Inspection·January 17, 2024

F 0558 Reasonably accommodate the needs and preferences of each resident. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, it was determined that the facility failed to ensure the call bell alerts were answered in a timely manner on one of two floors. (First Floor) Residents Affected - Few Findings include: Observation conducted on January 17, 2024, at approximately 12:15 p.m., of the call bell alert unit at the first-floor nursing station, responsible for monitoring room [ROOM NUMBER], revealed that the room's call bell was on for 17 minutes. Continued observation on January 17, 2023, from 12:15 p.m. through 1:00 p.m. revealed the call bell alert system continued to be activated for room [ROOM NUMBER]. Interview conducted on January 17, 2024, at approximately 1 p.m., with Resident R2, revealed that he/she pushed the call bell for staff assistance. R2 confirmed the call bell remained activated at time of the interview. R2 could not confirm the exact time call bell was initiated but stated it had been a while. R2 stated his/her bed was broken and was the reason he/she pushed the call bell for assistance. R2 stated that he/she informed staff the previous day and earlier that morning the bed was broken. Additional observation conducted on January 17, 2024, at 2:31 p.m., revealed the call bell alert system was activated by lights inside the room and outside of the door and appeared to be operating properly. Further observation of staff responded to a call bell alert within three minutes of activation, indicating the system was working properly at the nurse's station as well. Additional observation conducted on January 17, 2024 revealed maintenance personnel taking a new bed towards R2's room. Interview conducted on January 17, 2024, at approximately 3:35 p.m., the Nursing Home Administrator (NHA) and Director of Nursing (DON) revealed that they interviewed R2 and roommate R3 concerning the call bell alert system in their room. NHA and DON stated both residents denied activating the call alert system at anytime during the day. NHA and DON provided a signed statement from both R2 and R3 documenting neither activated the system. NHA and DON stated that nursing staff did go into the resident's room to provide medications during the time of observation. Further interview with Administrator and Director of Nursing revealed in response to enquiry of (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 3 Event ID: 395740 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 395740 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/17/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE West Chester Rehabilitation and Healthcare Center 800 West Miner Street West Chester, PA 19382 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)