a wheelchair, in the day room, shirt sleeves pushed up, and Geri-Sleeves not applied. Clinical record review revealed that Resident 17 was admitted to the facility on [DATE], and had diagnoses that included Parkinson's disease, multiple sclerosis, and metabolic encephalopathy. The Minimum Data Set (MDS) Care Area Assessment (CAA) summary dated October 10, 2024, noted that the resident's activities, dehydration/fluid maintenance, nutritional status, pain, pressure ulcer/injury, and psychosocial well-being were to be addressed in the care plan. There was no evidence that interventions to address Resident 17's activities, dehydration/fluid maintenance, nutritional status, pain, pressure ulcer/injury, and psychosocial well-being were included in the current care plan. Clinical record review revealed that Resident 21 had diagnoses that included polyneuropathy and muscle weakness. Review of the current care plan revealed Resident 21 demonstrated loss of range of motion in bilateral lower extremities and was at risk for functional deterioration with an intervention for restorative range of motion. There was no evidence that interventions were developed or implemented to address Resident's 21's risk for functional deterioration. In an interview on November 15, 2024, at 9:40 a.m., the Director of Nursing confirmed there was no documented evidence that the care areas were addressed in the residents' current care plans. CFR 483.21(b)(1) Comprehensive Care Plans Previously cited 12/7/23 28 Pa. Code 211.12(d)(1)(3)(5) Nursing services. 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 3 Event ID: 395138 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 395138 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/15/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mifflin Center 500 East Philadelphia Avenue Shillington, PA 19607 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)