Health inspection·July 10, 2024

F 0661 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. Based on a review of clinical records and interview with staff, it was determined that the facility failed to ensure a physician's discharge summary was completed prior to or at the time of discharge for one of two closed records (Resident 83). Findings include: Review of Resident 83's clinical record revealed that the resident was discharged from the facility on July 2, 2024. Further review of Resident 83's clinical record failed to reveal evidence that the discharge summary was completed by the physician prior to or at the time of discharge. Interview with the Nursing Home Administrator on July 10, 2024 at 10:00 a.m. confirmed that the discharge summary was not completed. 28 Pa Code 211.5(d) Clinical record Page 1 of 2 395336 395336 07/10/2024 Quarryville Presbyterian Retirement Community 625 Robert Fulton Highway Quarryville, PA 17566

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm Based on observations, clinical record reviews, and staff interviews, it was determined the facility failed to ensure Enhanced Barrier Precautions (EBP-infection control prevention designed to reduce transmission of multidrug-resistant organisms that employs targeted gown and glove use during high contact resident care activities) were in place for residents requiring enhanced barrier precautions for one of four residents reviewed (Residents 2). Residents Affected - Few Findings include: Review of the facility's policy titled Enhanced Barrier Precautions (EBP) dated March 2024, revealed EBP will be used in the care of any residents who are at higher risk of colonization or infection with multi-drug resistant organisms (MDROs). Use of Enhanced Barrier Precautions is a strategy for improved success for infection control and to expand on standard precautions. Enhanced Barrier Precautions are designed to reduce the risk of transmission and/or colonization of MDROs from both recognized and unrecognized sources. Enhanced Barrier Precautions require gowns and gloves to be worn during any high-contact resident care based on the location of the organism (i.e., urine, nares, wounds, etc ). EBP are to be used for residents who are at an increased risk of infection, including those with a known infection or colonization of a resistant organism who do not require contact precautions, and residents with chronic wounds or indwelling medical devices. It is meant to remain in place for these residents during the duration of their stay at the facility. Isolation is not required for those who have EBP in place. Clinical records review revealed Resident 2 had a Stage 4 Pressure Ulcer (Full-thickness skin and tissue loss) to the coccyx. Observation conducted of Resident 2's room failed to reveal evidence of EBP signage/communication. Interview with the Director of Nursing, Nursing Home Administrator, and Wound Nurse was conducted on July 10, 2024, at 2:10 p.m., where it was confirmed that the EBP process was not followed for Resident 2. 28 Pa. Code 201.18(b)(1) Management 28 Pa. Code 211.5(f) Clinical records 28 Pa. Code 211.12(d)(1)(3)(5) Nursing services 395336 Page 2 of 2