Inspection·October 5, 2023

F 0657 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. Based on review of facility policy, observation, clinical record review and interview with staff, it was determined that the facility did not ensure that the comprehensive care plan was updated in a timely manner related to contracture care for one of 15 records reviewed (Resident R14). Findings include: Review of facility policy titled Care Plans, Comprehensive Person-Centered, dated March 2022, revealed that, Assessments of residents are ongoing and care plans are revised as information about the residents and the residents' conditions change. Observations conducted on October 2, 2023, at 1:24 p.m. revealed that Resident R14's head was laying to the right in an exaggerated way. No collar or other device was noted at the time. Review of Resident R14's clinical record, revealed that the resident's care plan stated that she was to have Passive ROM (range of motion exercises) for both Upper and Lower extremities. Apply Kentucky neck collar/Aspen collar, (a form of neck brace which is used to correct head and neck misalignment) L (left) resting hand splint and R (right) palm cushion as recommended. This care plan item had been created on November 11, 2019. Interview with Nursing staff, Employee E4 on October 4, 2023, at 11:50 a.m. revealed that the resident no longer uses a collar, hand splint, or resting cushion, and instead utilizes passive ROM and a specialized pillow for her neck, a hand roll with finger separators for her left hand, and a towel roll for her right hand. Interview with Employee E2, the director of nursing on October 4, 2023, at 12:15 p.m. confirmed that the above care plan was not, but should have been revised as the resident's needs changed. 28 Pa. Code 211.12(d)(1) Nursing services 28 Pa. Code 211.12(d)(3) Nursing services 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 2 Event ID: 395847 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 395847 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/05/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Montgomery Subacute and Respiratory Center 251 Stenton Avenue Plymouth Meeting, PA 19462 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)