Health inspection·April 2, 2025

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 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of clinical records, review of facility documents and interviews with staff, it was determined that the facility failed to ensure that residents receive treatment and care in accordance with professional standards of practice related to verifying medication orders for one of nine resident reviewed. (Resident R1) Residents Affected - Few Findings include: Review of Resident R1's clinical record revelaed that this resident entered the facility on November 5, 2025 with diagnosis' including infection and inflammatory reaction (immune response to injury or disease) due to internal joint prosthesis (artificial joint), and respiratory failure. Review of hospital Discharge summary dated [DATE], revealed that Resident R1 was hospitalized for prosthetic (artificial) right knee infection. Resident R1's lab work revelaed that the artificial joint was infected with multiple bacteria and treated with antibiotics including: Ancef, Levaquin, Cefepime, with instructions to then transition to Cefepime with a plan to transition to Cephadroxel afterwards, continue suppressive antibiotic Bactrim twice a day for life, follow with appointment with infection disease on November 22, 2024. Review of the hospital discharge medications revealed an order for the antibiotic Sulfamethozazole-Trimethoprim 800-160 mg per tablet (commonly known as Bactrim) to administer 1 tablet by peg tube (feeding tube) route every 12 hours for 3 days. Review of Social Service note dated November 11, 2024 which revealed a concern from residents family pertaining to Resident R1's medication administration regarding antibiotics ordered. The resident's family questioned why the antibiotic Bactrim was discontinued, the family believed that the order was for continued use for three months. The resident had missed several days (four days for a total of eight doses) of the scheduled antibiotic. Review of resident's physician orders dated November 5, 2024 revealed an order for SulfamethozazoleTrimethoprim (Bactrim) Oral Tablet 800-160 MG to give 1 tablet via PEG-Tube every 12 hours for three days. Continued review of physician orders dated November 11, 2024 for Bactrim DS Oral Tablet 800-160 (Sulfamethozazole-Trimethoprim) give 1 tablet via Peg-tube one time a day for infection until January 14, 2025. (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: 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 04/02/2025 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)