Inspection·November 21, 2025

F 0655 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted Based on review of clinical records and staff interview, it was determined that the facility failed to provide a written summary of the baseline care plan and order summary to the resident and/or representative for eight of eight residents reviewed (Residents R9, R24, R25, R26, R28, R31, R35 and R37). Findings include: No facility policy was provided that included a written summary of the baseline care plan shall be provided to the resident and representative in a language that the resident/resident representative can understand, including a summary of the resident's medications and dietary instructions, any services and treatments to be administered. Resident R9's clinical record revealed an admission date of 10/23/25, with diagnoses including, aftercare from spinal surgery, high blood pressure, cervical myelopathy (compression of the spinal cord in the neck that can cause balance problems, weakness, and loss of fine motor skills), and osteoarthritis (a type of joint disease that results of breakdown of cartilage and bone). Resident R24's clinical record revealed an admission date of 11/13/25, with diagnoses including ortho aftercare from fractured right femur nailing (surgical procedure to stabilize a fractured or weakened femur, thigh bone in upper leg connecting to hip), morbid obesity (a person who is severely overweight), diabetes mellitus (a chronic condition where the body doesn't produce enough insulin or can't use the insulin effectively leading to high blood sugar levels), and high blood pressure. Resident R25's clinical record revealed an admission date of 11/17/25, with diagnoses including infection of sacral stage four decubitus (infection of a severe pressure injury to sacrum, the large triangular bone at base of spine, that extends into muscle, tendon, or bone), diabetes mellitus, hypothyroidism (a condition when the thyroid gland doesn't make enough thyroid hormone to meet the body's needs), chronic obstructive pulmonary disease (COPD - a group of respiratory conditions that involve shortness of breath, a persistent cough, and excess mucus). Resident R26's clinical record revealed an admission date of 11/04/25, with diagnoses including ortho aftercare status post repair of fractured distal fibula, anxiety, hyperlipidemia (high levels of fat, including cholesterol and triglycerides, in the blood) and high blood pressure. Resident R28's clinical record revealed an admission date of 11/10/25, with diagnoses including ortho aftercare from a right total hip repair, atrial fibrillation (abnormal heart rythm), hyperlipidemia (high levels of fat, including cholesterol and triglycerides, in the blood) and high blood pressure. Resident R31's clinical record revealed an admission date of 11/11/25, with diagnoses including ortho aftercare from fractured left acetabular fracture (hip fracture), left hip pain, repeated falls, and restless leg syndrome. Resident R35's clinical record revealed an admission date of 11/06/25, with diagnoses including ortho aftercare from trans metatarsal amputation, left foot osteomyelitis (bone infection) hyperlipidemia and high blood pressure. Resident R37's clinical record revealed an admission date of 11/06/25, with diagnoses including ortho aftercare from fractured right femur nailing, chronic deep vein thrombus of right leg (blood clot of circulatory system of leg), hyperlipidemia (high levels of fat, including cholesterol and triglycerides, in the blood) and high blood (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 5 Event ID: 395894 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 395894 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Meadville Medical Ctr Tcu 1034 Grove Street Meadville, PA 16335 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)