F 0580
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room,
etc.) that affect the resident.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
clinical record review, resident and staff interview, it was determined that the facility failed to ensure that the
responsible party was notified in a timely manner of a scheduled appointment for one of six sampled
residents. (Resident 1) Findings include: Clinical record review revealed that Resident 1 was admitted to the
facility with diagnoses that included fracture of the left lower leg, muscle weakness, and hypertension (high
blood pressure). Review of the Minimum Data Set assessment dated [DATE], indicated that the resident
was able to communicate needs to staff and required extensive assistance from staff for transfers. Review
of a nurse's note dated January 23, 2026, revealed that the resident had returned from an orthopedic
appointment. In an interview on January 27, 2026, at 12:30 p.m., Resident 1 stated that she would have
liked if someone would have called her daughter about the appointment so that she could have made plans
to attend. There was no documentation to support that the resident's responsible party was notified of the
appointment. In an interview on January 27, 2026, at 2:54 p.m., the Director of Nursing confirmed that there
was no documented evidence that the resident's responsible party had been notified of the appointment. 28
Pa. Code 211.12(d)(1)(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
01/27/2026
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)
F 0656
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
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 and implement
interventions to address bowel incontinence in the resident's comprehensive care plan for one of six
sampled residents. (Resident 1) Findings include: Clinical record review revealed that Resident 1 was
admitted to the facility on [DATE], and had diagnoses that included fracture left lower leg, hypertension
(high blood pressure), and muscles weakness. The Minimum Data Set assessment and Care Area
Assessment summary dated January 15, 2026, noted that the resident had bowel incontinence and it was
to be addressed in the care plan. There was no evidence that interventions to address Resident 1's bowel
incontinence were included in the care plan. In an interview on January 27, 2026, at 3:10 p.m., the Director
of Nursing confirmed there was no documented evidence that interventions for bowel incontinence were
included in Resident 1's care plan. 28 Pa. Code 211.12(d)(1)(5) Nursing services.
Event ID:
Facility ID:
395138
If continuation sheet
Page 2 of 3
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
01/27/2026
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)
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 that a
physician's order was implemented for one of six sampled residents. (Resident 1) Findings include: Clinical
record review revealed that Resident 1 had diagnoses that included hypertension (high blood pressure) and
muscle weakness. On January 23, 2026, a physician gave a verbal order that directed staff to collect a stool
sample to rule out Clostridium difficile (an inflammation of the colon). There was no documented evidence
that the stool sample was collected as ordered. In an interview on January 27, 2026, at 3:15 p.m., the
Director of Nursing confirmed that the stool sample was not collected as ordered. CFR 483.25 Quality of
CarePreviously cited 12/19/25 28 Pa. Code 211.12(d)(1)(3)(5) Nursing services.
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395138
If continuation sheet
Page 3 of 3