Health inspection·November 8, 2024

F 0600 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Level of Harm - Actual harm Residents Affected - Few Based on review of facility policies, facility documentation and review of clinical records, and staff interviews, it was determined that the facility failed to appropriately transfer a resident to ensure the resident was free from neglect which resulted in actual harm of a fracture of the right humeral head of the right shoulder for one of 13 residents reviewed (Resident R1). Findings include: The Mechanical Lifts and Slings policy, dated 2/05/24, revealed, Mechanical lift transfer status will be maintained indicating the use of a full mechanical lift or sit to stand mechanical lift. Transfer Status will also be documented in the Plan of Care. Two or more aides must be used for all full mechanical lift transfers. The Identifying Resident Neglect policy, dated 2/05/24, revealed, Neglect includes cases where the facility's indifference to or disregard for resident care, comfort, or safety results in (or could have resulted in) physical harm, pain, mental anguish or emotional distress. A review of Resident R1's clinical record revealed an admission date of 4/13/23, with diagnoses that included cerebral infarction due to embolism (a stroke due to a blood clot in the brain), muscle weakness, and major depressive disorder. A review of Resident R1's order summary revealed a physician's order dated 4/14/23, to utilize a mechanical lift with two staff for transfers. A review of Resident R1's ADL (Activities of Daily Living) Self Care Performance Deficit care plan, date initiated 4/25/23, revealed, mechanical lift and assist of two for transfers. A review of Resident R1's clinical record revealed a nursing note written by Registered Nurse (RN) Employee E2, dated 10/27/24, at 2:42 a.m. Called to resident room by LPN [Licensed Practical Nurse] to assess right arm and shoulder d/t [due to] increased pain. Resident has a history of CVA [cerebrovascular accident] which effected right side. Right arm has limited ROM [range of motion] since CVA. Right shoulder appears swollen, no increased warmth. Scarring to shoulder from previous surgery. Resident states shoulder is always swollen but is more painful at this time than usual. No recent falls or known injuries. Ice applied to site and Tylenol given by LPN. Will discuss with on call MD [medical doctor] in a.m. r/t [related to] need for Xray. A review of Resident R1's clinical record revealed a nursing note written by LPN Employee E4, dated 10/27/24, at 2:57 p.m. CRNP [Certified Registered Nurse Practitioner] Employee E5 notified of (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 3 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 11/08/2024 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)