Inspection·January 9, 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 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review, staff interviews, and review of facility documentation, the facility failed to provide quality care by not timely responding to Resident 1's change in condition, including the failure to implement appropriate interventions or timely transfer the resident to a higher level of care for one of 5 residents reviewed. (Resident 1). Residents Affected - Few Findings include: Clinical record review revealed Resident 1 was admitted to the facility on [DATE], with diagnoses including muscle weakness and hypertension. The resident was her own responsible party, as documented on admission, with no designated representative or power of attorney. A Quarterly Minimum Data Set assessment (Minimum Data Set - a federally mandated standardized assessment conducted at specific intervals to plan resident care) dated [DATE], revealed a BIMS score of 10 (Brief Interview for Mental Status (BIMS) calculator checks the resident cognitive impairment, a score of 8-12 indicates moderate, cognitive impairment) and required assistance with activities of daily living. On [DATE], at 10:15 P.M., nursing documentation noted that the resident had not urinated since 2:00 P.M., had poor oral intake, a blood pressure of 81/47 mmHg, a heart rate of 113, and oxygen saturation of 94%. A call was placed to the attending physician; however, no interventions were documented at that time. Laboratory results on [DATE], revealed significant abnormalities, including: Elevated BUN (24 mg/dL; normal 6-20) Elevated creatinine (1.9 mg/dL; normal 0.5-1.0) Low estimated glomerular filtration rate (28 mL/min; normal ?60) Hyponatremia (sodium 132 mmol/L; normal 135-146) Hyperkalemia (potassium 5.8 mmol/L; normal 3.5-5.1) Low CO2 levels (19 mmol/L; normal 22-32). These results indicated acute kidney injury and metabolic abnormalities, warranting immediate (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: 395298 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 395298 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lakewood Rehabilitation & Healthcare Center 147 Old Newport Street Nanticoke, PA 18634 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)