Health inspection·June 5, 2025

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 facility policy clinical records, as well as staff interviews, it was determined that the facility failed to follow the physician's orders for blood sugar checks for two of 8 residents reviewed (Residents 8,9), and failed to follow physician's orders for blood pressure checks for one of 8 residents reviewed (Resident 7). Residents Affected - Few Findings include: A facility policy for hypoglycemia (low blood sugar) <70 mg/dL dated, January 2, 2025, revealed that the resident is to be provided with a rapidly absorbed glucose (sugar), the provider notified, stay with the resident and recheck blood sugar in 15 minutes. An Annual Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs), for Resident 8, dated March 10, 2025, revealed that he was cognitively impaired and had diagnoses that included end stage kidney disease and diabetes mellitus. Physician's orders for Resident 8 dated April 18, 2025, revealed the resident was to receive 40 units of Insulin glargine solution 100 units/milliliter solution subcutaneously in the morning, and the physician was to be notified if the resident's blood sugar was <70 mg/dL or >400 mg/dL. The medication was to be held if the resident's blood sugar <80 mg/dL. A review of the Medication Administration Record (MAR) for Resident 8 for May revealed that on May 10, 2025, the resident's blood sugar was 65 mg/dL, May 15, 2025, the resident's blood sugar was 63 mg/dL, and May 30, 2025, the resident's blood sugar was 59 mg/dL. There was no documented evidence that the physician was notified of Resident 8's blood sugar per physician's order on the above dates, and no documented evidence that the resident was offered a quick absorbing glucose and blood sugar rechecked on the above dates. An admission MDS for Resident 9 dated, April 29, 2025, revealed that the resident was cognitively intact, was understood and understood others and had medical diagnosis of end stage kidney disease and diabetes mellitus. Physician's orders for Resident 9 revealed the resident was to receive blood sugar checks four times a day and notify the physician if blood sugar was >400 or <70 and to initiate hypoglycemic (low blood sugar) protocol. A review of the MAR for Resident 9 for May revealed that at 9:00 a.m. on May 9, 2025, the resident's blood sugar was 69, 9:00 a.m. on May 11, 2025, the blood sugar was 59, at 9:00 p.m. on May 12, and (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: 395224 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 395224 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/05/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hamilton Arms Center 336 South West End Avenue Lancaster, PA 17603 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)