Health inspection·April 24, 2025

F 0805 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. Based on clinical record review, facility dietary manual review, observations, and staff interviews, it was determined that the facility failed to provide a meal that was designed to meet the needs of residents requiring a mechanical soft meal, and failed to provide a pureed meal for one of three residents reviewed (Resident 1). Findings include: Review of the facility's dietary manual, section titled, Menus, revealed the facility's policy stated, .Menus are implemented by the Dietary Manager in conjunction with the Dietician . Further, review of subsection titled, Mechanical Soft Diet, stated, Purpose: The mechanical diet is modified in consistency to reduce the amount of chewing required to consume food. Review of the planned menu for April 22, 2025, lunch meal, revealed the mechanical soft lunch was to include ground chicken enchilada casserole and ground black beans. Review of the recipe for the chicken enchilada casserole revealed it included the instructions of, Mechanical Soft Steps: Remove desired number of servings to chop for the mechanical soft diets. Use a knife/fork or processor to chop foods to the desired consistency. Observation of the lunch meal service on April 22, 2025, revealed mechanical soft meals were served a chicken enchilada with chopped meat inside of a flour tortilla. The flour tortilla was served whole; not cut or chopped. Observations of the black beans served revealed they were served whole, not ground. During a staff interview on April 24, 2025, at approximately 2:30 PM, the Nursing Home Administrator (NHA) confirmed that the planned menu textures should have been followed as identified on the menu. Review of Resident 1's clinical record revealed diagnoses that included diabetes type II (decreased ability of the body to produce and utilize insulin) and essential hypertension (elevated/high blood pressure). Review of Resident 1's interdisciplinary progress notes revealed a note dated April 22, 2025, at 1:01 PM, by Employee 1 (Social Services), that stated, .[Resident 1] has been downgraded to puree texture [sic] [due to] difficulty swallowing pills . Review of Resident 1's physician orders revealed a diet order entered by Employee 4 (Registered (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: 395347 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 395347 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/24/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Oak Hill Center for Rehabilitation and Nursing 1020 North Union Street Middletown, PA 17057 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)