Health inspection·December 23, 2024

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Based on observations, clinical record review, and staff interviews, it was determined that the facility failed to ensure that care and services were provided in a manner that enhanced resident dignity for one of five residents reviewed (Resident 1). Findings include: Review of Resident 1's clinical record revealed diagnoses that included benign prostatic hyperplasia (a condition in which the flow of urine is blocked due to the enlargement of prostate gland), dementia (a chronic disorder of the mental processes caused by brain disease, marked by memory disorders, personality changes, and impaired reasoning), and anxiety disorder (a persistent feeling of worry, nervousness, or unease). Observation of Resident 1 on December 23, 2024, at 11:47 AM, revealed he was sitting in a dining area with other residents, and a yellow puddle consistent with urine appeared underneath his chair. Further observation in the dining area on December 23, 2024, at 12:10 PM, revealed Resident 1 wheeling away from the dining area and Employee 1 (Nurse Aide) wheeled him back over to the table where he was sitting previously, over the urine puddle. During an interview with Employee 2 (Licensed Practical Nurse) on December 23, 2024, at 1:02 PM, the surveyor revealed the concern that Resident 1 was still sitting in the dining area appearing to be incontinent of urine. Observation on December 23, 2024, at 1:09 PM, revealed Employee 3 (Nurse Aide) and Employee 4 (Nurse Aide) were wheeling Resident 1 into a shower room with incontinence care supplies and new pants. During an interview with the Director of Nursing on December 23, 2024, at 1:19 PM, she confirmed that Resident 1 was incontinent of urine, and when she spoke to Employee 1, she revealed she told Employee 3 that Resident 1 needed to be changed when she realized he was incontinent at 12:10 PM; but that Employee 3 got side tracked with other tasks and lost track of time before she was able to get to him to provide incontinence care. The surveyor revealed the concern with the lack of incontinence care until surveyor inquiry. No further information was provided. 28 Pa. Code 201.29(a) Resident rights 28 Pa. Code 211.12(d)(1)(5) Nursing services 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: 395372 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 395372 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/23/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Capitol Rehabilitation and Healthcare Center 4000 Linglestown Road Harrisburg, PA 17112 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)