Inspection·November 30, 2023

F 0686 Provide appropriate pressure ulcer care and prevent new ulcers from developing. Level of Harm - Minimal harm or potential for actual harm Based on clinical record review, observations, and staff interview, it was determined that the facility failed to provide interventions to prevent pressure ulcers for one of 29 sampled residents. (Resident 57) Residents Affected - Few Findings include: Clinical record review revealed that Resident 57 had diagnoses that included aphasia, hemiplegia, and hemiparesis affecting the right dominant side following a cerebral infarction (difficulty communicating combined with muscle weakness and paralysis on the right side of the body after a stroke), dementia, unspecified,(a mild or mixed form of cognitive impairment), and diabetes mellitus (a disease that affects how the body uses blood sugar). Review of the Minimum Data Set assessment, dated November 6, 2023, revealed that Resident 57 had cognitive impairment, required extensive assistance from staff for bed mobility and dressing, and was at risk for developing pressure ulcers/injuries. On February 9, 2023, the physician ordered that Prevalon boots (a soft boot to elevate heels and reduce pressure) were to be placed on both feet while the resident was in bed for prevention of skin breakdown. Review of the care plan revealed that the resident was at risk for alteration in skin integrity due to right-sided weakness secondary to a stroke. There was an intervention for staff to elevate his heels and provide Prevalon boots when in bed . Observation on November 28, 2023, at 9:50 a.m., November 29, 2023, at 9:45 a.m. and 10:45 a.m., November 30, 2023, at 11:45 a.m. and at 1:35 p.m, revealed Resident 57 was in bed without Prevalon boots In an interview on November 30, 2023, at 12:25 p.m., the Director of Nursing confirmed that Resident 57 should have had the Prevalon boots applied to his feet while in bed. 28 Pa Code 211.12 (d)(1)(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 4 Event ID: 395521 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 395521 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/30/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Langhorne Gardens Health & Rehabilitation Center 350 Manor Avenue Langhorne, PA 19047 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)