Health inspection·August 14, 2025

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, it was determined that the facility failed to provide a safe, clean, and comfortable environment on four of four nursing units. (1A, 1B, 2A, 2B)Findings include:Observations on August 12, 2025, from 9:00 a.m. through 12:17 p.m. revealed the following:Debris and a dark/black substance splattered throughout the hall floors of Units 1A, 1B, 2A, and 2B and rooms 101, 109, 110, and 115.The floor in 217 had red and brown spots between the beds.There were brown spots on the ceiling in the hallway at room [ROOM NUMBER].There were red spots on the wall by the door in room [ROOM NUMBER]. The radiator in the resident lounge was broken with sharp, loose parts lying on the floor. The wall by the left entrance door in the main dining room was damaged. The wall behind both beds in room [ROOM NUMBER] was damaged. The ceiling and wall behind the toilet in room [ROOM NUMBER] were damaged. The mirrors were damaged in the bathrooms in rooms 217, 224, 308, 309, and 310.There were flying winged insects noted around the nurse's station of section 1A and in room [ROOM NUMBER]. Observations on August 13, 2025, at 9:15 a.m. through 11:31 a.m., revealed the following:A strip of peeling wood sticking out of the bottom of the closet door for room [ROOM NUMBER] bed two. Debris and a dark/black substance splattered throughout the hall floors of Unit 1A and rooms 101, 109, 110, and 115.Flying winged insects were noted throughout the hallway in section 1A and in room [ROOM NUMBER].The wall was damaged by the resident's bed in room [ROOM NUMBER]. Observations in the shower room across from nurse's station intersecting halls 100-300 on August 13, 2025 at 11:30 a.m., revealed:The shower room had a musty smell.A grey and brown residue on the floor tiles in all three shower stalls. A yellow substance on the shower chair in the first stall. The non-skid strips in the first and third shower stalls were worn. A residue on all three shower curtains. All three shower curtains were missing hooks. A black substance on the non-skid mat in the third shower stall. A brown and red substance on the floor in front of the scale.28 Pa. Code 201.14(a) Responsibility of licensee. 28 Pa. Code 201.18(b)(1) Management. Page 1 of 4 395627 395627 08/14/2025 Fairlane Gardens Nursing and Rehab at Reading 21 Fairlane Road Reading, PA 19606

F 0641 Ensure each resident receives an accurate assessment. 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 the Minimum Data Set (MDS) assessment was completed to accurately reflect the resident's status for two of 24 sampled residents. (Residents 27, 78) Findings include: Clinical record review revealed that Section N (Medications) of Resident 27's MDS assessment dated [DATE], indicated that the resident was not on an antipsychotic medication during the seven-day review period. Review of the resident's Medication Administration Record from June 2025 revealed that the resident did receive an antipsychotic (lurasidone) during the seven-day review period. Clinical record review revealed that section O (Special treatments, procedures, and programs) of the MDS assessment dated [DATE], indicated that Resident 78 did not receive tracheostomy care during the seven-day review period. Review of Resident 21's Treatment Administration record from July 2025 revealed that the resident did receive tracheostomy care during the seven-day review period. In an interview on August 13, 2024, at 2:26 p.m., Registered Nurse Assessment Coordinator 1 confirmed the MDS assessments had not accurately reflected the residents' status and had to be modified by the facility. CFR 483.20(g) Accuracy of AssessmentsPreviously cited 7/12/24 Residents Affected - Few 395627 Page 2 of 4 395627 08/14/2025 Fairlane Gardens Nursing and Rehab at Reading 21 Fairlane Road Reading, PA 19606

