Inspection·April 4, 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 observation and staff interview, it was determined that the facility failed to ensure that meals were served in a manner that promoted and maintained each resident's dignity for two of 36 sampled residents. (Resident 82 and 175) Findings include: Observations of the lunch meal on the Station 5 unit on April 3, 2024, at 12:19 a.m., revealed Residents 82, 106, 117, 198, 490, and 497 were seated at a table together in the dining room. All the residents at the table were served and eating meals except Resident 82. Resident 82 was observed without a meal, looking around the room and reaching for the trays of other residents. Residents at other tables were being served their meals. Resident 82 was not served her lunch tray until 12:29 p.m. Observations of the lunch meal on the Station 5 unit on April 2, 2024, at 12:50 p.m., revealed Residents 82, 106, 117, 175, 198, 490, and 497 were seated at a table together in the dining room. All the residents at the table were served and were eating their meals except Resident 175. Resident 175 was observed throwing her hands in the air, making the sign of praying hands to a person walking by, and reaching towards other resident's trays. At 1:20 p.m., staff members escorted Resident 175 to the resident's room and served the lunch tray. In an interview on April 4, 2024, at 11:58 a.m., ADON 1 (Assistant Director of Nursing) confirmed that meals in the dining room should be served one table at a time. 28 Pa. Code 201.29(a) Resident rights. 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 3 Event ID: 395465 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 395465 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Cedarbrook Senior Care and Rehabilitation 350 S. Cedarbrook Road Allentown, PA 18104 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)