Inspection·August 19, 2024

F 0676 Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record reviews and interviews with residents and staff, it was determined that the facility failed to ensure that residents received assistance with bathing for three of seven residents reviewed (Residents R1, R2 and R4). Residents Affected - Few Findings include: Interview on August 19, 2024, at 9:12 a.m. Resident R1 stated that she did not receive a shower for a week after her admission to the facility. Resident R1 stated that she prefers to have a shower and not a bed bath or bedside basin. Review of Resident R1's care plan, dated initiated August 5, 2024, revealed that the resident was admitted to the facility on [DATE], and had an activities of daily living deficit related to deconditioning. Continued review revealed that there was no indication of level of assistance needed or preferences related to bathing. Review of Resident R1's nurse aide [NAME] (instructions for nurse aide staff for performing resident care) revealed that the resident was scheduled to receive showers on Mondays and Thursdays during the evening shift. Review of nurse aide documentation related to bathing for Resident R1 revealed that on August 5, 2024, the nurse aide documented, No the resident did not receive a shower. On August 8, 2024, the nurse aide documented Not applicable for showering. Further review revealed that Resident R1 was not provided with a shower until August 12, 2024, which was one week after her admission to the facility. Further record review for Resident R1 revealed no indication as to why the resident did not receive a shower on August 5 and 8, 2024. Review of Resident R2's care plan, dated initiated December 13, 2023, revealed that the resident was admitted to the facility on [DATE], and had an activities of daily living deficit related to disease process. The care plan indicated that the resident required assistance from one staff person for bathing. Review of Resident R2's nurse aide [NAME] revealed that the resident was scheduled to receive showers on Tuesdays and Fridays during the evening shift. Review of nurse aide documentation related to bathing for Resident R2 revealed that on July 26 and August 16, 2024, the nurse aide documented, No the resident did not receive a shower. Further record review for Resident R2 revealed no indication as to why the resident did not receive a shower on July 26 and August 16, 2024. Interview on August 19, 2024, at 9:14 a.m. Resident R4 stated that she does not receive proper care (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: 395690 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 395690 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/19/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Springfield Rehabilitation and Healthcare Center 463 West Sproul Road Springfield, PA 19064 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)