Health inspection·November 20, 2025

F 0605 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. **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 document the rationale for the continued use of as needed (PRN) anti-anxiety medications for two of 24 sampled residents. (Residents 2 and 3)Findings include:Clinical record review revealed that Resident 2 had diagnoses that included dysphagia (difficulty swallowing), malnutrition, and anxiety. Review of the Minimum Data Set (MDS) assessment dated [DATE], revealed that the resident had no cognitive impairment and had been administered an anti-anxiety medication. On September 16, 2025, a physician ordered for staff to administer an anti-anxiety medication (lorazepam) every 12 hours as needed for anxiety. Review of the Medication Administration Record (MAR) revealed that the anti-anxiety medication had been administered three times in November 2025. Clinical record review revealed that Resident 3 had diagnoses that included dysphagia, heart failure, and anxiety. Review of the MDS assessment dated [DATE], revealed that the resident had no cognitive impairment and had been administered an anti-anxiety medication. On October 5, 2025, a physician ordered for staff to administer an anti-anxiety medication (clonazepam) every eight hours as needed for anxiety. Review of the MARs revealed that the anti-anxiety medication had been administered two times in October 2025 and 13 times in November 2025.There was no documented evidence that the physician re-evaluated the medications and/or documented a rationale for the extended duration and use beyond 14 days. In an interview on November 20, 2025 at 10:33 a.m., the Director of Nursing confirmed that there was no stop date or rationale in the orders to extend the PRN medications. 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 3 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 11/20/2025 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)