Inspection·February 2, 2026

F 0745 Provide medically-related social services to help each resident achieve the highest possible quality of life. 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, hospital records, and staff interviews, it was determined that the facility failed to ensure appropriate social services were provided to ensure a safe discharge to home for one of the two residents reviewed (Resident CL1).Findings include: Review of Resident CL1 diagnosis list includes the following diagnoses: Altered mental status (Unusual changes in a person's emotional response, thinking, and behavior) and Metabolic Encephalopathy (A non-traumatic brain dysfunction caused by illnesses or chemical imbalance, resulting in altered mental status). Review of Resident CL1's admission Visit Physician Orders, dated December 4, 2025, revealed Resident is not capable of understanding rights and exercising own rights. Interview with Licensed Employee E3 was conducted on February 2, 2026, at 11:00 a.m. Employee E3 reported being the social worker (SW) assigned to Resident CL1. It was further reported that Resident CL1's emergency contact was an ex-husband who does not reside with the resident but aids with the resident's bills and finances. Employee E3 confirmed that the resident does not have a POA (Power of Attorney - A legal document that authorizes an agent to act on behalf of a principal for financial or medical matters). The residents had been deciding for themselves before hospitalization. Review of nursing progress notes revealed a note dated December 10, 2025, at 8:04 p.m., stating resident continues with frequent confusion/disorientation. Review of nursing progress notes revealed a note dated December 11, 2025, at 7:25 a.m., stating Staff report [the resident] is increasingly confused, found in the hallway carrying their purse saying they didn't know where their room was. Review of nursing progress notes revealed a note dated December 12, 2025, at 10:07 a.m., stating the resident's insurance company notified the facility of the resident's last cover date, which is December 13, 2025. A review of the Nurse Practitioner's (NP) notes dated December 12, 2025, revealed: Assessment and Plan - Dementia (A term used to describe a group of symptoms affecting memory, thinking, and social abilities severely enough to interfere with daily life) associated with alcoholism, oriented only to self. The same note revealed SLUMS (The St. Louis University Mental Status- Examination for detecting mild cognitive impairment and early dementia) done in the facility was 16 out of 30. Further note review indicated [The Resident] exhibits memory impairment and tangential (Someone whose conversation wanders off topic, bringing irrelevant details, without returning to the original point, failing to answer the question asked) thought process. Further review of the same notes revealed Resident is not capable of making sound medical decisions. There is concern regarding discharge plan as they live alone with limited support. History of Present Illness revealed [The resident] has a marked severe level of impairment, demonstrated by a SLUMS score of 16 out of 30 indicatives of dementia. [Name of insurance] gave an insurance cut, but due to concern for a safe discharge plan as they live alone in a dilapidated trailer with unsanitary living conditions, peer-to-peer was done by this provider with extension until December 17, 2025. The resident has limited support with an ex-husband who is minimally involved. Review of the social services (SS) Residents Affected - Few (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: 395857 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 395857 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/02/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Ephrata Manor 99 Bethany Road Ephrata, PA 17522 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)