Health inspection·June 27, 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. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review, observation, and resident and staff interview, it was determined that the facility failed to provide grooming services to enhance and maintain each resident's dignity for one of two sampled residents. (Resident 51) Findings include: Clinical record review revealed that Resident 51 had diagnoses that included a stroke. The resident was observed on June 25, 2024, at 9:40 a.m., and June 26, 2024, at 10:05 a.m., with facial hair on her lower face. The resident stated that she wanted the facial hair removed, but sometimes staff is busy. The resident's Minimum Data Set assessment dated [DATE], revealed that the resident required moderate assistance with personal hygiene to include shaving. The resident had a care plan for activities of daily living due to a self care deficit and one of the interventions was for staff to assist her with grooming as needed. In an interview on June 27, 2024, at 10:06 a.m., the Director of Nursing confirmed that staff were to assist the resident with grooming as needed. 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 5 Event ID: 395402 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 395402 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/27/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Pottstown Skilled Nursing and Rehabilitation Cente 724 North Charlotte St Pottstown, PA 19464 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)