Inspection·March 10, 2023

F 0677 Provide care and assistance to perform activities of daily living for any resident who is unable. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review and observation, it was determined that the facility failed to provide services to maintain adequate grooming and personal hygiene for residents unable to carry out activities of daily living for two of 29 sampled residents. (Residents 48, 71) Residents Affected - Few Findings include: Clinical record review revealed that Resident 48 had diagnoses that included dementia, contractures of both legs, and history of a stroke. The Minimum Data Set assessment dated [DATE], indicated that the resident was cognitively impaired and required extensive staff assistance for personal hygiene. The care plan identified that Resident 48 had difficulty caring for herself due to her physical limitations and interventions included that staff assist with daily hygiene and grooming. Observations on March 7, 2023, at 1:53 p.m., and March 8, 2023, at 9:59 a.m., revealed that Resident 48's fingernails on both hands were long with dirt underneath. Clinical record review revealed that Resident 71 had diagnoses that included muscle weakness, history of a stroke affecting the right dominant side, and contractures of the right elbow, muscle of the right arm, and right hand. The MDS assessment dated [DATE], indicated that the resident was cognitively impaired and required extensive staff assistance for personal hygiene. The care plan identified that Resident 71 had difficulty caring for herself due to unsteady gait and physical limitations and interventions included that staff assist with daily hygiene and grooming. Observations on March 7, 2023, at 12:54 p.m., and March 8, 2023, at 10:24 a.m., revealed that Resident 71's fingernails on both hands were long with dirt underneath. 28 Pa. Code 211.12(d)(1)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395817 If continuation sheet Page 2 of 5 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 395817 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/10/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Yardley Rehabilitation and Healthcare Center 1480 Oxford Valley Road Yardley, PA 19067 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)

F 0679 Provide activities to meet all resident's needs. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review, observation, staff interview, and resident interview, it was determined that the facility failed to provide an activities program to meet needs and preferences based on the comprehensive assessment and care plan for one of 29 sampled residents. (Resident 121) Residents Affected - Few Findings include: Clinical record review revealed that Resident 121 had diagnoses that included depression, anxiety disorder, and limitation of activities due to disability. The quarterly Minimum Data Set (MDS) assessment dated [DATE], indicated that the resident had no memory problems, but was unable to report the correct day of the week. In addition, Resident 121 required staff assistance for transferring between surfaces and moving about the unit. The annual MDS assessment dated [DATE], identified that Resident 121 expressed that it was important to do things with groups of people, listen to preferred music, and to participate in religious services or practices. The resident's care plan identified that the resident enjoyed activities such as watching movies and listening to oldies music. Interventions included offering activities consistent with known interests and encouraging participation. Review of the Social Services assessment dated [DATE], indicated that the resident's religious preference was Catholic. During an interview on March 7, 2023, at 1:24 p.m., Resident 121 reported that he was not informed of activities programming and was not able to read the activities calendar. The resident stated that he found out about a religious service for Ash Wednesday on March 22, 2023, after it was over and that participation was important for him to receive the ashes. Also, the resident stated that he desired to meet with a priest at other times, requested the same, and was not provided with the opportunity. In addition, Resident 121 stated that he would like to attend group activities, such as movies, if someone would assist him to go. Review of activities calendars for February and March 2023, revealed that bible study was offered on Resident 121's unit weekly, that movies were shown in the Main Dining Room three times in February 2023, and oldies music was offered four times in March 2023. Observation in the South lounge on March 8, 2023, from 10:30 a.m. through 11:00 a.m., revealed that a religious activity, including music/singing, was held on Resident 121's unit while the resident remained in bed. Review the resident's clinical record and activities attendance sheets revealed there was a lack of documentation to support that Resident 121 was invited to any group activities and/or provided with an opportunity to participate in religious services or practices. During an interview on March 10, 2023, at 1:13 p.m., the Activities Director confirmed that the priest did not visit residents in their rooms and that services were held on Ash Wednesday. 28 Pa. Code 201.29(j) Resident rights. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395817 If continuation sheet Page 3 of 5 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 395817 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/10/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Yardley Rehabilitation and Healthcare Center 1480 Oxford Valley Road Yardley, PA 19067 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)

