Health inspection·September 5, 2023

F 0561 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. Based on review of facility and clinical records, resident and staff interviews, and observations, it was determined that the facility failed to provide a bath/shower in accordance with resident preferences for two of two residents reviewed (Residents R1, R2). Findings include: Review of the Bath (Shower) policy, dated 8/2018, revealed The purpose of Bath (Shower) is to cleanse and refresh the resident. Frequency of Baths/Showers are based on resident preference. During an interview with Resident R1 on 8/30/23, at 1:05 p.m. it was indicated that a bed bath was preferred over a shower. Resident R1 further indicated his/her hair gets wet during a shower and a bath was not offered by staff anymore. He/she indicated he/she has only had a few bed baths in the past months, and it was a struggle to get the ones he/she did get. Resident R1 was observed with curled set hair. A review of clinical documentation revealed Resident R1 received a bed bath on 8/09/23, 8/30/23, and 9/02/23. No further bath/shower documentation was noted within the thirty-day period between 8/06/23 and 9/05/23. During an interview with Resident R2 on 8/30/23, at 12:00 p.m. it was indicated that he/she never gets a shower/bath. Resident R2 verbalized he/she would like to receive a shower/bath each week. Resident R2 was observed with greasy hair during the interview. A review of clinical documentation revealed that Resident R2 received a bed bath on 8/09/23, 8/13/23, 8/16/23, 8/20/23, and 9/2/23; Refusals were noted on 8/08/23, 8/15/23, and 8/29/23. No further documentation of baths/shower provided was noted within the thirty-day period between 8/06/23 and 9/05/23. An interview with the Nursing Home Administrator and Director of Nursing on 9/05/23, at 3:55 p.m. confirmed there was no evidence to indicate that Resident R1 and Resident R2 received a bath/shower per resident preferences for the 30 days reviewed. 28 Pa. Code 201.14(a) Responsibility of licensee 28 Pa. Code 211.12 (d)(1)(3)(5) Nursing services 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: 395728 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 395728 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/05/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lecom at Snyder Memorial 156 Snyder Memorial Rd Marienville, PA 16239 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)