Health inspection·September 8, 2023

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Based on observations and review of facility policy, it was determined that the facility failed to maintain resident dignity and respect by serving meals in a timely manner to individuals seated at the same table and implementing dignified feeding practices in the main dining room. Findings include: Review of the Dining Room Service policy dated 1/1/23, revealed that Residents will be greeted and served upon arrival. Observations of the afternoon meal in the main dining room on 9/6/23, between 11:43 a.m. and 12:07 p.m. revealed the following. Observation at 11:43 a.m. on 9/6/23, revealed Resident R26 and Resident R150 were seated at the same table in the dining room together and at 11:45 a.m. Resident R26 was served his/her meal and began eating. At 11:51 a.m. Resident R26 completed his/her meal and left the dining room. Resident R150 was served his/her meal at 12:07 p.m. 22 minutes after Resident R 26 received and completed his/her meal. Observation on 9/6/23, at 11:48 a.m. revealed a table in the dining room with five residents seated together around the table. One resident was served his/her meal at 11:48 a.m. while the other four residents watched him/her eat. The last resident at the table was served at 12:06 p.m. 18 minutes after the first resident received and began eating his/her meal. During an interview on 9/6/23 at 12:52 p.m. Dietary Manager Employee E2 verified that the current process for delivering meals to residents in the dining room included that when residents arrive at the dining room, the staff take the resident's meal ticket to the kitchen and when the dietary staff get to the ticket then they prepare the meal and take it to the residents. 28 Pa. Code 201.14(a) Responsibility of licensee 28 Pa. Code 211.12(d)(1)(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: 395908 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 395908 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/08/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Bradford Ecumenical Home, Inc 100 Saint Francis Drive Bradford, PA 16701 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)