Health inspection·July 30, 2024

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review and resident interview, it was determined that the facility failed to provide services to enhance each resident's quality of life by offering showers as scheduled to two of seven sampled residents. (Residents 1, 7) Findings include: Clinical record review revealed that Resident 1 had diagnoses that included chronic respiratory failure, seizures, and diabetes. The Minimum Data Set assessment (MDS), dated [DATE], indicated that the resident had cognitive impairment and required staff assistance for bathing. According to the task flowsheet, the resident was to receive a shower twice per week, on Monday and Thursday. There was no documented evidence that Resident 1 was showered on July 8 or 18, 2024. Clinical record review revealed that Resident 7 had diagnoses that included heart failure. The MDS assessment, dated May 10, 2024, indicated that the resident had no cognitive impairment and required staff assistance for bathing. The resident was to receive a shower twice per week, on Wednesday and Saturday. During an interview on July 30, 2024, at 11:15 a.m., the resident reported that she preferred to take a shower twice a week and was not offered the opportunity to do so. Resident 7 stated that she would not refuse the opportunity to shower. Review of the clinical record revealed a lack of documentation to support that the resident was offered a shower three of six scheduled times in the past 30 days. In an interview on July 30, 2024, at 4:20 p.m., the Administrator confirmed there was no documented evidence that showers were given as scheduled. 28 Pa. Code 211.12(d)(1)(5) Nursing services. Page 1 of 2 395796 395796 07/30/2024 Montgomeryville Skilled Nursing and Rehabilitati 640 Bethlehem Pike Montgomeryville, PA 18936

F 0580 Level of Harm - Minimal harm or potential for actual harm Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Based on clinical record review and staff interview, it was determined that the facility failed to notify the resident representative of a change in condition for one of seven sampled residents. (Resident 1) Residents Affected - Few Findings include: Clinical record review revealed that Resident 1 had diagnoses that included chronic respiratory failure, seizures, and diabetes. The Minimum Data Set assessment, dated May 13, 2024, indicated that the resident had cognitive impairment. Review of a nurse's note dated June 30, 2024, revealed that Resident 1's right buttock was observed to be red and irritated with new orders from the physician to cleanse the area with normal saline solution, pat dry, and apply barrier cream and a foam border dressing. Review of a wound care progress note dated July 19, 2024, revealed that Resident 1 had a new left-sided anterior neck abrasion with orders to cleanse with wound cleanser and leave open to air. There was no documented evidence that the resident's representative was notified of the changes in condition. In an interview on July 30, 2024, at 12:45 p.m., the Director of Nursing confirmed that the resident's representative was not notified of the changes in condition. 28 Pa. Code 211.12(d)(1)(5) Nursing services. 395796 Page 2 of 2