Health inspection·April 13, 2023

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, it was determined that the facility failed to provide a safe, clean, and comfortable environment on two of two nursing units. ([NAME] and [NAME] nursing units) Findings include: Observations on the [NAME] and [NAME] nursing units on April 11 and 12, 2023, at various times revealed the following: In room [ROOM NUMBER], the corner to the right of the bathroom had dirt and grime. In room [ROOM NUMBER], there was a dried liquid that the Administrator later identified as paint, under the tube feeding pole. In the [NAME] dining room, there was a chair scale that had a stain on the top of the cushion. In the resident pantry refrigerator there was a dried sticky substance along the bottom shelves in both the refrigerator and freezer. The baseboard next to the refrigerator had a large crack. There were several sunflower seeds on the floor by the cracked baseboard. The walls in rooms 209, 210, 211, 212, 214, and 216 were marred and had chipped paint. The corner of the walls in rooms [ROOM NUMBERS] had holes in the plaster/drywall. In room [ROOM NUMBER] the wallpaper had peeled off the wall. In the bathroom shared by resident rooms [ROOM NUMBERS], the toilet was loose from the floor. The floor was completely lifted under the bed in room [ROOM NUMBER]. There were cobwebs above the window in room [ROOM NUMBER]. CFR 403.10 (i) Safe Environment Previously cited 5/12/22, 1/3/23 28 Pa. Code 207.2 (a) Administrator's responsibility. Page 1 of 3 395176 395176 04/13/2023 Ambler Extended Care Center 32 South Bethlehem Pike Ambler, PA 19002

F 0812 Level of Harm - Minimal harm or potential for actual harm Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on policy review, observation, and staff interview, it was determined the facility failed to properly store items and maintain sanitary conditions in the dietary department. Residents Affected - Many Findings include: Review of the facility's policy entitled, Storage of Refrigerated Foods, last reviewed March 31, 2023, revealed that all bulk condiment items were to be dated and outdated items were to be discarded. Review of the facility's policy entitled, Storage of Dry Food, last reviewed March 31, 2023, revealed that food stored in containers were to be identified with name of food item and date opened. Observation during the tour of the dietary department on April 11, 2023, at 9:45 a.m., revealed in the walk in cooler, there was a package of ham removed from the original container with no date on it. In the cook's refrigerator, there were multiple opened bottles of condiments with no date to reflect when opened and a carton of eggs with a best by date of March 13. In the trayline cooler, there was a bulk container of a food the Food Service Director (FSD) identified as jelly that was not labelled or dated. There were three large bulk containers of powdered food items that the FSD identified as flour and bread crumbs that were not labelled or dated. In dry storage there were three large bulk food containers that had various food debris that covered the lids. The shelves next to the containers had food debris on all of shelves. There were three opened packages of pasta that were not dated. In an interview conducted with the FSD at 10:30 a.m., he confirmed that the food items should have been dated, labelled and the expired food items should have been removed. CFR 483.6 (i) Food Safety Requirement Previously cited 1/3/23 28 Pa. Code 211.6 (c) Dietary services. 28 Pa. Code 201.14 (a) Responsibility of licensee. 395176 Page 2 of 3 395176 04/13/2023 Ambler Extended Care Center 32 South Bethlehem Pike Ambler, PA 19002

F 0919 Make sure that a working call system is available in each resident's bathroom and bathing area. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review, observation, and resident interview, it was determined that the facility failed to provide a working call bell for one of 21 sampled residents. (Resident 79) Residents Affected - Few Findings include: Clinical record review revealed that Resident 79 had diagnoses that included stroke, dysphagia (difficulty swallowing), and dysphonia (difficulty in speaking). The Minimum Data Set assessment dated [DATE], revealed that the resident had minimal memory impairment and required extensive assistance from staff for activities of daily living, including toileting, dressing, and bed mobility. Observations on April 11, 2022, at 10:20 a.m. and again at 12:30 p.m., revealed that the call bell cord was disconnected from the wall adapter so when the resident activated the call bell, no sound or lights were observed. Observations on April 12, 2023, at 9:15 a.m., revealed that the call bell cord was still disconnected from the wall adapter in Resident 79's room. In an interview on April 11, 2023, at 9:20 a.m., Resident 79 stated that the call bell had been broken for at least three days and that she wanted a call bell in order to be able to call for assistance from staff if it was necessary. 28 Pa. Code 201.18(b)(3) Management. 28 Pa. Code 211.12(d) Nursing services. 395176 Page 3 of 3