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 and staff interview, it was determined that the facility failed to ensure physicians' orders were implemented for two of 29 sampled residents. (Residents 38, 71) Residents Affected - Few Findings include: Clinical record review revealed that Resident 71 had diagnoses that included high blood pressure and history of a stroke. On June 15, 2020, a physician ordered that staff administer a medication (metoprolol tartrate) three times daily to treat the resident's high blood pressure. Staff was not to give the metoprolol tartrate if the resident had a systolic blood pressure (the first measurement of blood pressure when the heart beats, and the pressure is at its highest) of less than 110 millimeters of mercury (mm/Hg) or heart rate of less than 60 beats per minute (bpm). A physician's order dated January 21, 2021, directed staff to administer an additional medication (hydralazine) every six hours to treat the resident's high blood pressure. Staff was not to give the hydralazine if the resident had a systolic blood pressure of less than 130 mm/Hg or heart rate of less than 60 bpm. A review of Medication Administration Records (MARs) revealed that staff administered the hydralazine when the resident's systolic blood pressure was under 130 mm/Hg on seven occasions in February 2023, and three occasions in March 2023. In addition, staff administered the metoprolol on 18 occasions in February and six occasions in March 2023, and administered the hydralazine on 20 occasions in February 2023, and six occasions in March 202,3 with no evidence that blood pressure and/or heart rate was measured prior to giving the medications. In an interview conducted on March 10, 2023, the Director of Nursing confirmed that Resident 71 received the hydralazine outside prescribed parameters on multiple occasions. Clinical record review revealed that Resident 38 had diagnoses that included high blood pressure and an irregular heart rhythm. On November 17, 2015, a physician ordered that staff administer a medication (metoprolol succinate) once daily at bed time to treat the resident's high blood pressure. Staff was not to give the medication if the resident had a systolic blood pressure of less than 100 mm/Hg or heart rate of less than 60 bpm. A review of the February and March 2023, MARs revealed that staff administered the medication with no evidence that blood pressure and/or heart rate was measured on five occasions in February 2023, and three occasions in March 2023. 28 Pa. Code 211.12(d)(1)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395817 If continuation sheet Page 4 of 5 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 395817 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/10/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Yardley Rehabilitation and Healthcare Center 1480 Oxford Valley Road Yardley, PA 19067 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)

F 0685 Assist a resident in gaining access to vision and hearing services. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review, observation, and staff interview, it was determined that the facility failed to ensure each resident received assistive devices to maintain hearing abilities for one of 29 sampled residents. (Resident 38) Residents Affected - Few Findings include: Clinical record review revealed that Resident 38 had diagnoses that included pigmentary retinal dystrophy (causes progressive vision loss), depression, and anxiety disorder. The Minimum Data Set assessment dated [DATE], indicated that the resident's vision was impaired and hearing was highly impaired. The care plan identified that the resident had difficulty communicating as evidenced by hearing loss/deafness. Interventions included for the resident to use cochlear implant hearing aides in both ears and to use a communication board. On September 15, 2022, the Nurse Practioner noted that staff was to encourage Resident 38 to wear the cochlear devices daily. Review of additional physician's documentation dated January 13, 2023, revealed that Resident 38's cochlear implants were broken and awaiting replacement. It was also noted that the resident had a white board at bedside for communication; but, typically stated, I can't see it. Resident 38 was observed in bed on March 7, 2023, with signs posted on the overbed light fixture that read, [Patient] can't hear without cochlear implants. Both broken. [Patient] can read lips. On March 8, 2023, at 10:17 a.m., the surveyor attempted to communicate with the resident by writing on the white board. The resident stated, I can't see it. In addition, when speaking to the the resident with lips visible, Resident 38 squinted while looking toward the speaker; but, did not respond. During an interview on March 7, 2023, at 12:15 p.m., LPN 1 was not aware of the status of the broken hearing devices. There was a lack of documentation to support that the facility assisted Resident 38 with acquiring needed hearing devices. 28 Pa. Code 211.12(d)(1)(3)(5) Nursing services. 28 Pa. Code 211.16(a) Social services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395817 If continuation sheet Page 5 of 5