Health inspection·October 18, 2024

F 0610 Respond appropriately to all alleged violations. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of facility provided documentation and interview with staff, it was determined facility did not have evidence that alleged violations were thoroughly investigated for one of 23 residents reviewed related to fracture of left lower extremity. (Resident R27) Residents Affected - Few Findings include: Review of facility provided investigation report, completed July 3, 2024 at 10:01 a.m., revealed that Resident R27 a [AGE] year old female with a brief interview for mental status (BIMS) score 2, and medical history of dementia, Alzheimer's disease, unsteadiness on feet, unspecified lack of coordination, fatigue, muscle wasting and atrophy was found with warm to touch and swelling to her left lower leg during the morning ofJuly 1st, 2024. ResidentR27 was unaware what happened nor that there was any bruising or swelling. Review of progress notes completed by facility's provider,Employee E8, dated July 2, 2024, revealed the following: Chief complaints: 1. Patients rehab facility/residence has noticed bruising on patient left lower leg earlier today. No known mechanism of injury. Further review of Employee E8's progress notes indicates Assessment: 1. Closed displaced oblique fracture of shaft of left tibia, initial encounter .- displaced mid-distal tibia shaft fracture left lower leg (date of possible injury 6/30/2024) Further review of Employee E8's progress notes states Plan: Treatment: [Resident R27] has a displaced mid distal tibia shaft fracture. No known mechanism of injury is brought to our attention and the specific date event of injury is unknown however her accompaniment (nurse aide, employee E9) states that either Saturday or Sunday (June 29t, 2024, or June 30, 2024) may have been the time frame, but the discoloration was noted yesterday by one of the staff members as it was told to her. Further review of progress notes dated July 1, 2024, at 10:56 a.m., completed by Unit manager, Employee E10, revealed that Resident R27 has a platelet disorder which may have contributed to bruising. Interview with facility's nurse aides, on Friday, October 18, 2024, at 12:00 p.m., Employee E9 (worked day shift on June 29, 2024) and Employee E12 (worked day shift on June 29, 2024, and June 30, 2024) revealed no concerns nor incidents noted related to cause of possible fracture of Resident R27's left lower extremity. Both nurse aides, Employees E9 and E12 stated resident was transferred from bed to wheelchair via hoyer lift; and Resdient R27 was out of bed on Saturday, June 29, 2024. (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 6 Event ID: 395483 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 395483 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/18/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Markley Rehabilitation and Healthcare Center 550 East Fornance Street Norristown, PA 19401 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)