Health inspection·June 22, 2023

F 0686 Provide appropriate pressure ulcer care and prevent new ulcers from developing. Level of Harm - Minimal harm or potential for actual harm Based on facility policy review, clinical record review, and staff interview, it was determined that the facility failed to provide routine assessments of pressure ulcers for two of five residents reviewed (Residents 4 and 5). Residents Affected - Some Findings Include: Review of facility policy, titled NSG236 Skin Integrity and Wound Management with a revision date of February 1, 2023, revealed that the licensed nurse will Complete wound evaluation upon admission/readmission, new in-house acquired, weekly, and with unanticipated decline in wounds .Document daily monitoring of ulcer/wound site with or without dressing. Monitor: status of the dressing (e.g., intact and clean); status of the tissue surrounding the dressing (e.g., free of new redness or swelling); adequate control of wound associated pain; signs of decline in wound status. Review of Resident 4's clinical record revealed diagnoses that included cerebral infarction (stroke), hypertension (elevated blood pressure), and a stage 4 pressure ulcer (localized damage to the skin and/or underlying soft tissue usually over a bony prominence; stage 4 is full-thickness skin and tissue loss) to the coccyx. Review of Resident 4's clinical record on June 22, 2023, revealed that the last wound assessment of the stage 4 pressure ulcer was completed on May 26, 2023. On June 22, 2023, at 12:19 PM, the Director of Nursing (DON) stated that she was unable to locate any additional wound assessments for Resident 4 since May 26, 2023. An additional review of Resident 4's clinical record revealed that a pressure ulcer assessment was completed on June 22, 2023, at 12:28 PM. On June 22, 2023, at 12:33 PM, the DON stated that Resident 4's pressure ulcer is improving. Review of Resident 5's clinical record revealed diagnoses that included encephalopathy (a broad term for any brain disease that alters brain function or structure), hypertension, and an unstageable (obscured full-thickness skin and tissue loss) pressure ulcer to the sacrum. Review of Resident 5's clinical record on June 22, 2023, revealed that the last wound assessment of the unstageable pressure ulcer was completed on May 10, 2023. On June 22, 2023, at 12:19 PM, the DON stated she was unable to locate any additional wound assessments for Resident 5 since May 10, 2023. Page 1 of 2 395440 395440 06/22/2023 Camp Hill Skilled Nursing and Rehabilitation Ctr 1700 Market Street Camp Hill, PA 17011

F 0686 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some An additional review of Resident 5's clinical record revealed that a pressure ulcer assessment was completed on June 22, 2023, at 12:23 PM. On June 22, 2023, at 12:33 PM, the DON stated that Resident 5's pressure ulcer has resolved. During an interview with the Nursing Home Administrator and DON on June 22, 2023, at 1:36 PM, the DON stated that weekly wound assessments are done and pictures of the wounds are taken. She stated that the facility recently switched from using iPads to cell phones and, therefore, some of the assessments got deleted. In a follow-up interview with the DON on June 22, 2023, at 1:54 PM, she stated she was unable to locate any additional pressure ulcer assessments for Residents 4 and 5. 28 Pa. Code 211.12(d)(1)(3)(5) Nursing services 395440 Page 2 of 2