Inspection·June 21, 2024

F 0563 Honor the resident's right to receive visitors of his or her choosing, at the time of his or her choosing. Level of Harm - Minimal harm or potential for actual harm Based on observation, review of clinical records and staff interviews, it was determined that the facility failed to ensure that one of 12 residents reviewed was able to received visitors. (Resident R1) Residents Affected - Few Findings include: CMS issued guidance to the previously released QSO-NH-20-39 originally issued on 9/17/20 and revised on 11/12/21 regarding visitation in nursing homes. This revised guidance stated that, Visitation is now allowed for all residents at all times This will be implemented immediately by nursing home facilities. Review or Resident R1's Quarterly Minimum Data Set (MDS-federal mandated process for clinical assessment for all residents) dated May 2, 2024, revealed that Resident R1 entered the facility February 18, 2024, with diagnoses of anemia (blood disorder occurring when the blood lacks adequate healthy red blood cells), hypertension (also known as high blood pressure is a condition in which the blood pressure in artery is persistently elevated), diabetes mellitus (a metabolic disease involving inappropriately elevated blood glucose levels), hyperlipidemia (a chronic metabolic disorder characterized by elevated levels of lipids in the blood), hemiplegia (paralysis that effects one side of the body that results from disease or injury of the brain), anxiety (a mental condition characterized by excessive apprehensiveness about real or perceived thoughts), depression (a mood disorder that causes a persistent feeling of sadness and loss of interest),and asthma (a chronic lung disease that causes the airways to become inflamed and narrow making breathing difficult). Resident R1's Brief Interview for Mental Status (BIMS) measuring cognitive abilities received a BIMS score of 9 suggesting moderately impaired cognition. . Review of Resident R1's nursing note dated June 6, 2024, revealed IDT (Interdisciplinary team) attempted to conduct care conference with [resident's friend and emergency contact], regarding the resident's emergency contact aggressive behaviors with staff. During meeting [the resident's emergency contact] was aggressive using profanity and unable to redirect. IDT was unable to continue the meeting, will reschedule. Further review of Resident R1's social service documentation dated June 4, 2024, stated IDT team met with [resident's friend and emergency contact], educated to coordinate with business office and facility management in financial matters. (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 2 Event ID: 395687 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 395687 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/21/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE York Nursing and Rehabilitation Center 7101 Old York Road Philadelphia, PA 19126 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)