Health inspection·December 3, 2025

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 staff interviews, review of facility policy and clinical record review, it was determined that the facility failed clinically assess and notify the resident's physician after a change in condition for 1 out of 16 residents reviewed (Residents R12). Findings include: Review of Resident R12's September 2025 physician orders included the following diagnoses obesity, hypertension (high blood pressure); chronic pain; depression (a mood disorder that causes a persistent feeling of sadness and loss of interest); anxiety (intense, excessive and persistent worry and fear about everyday situations); muscle weakness, and osteoarthritis (the most common form of arthritis, characterized by joint pain and stiffness). Review of the facility policy, Changes in a Resident's Condition or Status revised February 2021 indicated that the facility promptly notifies the resident, his or her attending physician, and the resident's representative of changes in the resident's medical/mental condition and his/her status. Continued review of the policy indicated that prior to notifying the physician or healthcare provider, the nurse will make detailed observations and gather relevant information and pertinent information for the provider, including (for example) information prompted by the Interact SBAR Communication Form (Situation-Background-Assessment-Recommendation) a tool used by nursing staff that includes, but not limited to, an assessment of the resident's current change in condition, including clinical findings.Review of a nursing note documented by Employee E3 (licensed nurse) dated September 20, 2025 at 5:29 p.m. revealed Resident returned to the unit from her apartment around 1710 (5:10 p.m.). Resident has a slurred speech and has difficulty making sentences. Eyes closing while talking to staff. Cheeks flushed. Resident unable to fully pull herself up when using Hoyer lift for sit to stand. Says she is sleepy and would like to take a nap. Resident was placed in her bed around 1725 (5:10 p.m.)Review of the resident's nursing notes did not show evidence that any other follow-up was initiated by licensed nursing staff (e.g. vital signs) regarding the above referenced changes in the resident's medical condition that the resident was observed as exhibiting. Continued review of the nursing notes did not show evidence that the physician was notified regarding the resident's change in medical condition on September 20, 2025 to see if there were any interventions/instructions/treatment and/or further assessments that the physician may have wanted nursing staff to implement for the resident. During an interview with Employee E3 on September 25, 2025 at 12:02 p.m. Employee E3, the note from September 20, 2025 that Employee E3 wrote was reviewed with her. During the interview, Employee E3 confirmed that that she observed the resident having slurred speech, having difficulty making sentences, and explained that the resident was closing her eyes while the resident was speaking to nursing staff upon the resident's return from her leave of absence outside of the facility. During the above referenced interview Employee E3 also confirmed that she did not conduct any clinical assessments of the resident after she observed the resident exhibiting the above referenced changes in her condition. Continued interview with Employee E3 on September 26, 2025 at 10:30 a.m. confirmed that she also did not notify the physician of the resident's change in medical Residents Affected - Few (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 3 Event ID: 395473 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 395473 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/03/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Pennswood Village Route 413 Newtown, PA 18940 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)