Health inspection·December 4, 2025

F 0655 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted Based on review of facility policy and clinical records, and staff interview, it was determined that the facility failed to initiate a baseline care plan and provide a written summary of the baseline care plan and order summary to the resident and/or representative for five of five residents reviewed (Residents R2, R6, R9, R10, and R13). Findings include: Review of facility policy entitled Care Plans - Baseline dated 11/4/25, revealed that A baseline plan of care to meet the resident's immediate health and safety needs is developed for each resident within forty-eight hours of admission. The policy further stated The baseline care plan includes instructions needed to provide effective, person-centered care of the resident that meet professional standards of quality of care and must include the minimum healthcare information necessary to properly care for the resident including, but not limited to the following: Initial goals based on admission orders and discussion with the resident/representative, physician orders, dietary orders, therapy services, social services, and PASARR recommendations if applicable. The policy further stated that The resident and/or representative are provided a written summary of the baseline care plan, and provision of the summary to the resident and/or representative is documented in the medical record. Resident R2's clinical record revealed an admission date of 8/2/25, with diagnoses the included Chronic Obstructive Pulmonary Disease (COPD - a condition that prevents airflow to the lungs resulting in difficulty breathing), Stroke (occurs when blood flow to the brain is blocked or a blood vessel inside or on the surface of the brain bursts causing brain cells to die often times leading to permanent disabilities), and Diabetes (a health condition caused by the body's inability to produce enough insulin). Resident R2's clinical record lacked evidence that a baseline care plan was initiated and/or a summary of the baseline care plan and order summary were provided to the resident and/or his/her representative. Resident R6's clinical record revealed an admission date of 4/25/25, with diagnoses that included Diabetes, Benign Prostatic Hyperplasia (BPH - a noncancerous enlargement of the prostate gland, which can result in frequent urination, difficulty starting or stopping urination and a weak urine stream), and Atrial Fibrillation (A-Fib - irregular and often rapid heartbeat that can lead to stroke, heart failure, and other complications). Resident R6's clinical record lacked evidence that a baseline care plan was initiated and/or a summary of the baseline care plan and order summary were provided to the resident and/or his/her representative. Resident R9's clinical record revealed an admission date of 11/6/25, with diagnoses that included Atrial Fibrillation, Dementia (loss of cognitive functioning affecting a person's memory and behaviors), and Diabetes. Resident R9's clinical record lacked evidence that a baseline care plan was initiated and/or a summary of the baseline care plan and order summary were provided to the resident and/or his/her representative. Resident R10's clinical record revealed an admission date of 11/14/25, with diagnoses that included Diabetes, Atrial Fibrillation, and Anxiety (a condition that causes a person to be nervous, uneasy, or worried about something or someone). Resident R10's clinical record lacked evidence that a baseline care plan was initiated and/or a (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 3 Event ID: 395550 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 395550 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Dr Arthur Clifton McKinley Ctr 133 Laurelbrooke Drive Brookville, PA 15825 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)