Health inspection·September 25, 2024

F 0656 Level of Harm - Minimal harm or potential for actual harm Review of Resident 93's [NAME] (tool used to instruct nurse aides on providing care to residents) revealed an intervention to apply a rolled up washcloth in left hand daily to slow progression of the contracture. Observations of Resident 93 on September 22, 2024, at 10:05 a.m. and on September 25, 2024, at 11:00 a.m. revealed the resident did not have a rolled up washcloth in the left hand. Residents Affected - Few Interview with the Director of Nursing on September 25, 2024, at 11:30 a.m. confirmed there was no active care plan addressing Resident 93's contracture and that staff did not implement the intervention to use a rolled up washcloth in the resident's left hand. 483.21(b) Comprehensive care plans Previously cited 10/20/23 28 Pa. Code 211.5(f) Clinical records Previously cited 6/13/24, 10/20/23 28 Pa. Code 211.11(a) Resident care plan 28 Pa. Code 211.11(d) Resident care plan Previously cited 10/20/23 28 Pa. Code 211.12(d)(1)(5) Nursing services Previously cited 10/20/23 FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395403 If continuation sheet Page 2 of 9 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 395403 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/25/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Newport Meadows Health and Rehabilitation Center 41 Newport Avenue Christiana, PA 17509 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)

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm Based on clinical record review, it was determined the facility failed to follow physician orders in regard to fluid restriction for one of 25 residents reviewed (Resident 11). Residents Affected - Few Findings include: Review of Resident 11's physician orders revealed an order dated August 13, 2024, stating 1500 ml (milliliter) fluid restriction, 900 ml from nursing, 600 ml from dietary. Review of Resident 11's clinical record failed to reveal evidence of fluid consumption amounts administered by nursing. Review of Resident 11's dietary fluid consumption from August 13, 2024, through September 24, 2024, revealed on multiple dates Resident 11 consumed greater than the 600 ml fluid restriction as ordered by Resident 11's physician as follows: August 13, 2024 - 1080 ml; August 16, 2024 - 720 ml; August 17, 2024 - 960 ml; August 18, 2024 - 1080 ml; August 19, 2024 - 880 ml; August 20, 2024 - 1340 ml; August 21, 2024 - 720 ml; August 22, 2024 - 920 ml; August 23, 2024 - 970 ml; August 25, 2024 - 3240 ml; August 26, 2024 - 840 ml; August 28, 2024 - 620 ml; August 29, 2024 - 730 ml; September 1, 2024 - 1080 ml; September 2, 2024 - 780 ml; September 3, 2024 1020 ml; September 4, 2024 - 1140 ml; September 7, 2024 - 1020 ml; September 9, 2024 - 660 ml; September 11, 2024 - 800 ml; September 12, 2024 - 1040 ml; September 13, 2024 - 710 ml; September 15, 2024 - 980 ml; September 16, 2024 - 960 ml; September 17, 2024 - 1740 ml; September 18, 2024 - 860 ml; September 19, 2024 - 1040 ml; September 20, 2024 - 720 ml; September 21, 2024 - 960 ml; September 22, 2024 - 1080 ml; September 24, 2024 - 960 ml. Interview with the Director of Nursing on September 25, 2024, at 10:00 a.m. confirmed there was no nursing documentation to indicate Resident 11's fluid consumption from nursing and further confirmed Resident 11 did not adhere to the 600-milliliter dietary fluid restriction as ordered by Resident 11's physician. 28 Pa. Code 211.12(c)(d)(1)(2)(3)(5) Nursing Services Previously cited 10/20/2023, 6/13/2024 FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395403 If continuation sheet Page 3 of 9 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 395403 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/25/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Newport Meadows Health and Rehabilitation Center 41 Newport Avenue Christiana, PA 17509 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)

