Inspection·November 21, 2024

F 0600 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Based on review of facility policies, investigation reports, and clinical records, as well as staff and resident interviews, it was determined that the facility failed to ensure that residents were free from abuse for one of 8 residents reviewed (Resident 1) Findings include: The facility's policy regarding abuse and neglect, last revised November 2019, define abuse as infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish. Abuse also includes the deprivation by an individual, including a caretaker of goods or services that are necessary to attain or maintain physical, mental and psychosocial well-being. Instances of abuse of all residents, irrespective of any mental or physical condition, cause physical harm, pain or mental anguish. It includes verbal abuse . A quarterly Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs) for Resident 1, dated October 31, 2024, revealed Resident 1's brief interview for mental status (BIMS, used to identify cognitive impairment) of 15 out of 15 (cognition is intact). Review of Event number: 1045802, revealed Resident 1 was verbally abused by Employee 3 (E3) when Resident 1 attempted to enter the kitchen to offer help, due to believing the kitchen was short staffed. Review of facility investigation, dated October 26, 2024, revealed that E3 verbally abused Resident 1 at approximately 12:30 p.m. on October 26, 2024, when Resident 1 attempted to enter the Kitchen. Review of investigation statement 1 from Employee 4 (E4) stated The [E3] came out of the kitchen complaining at a [Resident 1] in the kitchen. [Resident 1] and [E3] are yelling back and forth. [E3] threatens, yells at the [Resident 1], that she will slap the shit out of her . She told the [Resident 1] she will get scraps. Told resident she will not receive a meal . Review of investigation statement 2, dated October 26, 2024, states While cleaning the service hallway [Resident 1] had walked back to volunteer to help the cooks, one of the cooks snapped and told [Resident 1] to leave, as she followed [Resident 1], [E3] argued with [Resident 1] and said You dirty whore, I'll slap the shit out of you . Review of investigation statement 3, dated October 26, 2024, at 1:34 p.m. states At approximately 12:30 p.m., [E3] opened the door to the hall and stated to me come get your resident, I don't need them back in the kitchen . I came out through the doors and observed [Resident 1] yelling and [E3] (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: 395284 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 395284 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/21/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Phoenix Center for Rehabilitation and Nursing,the 833 South Main Street Phoenixville, PA 19460 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)