Inspection·June 24, 2024

F 0658 Ensure services provided by the nursing facility meet professional standards of quality. Level of Harm - Minimal harm or potential for actual harm Based on observation, clinical record review, and staff interviews, it was determined that the facility failed to ensure care and services were provided in accordance with professional standards for one of three residents reviewed (Resident 1). Residents Affected - Few Findings include: Review of Resident 1's clinical record revealed diagnoses that included congestive heart failure (a long-term condition that happens when your heart can't pump blood well enough to meet your body's needs), gastro esophageal reflux disease (a chronic digestive disease where the liquid content of the stomach refluxes into the esophagus, the tube connecting the mouth and stomach), and hypertension (high blood pressure). Review of Resident 1's physicians orders revealed the following medications: Clopidogrel Bisulfate Oral Tablet 75 mg (milligram- unit of measure), give one tablet by mouth one time a day, with a start date of November 13, 2023. Famotidine Tablet 20 mg, give one tablet by mouth one time a day, with a start date of May 25, 2024. Jardiance Oral Tablet 10 mg, give one tablet by mouth one time a day, with a start date of May 10, 2024 MagOx 400 Oral Tablet, give 800 mg by mouth three times a day, with a start date of November 13, 2023. Metoprolol Tartrate Oral Tablet 25 mg, give 0.5 tablet by mouth every 12 hours, with a start date of November 12, 2023. Lasix Oral Tablet 20 mg, give one tablet by mouth one time a day, with a start date of November 12, 2023. Eliquis Oral Tablet, give 5 mg by mouth two times a day, with a start date of January 19, 2024. Florastor Capsule 250 mg, give one capsule by mouth two times a day, with a start date of November 12, 2023. Observation in Resident 1's room June 24, 2024, at 9:49 AM, revealed a cup of medications on her (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 2 Event ID: 395142 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 395142 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/24/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Amoroso Healthcare and Rehabilitation Woodridge 3625 North Progress Ave Harrisburg, PA 17110 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)