F 0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Level of Harm - Actual harm Residents Affected - Few **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of facility policy and procedure and clinical record and staff interview, it was determined the facility failed to safely reheat a beverage for one of 32 residents reviewed causing actual harm to Resident 32 who developed a 2nd degree burn. Findings Include: Review of facility policy and procedure titled Microwave Use, undated, revealed staff should remove beverage from microwave, uncover, stir and insert thermometer probe into center of beverage item ensuring contact with beverage only. Check digital display for a maximum temperature of <165. Let sit for three minutes before serving. Review of Resident 32's Progress Notes revealed a nursing entry dated July 10, 2024 at 8:16 a.m. indicating While administering medication [resident] states that [resident] burned [himself/herself] while drinking [his/her] coffee. [Resident] states, I asked him to heat up my coffee and I spilled it on myself. [Resident] reports [he/she] burned both [his/her] butt cheeks. Further review of Resident 32's progress notes revealed a skin and wound note dated July 10, 2024 at 10:08 a.m. indicating staff reports resident sustained burns to bilateral (both) buttocks due to coffee on July 9. An assessment of the wound included in the progress note read as follows: wound 4, left buttock, 2nd degree burn, 16 cm (centimeters), x 16 cm x 0.1 cm. 60% erythema (redness), 20% intact fluid filled blister, 20% epithelial (pink or pearly white tissue and wrinkles when touched). Wound 5 right buttock, 2nd degree burn, 8 cm x 6.7 cm, 0.1 cm, 100% epithelial. Review of Facility Action Plan, signed by the Nursing Home Administrator on September 4, 2024 revealed Resident 32 is a [AGE] year-old [male/female] with a BIMS (brief interview for mental status) of 15 (indicating no cognitive deficit). On July 9, 2024 [Resident] kept [his/her] coffee from dinner and asked for it to be heated up prior to bed (approximately 10:45 p.m.). (Nursing Employee E4) honored [his/her] request to heat the coffee and placed it in the microwave for approximately 30 seconds, three time (testing between each time). Interview with the Director of Nursing on September 24, 2024 at 11:30 a.m. revealed (Nursing Employee E4) was asked to heat up coffee left over from dinner by Resident 32. He heated it up and when he returned Resident 32 said it wasn't hot enough, so he heated up and again Resident 32 said it was not hot enough. When he heated it up a third time, he left it on the bedside table for Resident 32 because it was the end of the shift. On September 24, 2024 at 11:30 a.m. the facility was asked to provide any evidence the beverage was temperature tested each time it was heated up by the nursing Employee E4. The Director of Nursing stated, we do not have logs for when (Nursing Employee E4) heated up the coffee for Resident 32 and a statement was taken from (Nursing Employee E4) but was unable to be found. The facility failed to ensure beverages that were heated in a microwave were safe temperature prior to serving to residents resulting in actual harm to Resident 32. 28 Pa. Code 201.14(a) Responsibility of licensee (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395403 If continuation sheet Page 4 of 9 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 395403 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/25/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Newport Meadows Health and Rehabilitation Center 41 Newport Avenue Christiana, PA 17509 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)

F 0689 28 Pa. Code 201.18(b)(1)(3)(e)(1) Management Level of Harm - Actual harm 28 Pa. Code 201.29(c) Resident rights Residents Affected - Few 28 Pa. Code 211.5(f) Clinical records 28 Pa. Code 211.11(d) Resident care plan 28 Pa. Code 211.12 (c)(d)(1)(5) Nursing services FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395403 If continuation sheet Page 5 of 9 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 395403 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/25/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Newport Meadows Health and Rehabilitation Center 41 Newport Avenue Christiana, PA 17509 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)

F 0756 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. Based on review of Consultant Pharmacy Reviews, it was determined the physician failed to ensure a rationale was provided in declining a Consultant Pharmacist recommendation for one of five residents reviewed (Resident 102). Findings include: Review of Resident 102's Consultant Pharmacy Medication Review dated March 27, 2024, regarding a Gradual Dose Reduction (GDR) revealed the physician disagreed with the request from the Consultant Pharmacist. Further review of Resident 102's medication review failed to reveal a clinical rationale for declining the recommendation. Interview with the Director of Nursing on September 25, 2024, at 10:15 a.m. confirmed no clinical rationale was provided by Resident 102's physician for declining the consultant pharmacist's recommendation. 28 Pa. Code 211.9(a) Pharmacy Services FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395403 If continuation sheet Page 6 of 9 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 395403 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/25/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Newport Meadows Health and Rehabilitation Center 41 Newport Avenue Christiana, PA 17509 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)

F 0758 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. Based on clinical record review and staff interview, it was determined that the facility failed to accurately monitor and assess residents for side effects of antipsychotic medications for three of five residents reviewed for unnecessary medications (Residents 2, 84, and 93). Findings include: Review of Resident 2's physician's orders revealed an order dated March 31, 2023, for Abilify (antipsychotic medication) 5 milligrams (mg) once daily. Review of Resident 2's clinical record failed to reveal evidence of side effect monitoring for the antipsychotic medication. Review of Resident 84's physician's orders revealed an order dated September 14, 2024, for Abilify 10 mg once daily. Review of Resident 84's clinical record failed to reveal evidence of side effect monitoring for the antipsychotic medication. Interview with licensed nurse Employee E3 on September 25, 2024, at approximately 10:50 a.m. revealed side effect monitoring for residents on antipsychotics should be found on the residents' Medication Administration Record (MAR). Review of Resident 2 and Resident 84's September 2024 MAR's failed to reveal evidence of side effect monitoring for the antipsychotic medications. Review of Resident 93's physician's orders revealed an order dated July 1, 2024, for Risperidone (antipsychotic medication) 0.5 mg twice daily. Further review of Resident 93's orders revealed an order dated November 3, 2023, to monitor for side effects for antipsychotics every shift. Each side effect was numbered 1-14. Document N if monitoring was conducted and no side effects were observed; document Y if monitoring was conducted and side effects were observed. Review of Resident 93's September 2024 Treatment Administration Record revealed staff were not documenting N or Y and the side effect monitoring was signed off via a checkmark and staff initials. The above findings were confirmed with the Director of Nursing on September 25, 2024, at approximately 11:30 a.m. 28 Pa Code 211.5 (f) Clinical records 28 Pa code 211.10 (c) Resident care policies 28 Pa. 211.12(c)(d)(1)(3)(5) Nursing services FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395403 If continuation sheet Page 7 of 9 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 395403 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/25/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Newport Meadows Health and Rehabilitation Center 41 Newport Avenue Christiana, PA 17509 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)

