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 observation, it was determined that the facility failed to provide assistance with
dining in a manner that promoted and maintained dignity for two residents (Residents 42, 74) on two of four
nursing units. (Homestead and C Unit)
Findings include:
Clinical record review revealed that Resident 42 had diagnoses that included Alzheimer's disease. Review
of the Minimum Data Set (MDS) assessment dated [DATE], revealed that the resident had cognitive
impairment, and required supervision with eating. Review of Resident 42's current care plan revealed that
the resident was on a restorative nursing program for dining and staff was to provide assistance with meals.
Observation on May 7, 2024, from 1:37 p.m. through 1:50 p.m., revealed Resident 42 in the dining room on
the Homestead nursing unit eating spaghetti with meat sauce with her fingers. At no time did staff redirect
or offer assistance to Resident 42.
Clinical record review revealed that Resident 74 had diagnoses that included arthritis and vision problems.
Review of the MDS assessment, dated January 31, 2024, revealed that the resident was alert, oriented,
and required set-up by staff for all meals. Review of Resident 74's current care plan revealed that the
resident was on a restorative nursing program for eating, was at risk for nutrition related problems related to
varied intakes at mealtimes, and had difficulty completing activities of daily living due to compromised
functional ability and impaired vision. Interventions were for staff to set-up the resident for her meals, and to
provide as needed assistance. On May 8, 2024, from 12:08 p.m. through 12:40 p.m., in the C unit dining
room, Resident 74 was observed to be eating a piece of cake with her hands. Resident 74's hands were
covered in cake and icing. At no time did staff redirect or offer any assistance to Resident 74.
28 Pa. Code 201.29(a) Resident rights.
28 Pa. Code 211.12(d)(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 6
Event ID:
395831
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
395831
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
05/10/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Schuylkill Center
1000 Schuylkill Manor Rd
Pottsville, PA 17901
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 0656
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Develop and implement a complete care plan that meets all the resident's needs, with timetables and
actions that can be measured.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
clinical record review and staff interview, it was determined that the facility failed to develop a
comprehensive care plan to meet each resident's needs identified in the comprehensive assessment for
two of 34 sampled residents. (Resident 141, 168)
Findings include:
Clinical record review revealed that Resident 141 had diagnoses that included difficulty communicating due
to a cognitive issue, hearing loss, and dementia. The Minimum Data Set (MDS) assessment dated [DATE],
identified that Resident 141 was cognitively impaired and used hearing aids. The Care Area Assessment
(CAA) summary indicated that communication was to be addressed in the care plan. There was no
evidence that interventions to address Resident 141's communication problems were included in the
current care plan.
Clinical record review revealed that Resident 168 had diagnoses that included dementia and chronic kidney
disease. The MDS assessment dated [DATE], indicated that Resident 168 was occasionally incontinent of
urine and the CAA summary indicated that it was to be addressed in the care plan. There was no evidence
that interventions to address Resident 168's urinary incontinence were included in the current care plan.
In an nterview on May 10, 2024, at 9:30 a.m. and 10:48 a.m., the Director of Nursing confirmed that the
identified care areas were not addressed in the residents' care plans.
28 Pa. Code 211.12(d)(1)(5) Nursing services.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395831
If continuation sheet
Page 2 of 6
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
395831
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
05/10/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Schuylkill Center
1000 Schuylkill Manor Rd
Pottsville, PA 17901
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 0803
Level of Harm - Minimal harm
or potential for actual harm
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be
updated, be reviewed by dietician, and meet the needs of the resident.
Based on observation, facility documentation, results of a test tray, and staff interview, it was determined
that the facility failed to follow the pre-approved menus on one of four nursing units. (C Unit)
Residents Affected - Some
Findings include:
Review of monthly Resident Council and Food Committee meeting minutes from December 2023, through
April 2024, revealed a pattern of complaints about portion size of food at mealtimes. On May 8, 2024, at
10:30 a.m., residents in a confidential group meeting stated that portion sizes were often too small.
Review of the facility menus revealed the lunch meal on May 8, 2024, was to include three ounces of
glazed pork medallions and four ounces of California blend vegetables.
Results of a test tray audit conducted on May 8, 2024, from 12:05 p.m. through 12:20 p.m., revealed staff
served two ounces of glazed pork and three ounces of California blend vegetables.
In an interview on May 8, 2024, the Dietary Manager confirmed that the incorrect portion size was given for
the entree and vegetables for the lunch cart delivered to C Unit.
28 Pa. Code 211.6(a) Dietary services.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395831
If continuation sheet
Page 3 of 6
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
395831
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
05/10/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Schuylkill Center
1000 Schuylkill Manor Rd
Pottsville, PA 17901
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 0804
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Level of Harm - Minimal harm
or potential for actual harm
Based on observation, resident interview, and results of a test tray audit, it was determined that the facility
failed to provide food that was palatable and at appetizing temperatures on one of four nursing units. (C
Unit)
Residents Affected - Few
Findings include:
On May 7, 2024, at 1:10 and 1:15 p.m., Residents 66 and 74 stated their lunch was cold to taste. Review of
monthly Resident Council and Food Committee meeting minutes from December 2023 through April 2024,
revealed a pattern of complaints about food not being served at correct temperatures. In a confidential
group interview on May 8, 2024, at 10:30 a.m., residents also stated that food was often not the right
temperature and the pork was too tough.
