Health inspection·April 18, 2024

F 0711 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of facility policy, clinical records, and staff interview, it was determined that the facility failed to ensure that the physician reviewed the residents' total program of care including medications during physician visits for one of nine residents reviewed (Resident R1). Findings include: Review of facility policy entitled, Monthly Medication Regimen Review dated 9/25/23, indicated the intent, To ensure the resident's highest practicable level of physical, mental, and psychosocial well-being and prevent or minimize adverse consequences related to medication therapy to the extent possible, by providing oversight by a licensed pharmacist, attending physician, medical director, and the director of nursing. Resident R1's clinical record revealed an admission date of 2/21/22, with diagnoses that included multiple subsegmental pulmonary emboli (a blood clot in the lung(s) in more than one artery), muscle weakness, and hypertension (high blood pressure). Resident R1's progress notes revealed that he/she was sent to the emergency room on [DATE], due to a positive doppler scan indicating he/she had a deep vein thrombosis (blood clot) in his/her left lower extremity. Resident R1 returned to the facility on [DATE] with an order for the medication Eliquis (an anticoagulant/blood thinner) 5 milligrams (mg) two times a day for 74 doses. The Certified Registered Nurse Practitioner (CRNP) documented in the progress notes during his/her visits with Resident R1 on 12/28/23, 1/4/24, and 1/11/24, that Resident R1 was to remain on the anticoagulant medication long-term. Review of Resident R1's medication administration record (MAR) revealed Eliquis 5 mg twice a day was administered as ordered from 12/27/23, through 2/1/24. Resident R1 did not receive Eliquis 5 mg twice a day from 2/2/24, through 4/8/24. The CRNP documented in the progress notes during his/her visits with Resident R1 on 2/1/24, 2/16/24, and 3/1/24 that Resident R1 was receiving Eliquis 5 mg twice a day due to an extensive deep vein thrombosis in the left lower extremity. Eliquis 5 mg twice a day was no longer on the current medication list during the identified visits as it had been discontinued after the 2/1/24, administered doses. (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 4 Event ID: 395959 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 395959 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/18/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Caring Place, The 103 N. Thirteenth Street Franklin, PA 16323 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)