F 0842
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in
accordance with accepted professional standards.
Based on review of clinical records, facility policy, and staff interview, it was determined that the facility
failed to have complete and accurate documentation regarding personal hygiene, oral hygiene, toileting,
and dressing for three of three residents reviewed (Residents R1, R2, and R3).Findings include: Review of
facility policy entitled Flow of Care dated 3/27/25, indicated The provision of targeted care needs shall be
documented on Care Tracker/Point of Care/ADL [activities of daily living] Flow Records. Review of Resident
R1's clinical record revealed an admission date of 12/12/25, with diagnoses that included fracture of neck of
left femur (broken bone of the hip), chronic obstructive pulmonary disease (when your lungs do not have
adequate air flow), and hypertension (high blood pressure). Review of resident R1's clinical record under
tasks (area in the clinical record where nursing assistant's document) for the month of December 2025,
revealed oral hygiene, personal hygiene, toileting hygiene, and upper and lower body dressing lacked
evidence of documentation on 12/12/25, 12/13/25, 12/14/25, 12/15/25, 12/16/25, 12/18/25, and 12/19/25,
that oral hygiene, personal hygiene, toileting hygiene, and upper and lower body dressing had been
completed. Review of Resident R1's physician's orders revealed an order dated 12/14/25, to turn and
reposition every two hours dated. Resident R1's clinical record lacked evidence that he/she was turned and
repositioned every two hours per physician's orders. Review of Resident R2's clinical record revealed an
admission date of 11/15/25, with diagnoses that included heart failure (a condition where the heart cannot
supply the body with enough blood), hypertension, and need for assistance with personal care. Review of
resident R2's clinical record under tasks for the month of December 2025, revealed oral hygiene, personal
hygiene, toileting hygiene, and upper and lower body dressing lacked evidence of documentation on
12/1/25, 12/3/25, 12/4/25, 12/6/25, 12/7/25, 12/8/25, 12/9/25, 12/10/25, 12/11/25, 12/12/25, 12/13/25,
12/14/25, 12/15/25, 12/16/25, 12/22/25, 12/23/25, 12/24/25, 12/25/25, 12/26/25, 12/27/25, 12/28/25,
12/29/25, 12/30/25, and 12/31/25, that oral hygiene, personal hygiene, toileting hygiene, and upper and
lower body dressing had been completed. Review of Resident R3's clinical record revealed an admission
date of 11/26/25, with diagnoses that included anxiety (a condition that causes a person to be nervous,
uneasy, or worried about something or someone), respiratory failure (a condition where your lungs don't
exchange air properly), and hypertension. Review of resident R3's clinical record under tasks for the month
of December 2025, revealed oral hygiene, personal hygiene, toileting hygiene, and upper and lower body
dressing lacked evidence of documentation on 12/1/25, 12/6/25, 12/7/25, 12/8/25, 12/9/25, 12/10/25,
12/11/25, 12/12/25, 12/13/25, 12/15/25, 12/16/25, 12/27/25, 12/31/25, that oral hygiene, personal hygiene,
toileting hygiene, and upper and lower body dressing had been completed. During an interview on 1/23/26,
at 10:15 a.m. the Nursing Home Administrator and Director of Nursing confirmed that Residents R1, R2
and R3's clinical records did not have complete documentation regarding turning and repositioning,
personal hygiene, oral hygiene, toileting, and dressing. They also confirmed that turning and repositioning,
(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:
395197
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
395197
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/23/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kadima Rehabilitation & Nursing at New Wilmington
520 New Castle Street
New Wilmington, PA 16142
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 0842
personal hygiene, oral hygiene, toileting, and dressing should be documented in the clinical record after it is
completed. 28 Pa. Code 211.5(f) Medical Records 28 Pa. Code 211.12(d)(1)(5) Nursing Services
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395197
If continuation sheet
Page 2 of 2