Inspection·November 7, 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 review of facility policies and clinical records, as well as staff interviews, it was determined that the facility failed to ensure that physician's orders for medications were followed for one of twenty-two residents reviewed (Resident 28). Residents Affected - Few Findings include: Review of facility's policy regarding medication administration, revealed that medications are administered as prescribed in accordance with good nursing principles and only by persons legally authorized to do so. Right resident, right drug, right dose, right route, and right time are applied for each medication being administered. Medications are administered in accordance with written orders of the prescriber. Review of Resident 28's quarterly Minimum Data Set (MDS) assessment (mandated assessment of a resident's abilities and care needs) dated August 31,2024, indicated that the resident was cognitively intact, required assistance from staff for her daily care needs, and had diagnoses that included Chronic Systolic (Congestive) Heart Failure (long-term condition that happens when your heart can't pump blood well enough to give your body a normal supply),and Paroxysmal Atrial Fibrillation (irregular heartbeat). Review of Resident 28's Physician orders, dated July 26, 2024, included an order for the resident to receive 50 milligrams (mg) of Metoprolol Succinate Extended Release ER (blood pressure medication)every 12 hours for hypertension, and to hold the medication if the resident's systolic blood pressure (top number of a blood pressure reading) was below 105 millimeters of mercury (mmHg) OR heartrate is less than 60 beats per minute. Review of Resident 28's Medication Administration Record (MAR) for the month of October 2024 indicated that Metoprolol was administered twenty-three (23) times between dates of October 1, through October 31, 2024, when the resident's heartrate was less than 60 beats per minute. Interview with the Director of Nursing and the Nursing Home Administrator on November 07, 2024, at 12:10 p.m. confirmed that staff did not follow the physician-ordered parameters for Resident 28's Metoprolol on the above dates and times. 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 5 Event ID: 395173 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 395173 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/07/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Westgate Hills Rehabilitation and Nursing Ctr 2050 Old West Chester Pike Havertown, PA 19083 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)