Health inspection·February 22, 2024

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 clinical record review, review of select facility policies and procedures, and responsible party and staff interview, it was determined that the facility failed to provide the highest practicable care regarding the use of outside resources for one of nine residents reviewed (Resident 1). Residents Affected - Few Findings include: Review of the facility's current policy entitled Consults, indicates that the responsible party should be involved whenever possible. If the responsible party wishes to take the resident to appointments and is deemed safe that is an option. If the resident is competent and able to answer questions in the appointment, the resident may not need an attendant to go into the actual appointment. If they wish an attendant to go into the actual appointment, one will be arranged to go with the resident. Review of Resident 1's clinical record revealed that the facility initially admitted her in 2017. Resident 1 has a diagnosis of dementia, depression, cognitive communication deficit, mood disturbance, psychotic disturbance, and anxiety. The facility assessed Resident 1 as being not capable of making her own decisions and of being at high risk for falls. A nursing note dated February 14, 2023, at 7:19 PM indicated that Resident 1 returned from her orthopedic appointment that was located an hour and 45 minutes from the facility one way. Resident 1 had a fall with a fracture that happened on October 24, 2023, and the appointment was considered a follow up. There was no documented evidence in Resident 1's clinical record to indicate that the facility notified Resident 1's responsible party of the appointment so that the responsible party could be involved and attend the appointment. A phone interview with Resident 1's responsible party on February 22, 2024, at 10:50 AM confirmed that the facility did not notify her of the appointment on February 14, 2024. Resident 1's responsible party indicated that she attends all Resident 1's appointments if she is aware of them. A phone interview with a representative from the facility's transport company on February 23, 2024, at 11:00 AM revealed that the company does not send attendants with residents to be present with them during their appointments. Documentation provided by the Administrator on February 23, 2024, at 11:12 AM revealed that the transport company picked up Resident 1 at 1:15 PM on February 14, 2024. Page 1 of 2 395779 395779 02/22/2024 Centre Care Rehabilitation and Wellness Services 250 Persia Road Bellefonte, PA 16823

F 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Interview with the Administrator on February 23, 2024, at 11:30 AM revealed that the facility does not have an agreement or contract with the transport company that took Resident 1 to her appointment. The Administrator indicated that the facility just calls the company and then receives a bill. Resident 1, who was totally dependent on staff for care, was out of the facility for 6 hours without any assistance from facility staff. Interview with the Administrator and Director Nursing on February 23, 2024, at 1:20 PM acknowledged the above findings for Resident 1. 28 Pa. Code 211.10 (a)(c)(d) Resident care policies 28 Pa. Code 211.12(d)(1)(3)(5) Nursing services 395779 Page 2 of 2