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 Based on review of facility policy, clinical record review, and staff interview, it was determined that the facility failed to administer medications in accordance with physician orders for four of 24 sampled residents. (Residents 2, 6, 19, 34)Findings include: Review of the policy entitled, Medication Administration, last reviewed July 14, 2025, revealed staff were to obtain vital signs if necessary, and document physician indicated medication administration information.Clinical record review revealed that Resident 2 had diagnosis of hypertension (high blood pressure). On April 3, 2025, the physician ordered staff to administer a blood pressure medication (lisinopril) one time a day. The medication was to be held if the resident's systolic blood pressure (SBP, the first measurement of blood pressure when the heart beats and the pressure is at its highest) was less than 110 millimeters of mercury (mm/Hg) or if the resident's heart rate (the number of times a heart beats in one minute) was less than 60 bpm (beats per minute). Review of Resident 2's Medication Administration Records (MAR) for May, June, July, and August 2025, revealed that staff administered the medication three times in May, five times in June, and three times in July when the resident's SBP was below 110 mm/Hg. Review of Resident 2's MARs for May and June 2025, revealed no evidence that staff obtained the resident's heart rate prior to administration of the medication on 23 occasions in May 2025, and 16 occasions in June 2025.Clinical record review revealed that Resident 6 had diagnoses that included atrial fibrillation (irregular heartbeat) and hypertension (high blood pressure). On June 5, 2025, the physician ordered staff to administer a blood pressure medication (midodrine) two times a day for orthostatic blood pressure (a drop in blood pressure when changing positions) and to monitor for supine (laying) and sitting blood pressures. Review of Resident 6's care plan revealed an intervention to monitor blood pressure as ordered. Physician's notes dated June 6 and June 21, 2025, July 9, 21, and 26, 2025, and August 6, 2025, revealed staff were to continue to monitor the resident's blood pressure. There was no documented evidence that staff monitored Resident 6's blood pressure as ordered by the physician.Clinical record review revealed that Resident 19 had diagnoses that included congestive heart failure and type 2 diabetes. A physician's order dated May 3, 2025, directed staff to weigh the resident daily. Review of Resident 19's MAR for May, June, July, and August 2025, revealed no evidence that the resident's weights were obtained per physician's orders on six occasions in May, three occasions in June, four occasions in July, and three occasions in August 2025.Clinical record review revealed that Resident 34 had diagnoses that included hypertension and chronic kidney disease. On July 30, 2022, the physician ordered staff to administer a blood pressure medicine (metoprolol succinate) one time a day. Staff were not to administer the medication if Resident 34's heart rate was less than 60 bpm. Review of Resident 34's MAR for June, July, and August 2025, revealed no evidence that staff obtained the resident's heart rate prior to administration of the medication on 72 occasions.In an interview on August 14, 2025, at 10:10 a.m., the Director of Nursing confirmed that Resident 19's weights were not completed daily per the physician's orders and medications were administered outside of the established parameters for Residents 2, 6, and 34.28 Pa. Code 211.12(d)(1)(5) Nursing services. Residents Affected - Some 395627 Page 3 of 4 395627 08/14/2025 Fairlane Gardens Nursing and Rehab at Reading 21 Fairlane Road Reading, PA 19606

F 0688 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review and interview, it was determined that the facility failed to provide treatment and services to prevent a reduction in range of motion and/or to improve or maintain mobility on a consistent basis for two of 24 sampled residents. (Residents 27, 78) Findings include: Clinical record review revealed that Resident 27 had diagnoses that included muscle weakness and difficulty in walking. The Minimum Data Set (MDS) assessment dated [DATE], indicated that the resident was cognitively impaired and required limited assistance from staff for activities of daily living. On April 17, 2025, the physical therapist had recommended a Restorative Nursing Program (RNP) for ambulation. A physician's order dated April 17, 2025, directed staff to provide the RNP for 15 minutes twice a day, seven days a week. There was a lack of documentation to support that between July 16, 2025, through August 13, 2025, the resident was offered restorative ambulation twice a day, as ordered, on 30 of 30 days. Clinical record review revealed that Resident 78 had diagnoses that included anoxic brain damage (lack of oxygen to the brain), persistent vegetative state, and right and left-hand contractures. The MDS assessment dated [DATE], indicated that the resident was cognitively impaired and dependent on staff for all activities of daily living. A physician's order dated June 7, 2024, directed staff to provide a RNP for passive range of motion to the upper extremities, fingers and shoulders,15 minutes twice a day, seven days a week. On May 7, 2025, the occupation therapist recommended a range of motion program be continued for the bilateral should and fingers. There was a lack of documentation to support that between July 15, 2025, and August 12, 2025, the resident was offered the RNP twice a day, as ordered, on 18 of 30 days. In an interview on August 14, 2025, at 10:05 a.m. the Director of Nursing confirmed that there was no documented evidence that the RNPs were offered on the previously mentioned dates, twice a day, as ordered, to Residents 27 and 78 consistently. In an interview on August 14, 2025, at 11:15 a.m., the Director of Rehabilitation stated Resident 27 needed the RNP for mobility and Resident 78 needed the RNP for hand contractures. CFR 483.25(c)(1)-(3) Increase/Prevent Decrease in ROM/MobilityPreviously cited 7/12/24 28 Pa. Code 211.12(d)(1)(5) Nursing services. 395627 Page 4 of 4