Health inspection·September 28, 2023

F 0660 Plan the resident's discharge to meet the resident's goals and needs. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on document review and staff interviews, it was determined that the facility failed to implement an effective discharge planning process that focuses on the resident's discharge goals, the preparation, and the transition to post-discharge care for one of three residents reviewed (Resident 2). Residents Affected - Few Findings Include: Review of the facility's Social Services/Social Worker job description, described the essential duties and responsiblities as, Works with the resident, family and other members of the health care team to formulate a discharge plan that provides the resident services in the appropriate post-acute setting. Review of Resident 2's clinical record revealed diagnoses that included cerebral cysts (fluid filled sacs in the brain) and Diabetes Mellitus Type II (a disease that occurs when your blood glucose, also called blood sugar, is too high). Review of Resident 2's order summary sheet revealed the need for the use of a Peripherally Inserted Central Catheter (PICC-a type of long catheter that is inserted through a peripheral vein, often in the arm, into a larger vein in the body, used when intravenous treatment is required over a long period), requiring dressing change and antibiotic medication administration. Review of a Social Services note dated August 18, 2023, revealed a conversation with Resident 2 discussing a planned discharge on [DATE], if her IV ABX [antibiotics] have been delivered to her home address. Review of an additional Social Services note dated August 22,2023, one day post Resident 2's discharge, revealed the Resident declined additional home health services, however, she does have enough IV medications to last through tomorrow, 8/23/23. Continued review of Resident 2's order summary report revealed an order for schedule an appointment with PCP [primary care physician] within one week of discharge from the skilled nursing facility. Review of the facility's document, titled Discharge Instructions, dated August 21, 2023, revealed Resident 2 was going home and, regarding Medication Education, Nursing staff taught family how to instill the antibiotic, however, will need someone to change resident's dressing weekly. Review of Resident 2's clinical record revealed no evidence of a follow-up appointment scheduled with the PCP post-discharge nor evidence of discharge planning to support Resident 2's need for care (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 2 Event ID: 395844 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 395844 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/28/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Elizabethtown Nursing and Rehabilitation 141 Heisey Avenue Elizabethtown, PA 17022 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)