Inspection·January 24, 2024

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, a review of clinical records and select facility documentation, and resident and staff interviews, it was determined the facility to consistently provide maintenance services to assure a clean, safe, orderly, and comfortable interior, including comfortable room temperatures, on two of two resident units (first and second floor) affecting six out of 40 resident rooms in the facility (Rooms 101,104, 105, 107, 108, and 210) Findings included: During a tour of the facility conducted on January 24, 2024, random interviews were conducted with residents residing on both the second between 9 AM and 11 AM. Multiple residents reported that during the past weekend, Saturday January 20, 2024, and Sunday Janaury 21, 2024, the heat was not working in the facility and that it was very cold inside the building. A review of the weather forecast for the facility's locality on January 20, 204, revealed that the temperature was approximately 14 degrees Farenheit with a lower wind chill temperature. A review of the clinical record revealed that Resident 1 was cognitively intact with a BIMS (brief interview for mental status - a tool to assess cognitive function) score of 15. Interview with Resident 1, who resides in room [ROOM NUMBER] on the first floor of the facility, on January 24, 2024, revealed that the resident stated that temperature in the room varies. The resident stated that sometimes it is too hot and sometimes too cold and that facility staff told him, that staff members are not allowed to adjust the temperature in the resident's room. Observation of vacant resident room [ROOM NUMBER] on January 24, 2024, revealed that the resident who had resided in the room, had been discharged the prior day, January 23, 2024. A packaged terminal air conditioner system (PTAC self-contained heating and air conditioning unit) was present in the room with cool air flowing into the room through the window behind the unit. Clinical record review revealed that Resident 2 was cognitively intact with a BIMS score of 15. Interview conducted with Resident 2, who resides in room [ROOM NUMBER] on the first floor of the facility, on January 24, 2024, revealed that the resident stated that it was very cold in the resident's room last week. She stated she needed extra blankets. The resident was unable to recall the specific date this occurred, but did stated that it lasted for a while. A review of the clinical record revealed that Resident 3 was cognitively intact with a BIMS score of 15. Interview conducted with Resident 3, who resides in room [ROOM NUMBER] on the first floor of (continued on next page) 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 8 Event ID: 395466 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 395466 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/24/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Milford Rehabilitation and Healthcare Center 264 Route 6 & 209 Milford, PA 18337 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)