F 0776 Provide timely, approved x-ray services, or have an agreement with an approved provider to obtain them. Level of Harm - Minimal harm or potential for actual harm Based on clinical record review, it was determined the facility failed to ensure the radiological diagnostic studies were done in a timely manner for one of 25 residents reviewed (Resident 2). Residents Affected - Few Findings include: Review of Resident 2's clinical record revealed a podiatry consult dated April 15, 2024, which stated that the resident was seen at request of floor nurse - [resident] had a fall a week or 2 ago & is complaining of pain in [left] foot. Further review of same podiatry consult dated April 15, 2024 under the subsection titled Recommendations/New Orders the podiatrist wrote for the resident to have an x-ray of the left foot. Review of Resident 2's progress notes revealed a nurse's note dated April 15, 2024, which stated: Resident seen by the Podiatrist today for [complaints of] left outer foot pain near [his/her] pinky toe. [No new orders] received. Review of Resident 2's x-ray results revealed the x-ray was not obtained until April 23, 2024, which showed a fracture of the distal fifth metatarsal bone. The delay in obtaining Resident 2's x-ray was confirmed with the Director of Nursing on September 25, 2024, at approximately 11:30 a.m. Pa. Code: 211.12(b) Nursing services Pa. Code: 211.12(d)(1)(3) (5) Nursing services Pa. Code: 211.10(d) Resident care policies FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395403 If continuation sheet Page 8 of 9 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 395403 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/25/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Newport Meadows Health and Rehabilitation Center 41 Newport Avenue Christiana, PA 17509 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)

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm Based on review of facility policy and procedure and observation, it was determined the facility failed to ensure adequate adherence to Infection Prevention measures in regard to COVID-19 for one of five units observed (1st Floor Chestnut Unit). Residents Affected - Some Findings include: Review of facility policy and procedure titled Coronavirus Disease (COVID-19) - Resident Exposure, Quarantine and Isolation revealed staff will use full PPE (N95 or approved equivalent respirator, gown, gloves and eye protection) before entering the room and to provide care for the resident(s) in isolation; PPE will be discarded prior to exiting the room, or between care of residents residing in same room, with the exception of reusable universal eyewear to be cleaned at least daily and after patient encounter; N95 respirator will be removed and universal source control (i.e. facemask) will be worn upon exit if indicated. Observation of the 1st Floor Chestnut Unit on September 22, 2024, at 9:30 a.m. revealed Licensed Employee E5 standing in the hallway outside a resident room. Licensed Employee E5 was wearing a cover gown, N95 and gloves and stated that he/she was testing residents on the unit due to a resident testing positive for COVID-19 the prior evening, September 21, 2024. Further observation of the 1st Floor Chestnut Unit failed to reveal evidence of any staff persons wearing masks or providing any universal precautions. Further observation of Licensed Employee E5 revealed the employee moving from room to room conducting COVID-19 tests without changing cover gown, N95 respirator, or gloves. Licensed Employee E5 was further observed to place a second pair of gloves over the first pair of gloves and not removing/changing the first pair of gloves between residents during testing. No handwashing or hand sanitization was observed to occur during the observation. Observation of the entrance of the facility failed to reveal evidence that notification of COVID-19 presence in the building to family members or visitors. Observation on September 23, 2024, at 8:30 a.m. of the entrance and reception area to the building failed to reveal notification of COVID-19 in the building and no monitoring of visitors was conducted. Observation on September 24, 2024, and September 25, 2024, of the entrance and reception area failed to reveal notification of COVID-19 or any screening procedures, recommendations, or observations in place. Interview with the Director of Nursing on September 25, 2024, at 10:30 a.m. confirmed Licensed Employee E5 should have changed all PPE prior to entering resident rooms; all staff should have been wearing face masks upon detection of a positive COVID-19 resident and additional screening completed at the entrance/reception area. 28 Pa. Code 211.12(c)(d)(1)(2)(3)(5) Nursing Services Previously cited 10/20/2023, 6/13/2024 FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395403 If continuation sheet Page 9 of 9