Results of a test tray audit conducted on May 8, 2024, at 12:10 p.m., revealed glazed pork was served at a
temperature of 120.7 degrees Fahrenheit (F), scalloped potatoes at a temperature of 111 degrees F, and
California blend vegetables at a temperature of 116 degrees F. The food was cool to taste and the pork
tough and difficult to chew.
On May 8, 2024, from 12:10 p.m. through 12:35 p.m., Residents 63, 74, and 168 were observed eating
lunch in the C unit dining room and stated that their pork was tough to chew and was not hot. At 12:20 p.m.,
Resident 74 stated, The pork is always tough here. At 12:36 p.m., Resident 66 was observed eating her
lunch in her room when she stated that her pork was cold and tough to cut and chew, and that she was
having difficulty cutting and chewing it.
CFR 483(d) Food and drink.
Previously cited 6/16/23
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395831
If continuation sheet
Page 4 of 6
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
395831
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
05/10/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Schuylkill Center
1000 Schuylkill Manor Rd
Pottsville, PA 17901
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 0810
Provide special eating equipment and utensils for residents who need them and appropriate assistance.
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
that adaptive equipment was provided to two of four sampled residents who used adaptive equipment for
meals. (Residents 29, 76)
Residents Affected - Few
Findings include:
Clinical record review revealed that Resident 29 had diagnoses that included Parkinson's disease,
dementia, arthritis, and a lack of coordination. The Minimum Data Set (MDS) assessment dated [DATE],
indicated that the resident had cognitive impairment and required assistance from staff for all meals. A
review of the care plan revealed that the resident had a nutrition problem related to a history of weight loss
and that staff was to provide adaptive equipment including Kennedy cups (spill proof drinking cups that
included a lid and a straw) for all meals. On May 3, 2023, the dietitian documented that the resident
continued to benefit from the use of adaptive equipment at meals. On May 8, 2024, at 1:10 p.m., Resident
29 was observed in bed immediately after having finished with lunch. A disposable foam cup with a straw
was at the bedside and not a Kennedy cup. In an interview at that time, Resident 29 stated that was the
type of cup the resident usually received. On May 9, 2024, at 12:26 p.m., Resident 29 was in the dining
room eating lunch and was served coffee in a regular mug without a lid or a straw and juice in a regular
juice cup without a lid or straw.
Clinical record review revealed that Resident 76 had diagnoses that included paralysis on one side and
vision problems. The MDS assessment dated [DATE], indicated that the resident had cognitive impairment
and required supervision with eating. A review of the care plan revealed that the resident had a nutrition
problem related to diabetes and impaired skin integrity and that staff was to provide adaptive equipment
including a Kennedy cup with a straw for all meals. On April 23, 2024, the dietitian documented that the
resident continued to benefit from the use of a Kennedy cup at meals. On May 7, 2024, at 1:14 p.m., and
May 8, 2024, at 12:47 p.m., Resident 76 was observed eating lunch and was using a regular white foam
cup with a straw, a red juice cup, and a coffee mug. All cups had no lids or straws.
In an interview on May 10, 2024, at 9:35 a.m., the Director of Nursing stated that Residents 29 and 76 were
to have had their drinks served in Kennedy cups.
28 Pa. Code 211.12(d)(1)(5) Nursing services.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395831
If continuation sheet
Page 5 of 6
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
395831
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
05/10/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Schuylkill Center
1000 Schuylkill Manor Rd
Pottsville, PA 17901
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 0812
Level of Harm - Minimal harm
or potential for actual harm
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve
food in accordance with professional standards.
Based on observation and staff interview, it was determined that the facility failed to store food under
sanitary conditions in the kitchen.
Residents Affected - Many
Findings include:
In an interview on May 7, 2024, at 9:30 a.m., the Director of Dietary Services stated that refrigerated foods
were to be labeled and dated when opened and used within three days.
Observation of the kitchen during a tour on May 7, 2024, at 9:32 a.m., revealed the following in the walk-in
refrigerator: a container of opened pumpkin puree dated May 2, 2024, opened raspberry glaze dated April
25, 2024, pureed peaches dated May 3, 2024, a dish of cottage cheese that was undated, a dish of salad
dated May 2, 2024, and a container of spaghetti with sauce without a date. In reach-in refrigerator 1, there
was a dish of chopped lettuce that was browning dated May 2, 2024, and in reach-in refrigerator 3, there
was opened ham luncheon meat dated April 29, 2024, opened turkey luncheon meat dated April 29, 2024,
and a container of chicken dated May 2, 2024. In the walk-in freezer, there was a large accumulation of ice
buildup on food items and a container of ground beef that was opened and had ice buildup directly on the
beef. In the food preparation area, near the microwave oven there were two opened containers of cereal
that were undated. In the dry storage area, there was an opened, undated bag of noodles. There were
chunks of tile missing on the floor near the reach-in freezer, near the cooler across from the ice machine,
and under the coffee machine.
CFR 483.60 Food Procurement Store/Prepare/Serve-Sanitary.
Previously cited 6/16/23
28 Pa. Code 201.18(b)(3) Management.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395831
If continuation sheet
Page 6 of 6