Health inspection·April 3, 2024

F 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Based on clinical record review and staff interview, it was determined that the facility failed to notify the responsible party of a resident's change in condition requiring interventions for one of five residents reviewed (Resident CR1). Findings include: Closed clinical record review for Resident CR1 revealed a progress note dated November 28, 2023, at 8:47 AM that indicated she was coughing with her meal, pocketing food, and a speech therapy consult was initiated. Review of the speech therapy screen completed on November 28, 2023, and signed by the speech therapist on November 29, 2023, at 11:30 AM, revealed that Resident CR1 was pocketing food, but she was not medically appropriate for skilled treatment due to increased lethargy (unusual decrease in consciousness/alertness). The speech therapist indicated to downgrade Resident CR1's diet to puree (smooth with no lumps) texture with nectar thick (easily to pour and are comparable to heavy syrup found in canned fruit) liquids. Further clinical record review revealed a nursing progress note dated November 29, 2024, at 5:26 AM that indicated the nurse could not safely administer Resident CR1's medications due to lethargy and her being slow to arouse. The note also indicated that Resident CR1 was pale and that her temperature was 101.7 degrees Fahrenheit, so she administered Tylenol (a fever-reducing medication). A physician's order dated December 1, 2023, at 9:54 AM revealed that the physician ordered for Resident CR1 to have the following labs STAT (immediately): Complete Blood Count (CBC, a measure of the number of red blood cells, white blood cells, and platelets in the blood in order to look at overall health), Basic Metabolic Panel (BMP, a test that measures important information regarding the body's chemical balance), and a Urinalysis with Culture and Sensitivity (UA C&S, a lab test to check for bacteria or other germs in the urine). A nursing progress note dated December 1, 2023, at 10:00 AM indicated that Resident CR1's daughter was called and updated on her increased lethargy, tremors, difficulty taking medications, having a fever, and new orders. The facility did not update Resident CR1's daughter about her change of condition that began on November 28, 2024, that required new interventions, until December 1, 2023. The surveyor confirmed the above findings during an interview with the Director of Nursing and Page 1 of 2 395589 395589 04/03/2024 Mount Carmel Senior Living Community 2616 Locust Gap Highway MT Carmel, PA 17851

F 0580 Nursing Home Administrator on April 3, 2024, at 11:15 AM. Level of Harm - Minimal harm or potential for actual harm 28 Pa. Code 211.12(d)(1)(3)(5) Nursing services Residents Affected - Few 395589 Page 2 of 2