Health inspection·February 4, 2026

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 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review and staff interview, it was determined that the facility failed to ensure that recommendations from a consultant physician were implemented for one of four sampled residents. (Resident 1) Findings include:Clinical record review revealed that Resident 1 had diagnoses that included diabetes, history of sepsis, resistance to multiple antimicrobial drugs, dementia and chronic kidney disease. The Minimum Data Set assessment dated [DATE], indicated that he had memory impairment. On January 19, 2026, a physician ordered for an endocrinologist to evaluate and treat the resident. On January 21, 2026, a nurse practitioner endocrinologist conducted an evaluation. Review of the endocrinologist's note revealed that Resident 1 had diagnoses that included diabetes with hyperglycemia and neuropathy and Stage IV chronic kidney disease. At that time, the endocrinologist made recommendations for laboratory (lab) tests to be completed, including blood work to test his blood sugar levels and thyroid function. In addition, the endocrinologist recommended a consultation by a nephrologist (kidney specialist). There was no evidence that the lab tests had been ordered and/or completed as recommended by the endocrinologist. In addition, there was no evidence that a consultation by a kidney specialist was ordered as recommended by the endocrinologist. In an interview on February 4, 2026, at 12:27 p.m., the Administrator stated that the recommendations from the endocrinologist had not been acted upon nor addressed by the resident's attending physician. CFR 483.25 Quality of CarePreviously cited 7/3/25.28 Pa. Code 211.12(d)(1)(3)(5) Nursing services. Residents Affected - Few 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: 395506 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 395506 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/04/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Kadima Rehabilitation & Nursing at Palmyra 341 North Railroad St Palmyra, PA 17078 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)