Health inspection·August 27, 2024

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review, observation, policy review, and staff interview, it was determined that the facility failed to provide assistance with dining in a manner that promoted and maintained dignity for one resident on one of five nursing units. (Station 2, Resident 87) In addition, the facility failed to ensure that a call bell was answered in a timely manner for one of 35 sampled residents. (Resident 112) Findings include: Clinical record review revealed that Resident 87 had diagnoses that included Alzheimer's disease, dysphagia (difficulty in swallowing), and protein-calorie malnutrition. Review of the Minimum Data Set (MDS) assessment, dated August 14, 2024, revealed that the resident had cognitive impairment and needed staff assistance with eating. Review of Resident 87's care plan revealed that staff was to provide total assistance with feeding, feed the resident slowly, and provide verbal cueing with meals. On August 25, 2024, from 12:16 p.m. through 12:35 p.m., nurse aide (NA) 1 was observed standing while assisting Resident 87 with lunch. On August 26, 2024, from 12:03 p.m. through 12:20 p.m., NA 1 was observed standing while assisting Resident 87 with lunch. Review of facility policy entitled, Call Lights, last reviewed April 3, 2024, revealed that staff were to respond to call lights and communication devices promptly. Clinical record review revealed that Resident 112 had diagnoses that included peripheral vascular disease (a disorder of the blood vessels that manage blood flow to parts of the body outside of the heart, most commonly affecting legs and feet), a muscle disorder, and a history of falling. Review of the MDS assessment dated [DATE], revealed the resident had physical limitations and required staff assistance for repositioning. Review of the nursing note dated August 19, 2024, revealed that Resident 112 was alert and was able to make herself understood. Review of the current care plan revealed the resident had physical limitations and that staff were to assist with repositioning frequently. Observation on August 26, 2024, from 12:50 p.m. through 1:10 p.m., revealed that the resident had her call bell activated. Staff were available at the nurses' station and in the hallways where the call bell could be clearly heard. Staff was observed looking at the activated call bell and walking by the resident's room, but no one answered the call bell and offered any assistance to Resident 112. In an interview on August 26, 2024, at 1:50 p.m., the Nursing Home Administrator and Director of Nursing stated that call lights were expected to be answered promptly. 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 9 Event ID: 395541 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 395541 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/27/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Sinking Spring Skilled Nursing and Rehabilitation 3000 Windmill Road Sinking Spring, PA 19608 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)