Inspection·January 11, 2024

F 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Based on observations and interviews during a facility power outage, it was determined that the facility failed to ensure residents environment remained as free of accident hazards as is possible in two out of three nursing units (East and South Wings). Findings: Observations on January 10, 2024, at 9:30 a.m. revealed that the facility experienced a power outage during the night. Orange power cords (long extension cords) were in the lying, in the east and south wings of the nursing units, across the hallways into resident rooms. An interview with the Director of Nursing on January 10, 2024, revealed that the building is old and the outlets in the resident rooms were not active due to the power outage. Outlets that are in the hallways are active and for residents that are oxygen and have air mattresses need power. The extension cords provide these items power and function. Further observations at 12:00 p.m. revealed extension cords gathered in the middle of the hall in the east and south hall and staff walking over them and occasionally catching their feet in these cords. An interview with the Nursing Home Administrator on January 11, 2024, at 12:30 p.m., revealed the resident beds are powered by electricity to adjust the bed height and the head and foot of the bed. They could not secure the cords to the floor, with the tape, for this reason. The faciltiy failed to ensure the safety of residents and staff during a power outage by placing electrical cords across the hallways of the east and south halls. 28 Pa. Code 201.18(b)(1)(3) Management 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: 395498 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 395498 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/11/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wesley Enhanced Living Main Line Rehab and Skd Nsg 100 Halcyon Drive Media, PA 19063 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)