Health inspection·September 23, 2025

F 0677 Provide care and assistance to perform activities of daily living for any resident who is unable. Level of Harm - Minimal harm or potential for actual harm Based on clinical record review and staff interview, it was determined that the facility failed to provide care and services necessary for care dependent residents for two of five residents reviewed (Residents 1 and 2).Findings Include: Review of Resident 1's clinical record revealed diagnoses that included heart failure (a condition where the heart cannot pump blood effectively enough to meet the body's needs) and hypertension (high blood pressure). Review of Resident 1's comprehensive care plan under the focus section for Activities of Daily Living (ADL), revealed an intervention that Resident 1 required total assistance with eating and drinking, initiated on June 25, 2025. Further review of Resident 1's care plan, under the focus section for nutrition, revealed an intervention to provide feeding assistance at meals, initiated on April 18, 2024.Review of Resident 1's clinical record revealed an eating task with a 30 day look back from August 25, 2025, through September 22, 2025 revealed that Resident 1 did not receive the required assistance with eating on the following dates: August 27 for two meals, September 6 for one meal, September 8 for three meals, September 10 for one meal and September 16 and 17 for one meal.Review of Resident 2's clinical record revealed diagnoses that included dementia (loss of memory, language, problem-solving and other thinking abilities that are severe enough to interfere with daily lift) and atrial fibrillation (irregular heartbeat). Review of Resident 2's comprehensive care plan under the focus section for ADLs, revealed an intervention that Resident 2 required total assistance with eating and drinking, initiated on August 15, 2025. Further review of Resident 2's care plan under the focus section for nutrition revealed that the Resident was at risk for malnutrition related to dementia diagnosis, with an intervention to monitor and record intake at meals, initiated on August 20, 2025. Review of Resident 2's clinical record revealed an eating task with a 30 day look back from August 25, 2025, through September 22, 2025 revealed that Resident 2 did not receive the required assistance with eating on the following dates: August 26 for two meals, August 27 for one meal, September 6 for one meal, September 8 for three meals, September 12 for one meal, September 17 for two meals and September 18 for two meals. During an interview with the Nursing Home Administrator on September 23, 2025, at approximately 3:00 PM, it was revealed they would expect staff to be documenting if a resident received feeding assistance for every meal. 28 Pa Code 211.12(d)(1)(3)(5) Nursing services. Residents Affected - Few 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 09/23/2025 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)