F 0550
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or
her rights.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
clinical record review and resident interview, it was determined that the facility failed to provide services to
enhance each resident's quality of life by offering showers as scheduled to two of 24 sampled residents.
(Residents 7, 107)
Findings include:
Clinical record review revealed that Resident 7 had diagnoses that included hemiplegia and depression.
The Minimum Data Set (MDS) assessment dated [DATE], indicated that the resident was oriented and
needed substantial/maximal assistance from staff for bathing. The resident was to receive a shower twice
per week on Mondays and Thursdays. During an interview on December 12, 2023, at 12:05 p.m., the
resident reported that she preferred to take a shower twice a week and was not offered the opportunity to
do so. Review of documentation in the clinical record revealed that the resident was not offered a shower
seven of nine scheduled times from November 13, 2023, through December 11, 2023.
Clinical record review revealed that Resident 107 had diagnoses that included congestive heart failure and
chronic obstructive pulmonary disease. The MDS assessment dated [DATE], indicated that the resident
needed substantial/maximal assistance from staff for bathing. The resident was to receive a shower twice
per week on Mondays and Thursdays. During an interview on December 12, 2023, at 12:25 p.m., Resident
107 stated that she preferred to take a shower twice a week and was not offered the opportunity to do so.
Review of documentation in the clinical record revealed that the resident was not offered a shower seven of
eight scheduled times from November 16, 2023, through December 11, 2023.
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 4
Event ID:
395938
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
395938
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
12/15/2023
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Complete Care at Berkshire LLC
5501 Perkiomen Avenue
Reading, PA 19606
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)
F 0584
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited
to receiving treatment and supports for daily living safely.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
observation, it was determined that the facility failed to provide a safe, clean, and comfortable environment
on two of two nursing units. (First Floor, Second Floor)
Findings include:
During the environmental tour of the First Floor nursing unit on December 12, 2023, at various times, the
following was observed:
The linoleum floor was cracked, broken, and/or taped in resident rooms 125, 126, 127, 128, 132, and 133.
The floor was sticky in resident room [ROOM NUMBER].
There was a urine odor in resident rooms [ROOM NUMBERS].
Toilets were soiled with a brown substance in resident rooms [ROOM NUMBERS].
There was a rusty toilet seat in resident room [ROOM NUMBER].
The first floor resident lounge refrigerator was soiled with a brown substance inside.
During an environmental tour of the Second Floor nursing unit on December 14, 2023, at various times, the
following was observed:
The linoleum floor was taped in resident room [ROOM NUMBER].
Light bulbs were not working in resident rooms [ROOM NUMBER].
Toilets were soiled with a brown substance in resident rooms [ROOM NUMBER].
There was peeling wallpaper in resident room [ROOM NUMBER].
The lavatory faucet leaked in resident room [ROOM NUMBER].
In the multipurpose room, there were brown-stained ceiling tiles, taped cracks in the window, and the
telephone was hanging loosely on the wall.
28 Pa. Code 201.18(b)(3)(e)(2.1) Management.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395938
If continuation sheet
Page 2 of 4
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
395938
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
12/15/2023
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Complete Care at Berkshire LLC
5501 Perkiomen Avenue
Reading, PA 19606
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)
F 0641
Ensure each resident receives an accurate assessment.
Level of Harm - Minimal harm
or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
clinical record review and staff interview, it was determined that the facility failed to ensure that the
Minimum Data Set (MDS) assessment was complete to accurately reflect the resident's status for one of 24
sampled residents. (Resident 32)
Residents Affected - Few
Findings include:
Clinical record review revealed that Sections C (Cognitive Patterns) and D (Mood) of Resident 32's MDS
assessment dated [DATE], was incomplete.
In an interview on December 15, 2023, 12:57 p.m., the Administrator confirmed that the identified MDS
sections were not completed during the assessment period to reflect the resident's current status.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395938
If continuation sheet
Page 3 of 4
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
395938
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
12/15/2023
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Complete Care at Berkshire LLC
5501 Perkiomen Avenue
Reading, PA 19606
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)
F 0677
Provide care and assistance to perform activities of daily living for any resident who is unable.
Level of Harm - Minimal harm
or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
clinical record review, observation, and interview it was determined that the facility failed to provide
necessary services to maintain good personal hygiene for three of 24 sampled residents. (Residents 44,
91, 116)
Residents Affected - Few
Findings include:
Clinical record review revealed that Resident 44 had diagnoses that included tremor, osteoarthritis left
hand, and major depressive disorder. Review of the Minimum Data Set (MDS) assessment dated [DATE],
indicated that the resident had no memory impairment and required assistance from staff with daily hygiene
and grooming. Review of the current care plan revealed that staff was to provide the resident assistance
with hygiene. Observations on December 12, 2023, at 2:16 p.m. and December 14, 2023, at 1:09 p.m.,
revealed that the resident had long and jagged fingernails with a dark brown substance under the nails.
Clinical record review revealed that Resident 91 had diagnoses that included generalized muscle weakness
and mild cognitive impairment and end stage renal disease. The care plan dated December 1, 2023,
indicated that Resident 91 had difficulty caring for himself due to his physical and cognitive limitations and
interventions included for staff to provide assistance with daily hygiene and grooming. Observations on
December 13, 2023 at 12:14 p.m., and December 14, 2023 at 3:00 p.m., 2023, revealed that Resident 91's
mustache had grown over his mouth, interfering with eating.
Clinical record review revealed that Resident 116 had diagnoses that included fracture of right lower leg,
tremor, and diabetes. Review of the MDS assessment dated [DATE], indicated that the resident had no
memory impairment and required assistance from staff with daily hygiene and grooming. Review of the
current care plan revealed that staff was to provide the resident assistance with hygiene. Observations on
December 12, 2023, at 1:47 p.m., December 13, 2023, at 9:57 a.m., and December 14, 2023, at 1:14 p.m.,
revealed that the resident had thick facial hair growth. The resident stated that he needed assistance from
staff to shave and had asked staff to shave his facial hair on December 11, 2023, but that staff did not
provide the assistance.
In an interview on December 15, 2023, at 1:57 p.m., the Administrator stated that nail care and men's facial
hair shaves and trims were to be completed with shower and bathing activities and as requested.
28 Pa. Code 211.12(d)(1)(5) Nursing services.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395938
If continuation sheet
Page 4 of 4