Health inspection·January 3, 2024

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 and staff interview, it was determined that the facility failed to failed to ensure that physician's orders were implemented for two of eight sampled residents. (Residents CL2, 7) Residents Affected - Few Findings include: Clinical record review revealed that Resident CL2 had diagnoses that included venous insufficiency and diabetes. Review of Resident CL2's care plan revealed that he was at risk for alteration in skin integrity related to pressure. On December 14, 2023, the wound certified registered nurse practitioner documented that Resident CL2 had a deep tissue pressure injury to his left heel and ordered for staff to apply Betadine (antiseptic used to treat wounds) daily. There was no documented evidence that this treatment was implemented. In an interview on January 3, 2024, at 12:31 p.m., the Director of Nursing confirmed that the Betadine treatment was not provided to Resident CL2. Clinical record review revealed that Resident 7 had diagnoses that included sleep apnea and depression. Review of Resident 7's care plan revealed he was at risk for altered respiratory status/difficulty breathing related to sleep apnea with an intervention for staff to administer continuous positive airway pressure (CPAP) per physician's order. On March 28, 2023, the physician ordered for staff to apply a CPAP machine at bedtime. Review of Resident 7's treatment administration records revealed a lack of documentation to support that the CPAP was applied on November 6, 20, 24, 27, 28, and 30, 2023, December 5, 12, 13, 14, 18, 25, and 30, 2023, and January 1 and 2, 2024. In an interview on January 3, 2024, at 12:32 p.m., the Director of Nursing confirmed that there was no documentation to support that Resident 7's CPAP was applied on the above dates. 28 Pa. Code 211.12(d)(1)(3)(5) Nursing services. 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 2 Event ID: 395477 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 395477 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/03/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Laureldale Skilled Nursing and Rehabilitation Cent 2125 Elizabeth Avenue Laureldale, PA 19605 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)