Inspection·August 6, 2025

F 0658 Ensure services provided by the nursing facility meet professional standards of quality. Level of Harm - Minimal harm or potential for actual harm Based on review of the Pennsylvania Nurse Practice Act and clinical records, as well as staff interviews, it was determined that the facility failed to ensure that physician's orders were clarified when needed for two of 12 residents reviewed (Residents 1, 2).Findings include:The Pennsylvania Code, Title 49, Professional and Vocational Standards, State Board of Nursing, 21.11 (a)(1)(2)(4) indicated that the registered nurse was to collect complete and ongoing data to determine nursing care needs, analyze the health status of individuals and compare the data with the norm when determining nursing care needs, and carry out nursing care actions that promote, maintain and restore the well-being of individuals.A quarterly Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs) for Resident 1, dated May 23, 2025, revealed that the resident was understood, could understand others, had a diagnosis of included end-stage renal disease (ESRD - a permanent condition that occurs when the kidneys are no longer able to function properly), and received hemodialysis (a treatment that removes waste products and excess fluid from the blood when the kidneys are no longer functioning properly). A care plan for the resident, dated July 17, 2025, revealed that the resident received dialysis on Tuesday, Thursday, and Saturday. Physician's orders for Resident 1, dated May 19, 2025, included an order that the resident was to receive dialysis on Tuesday, Thursday, and Saturday at 6:15 a.m. Physician's orders for Resident 1, dated May 19, 2025, included an order that on dialysis days staff could administer the resident's medications prior to dialysis. Physician's orders for Resident 1, dated May 19, 2025, included an order that on dialysis days staff could administer the resident's medications upon return from dialysis. There was no documented evidence that Resident 1's physician was contacted to clarify which medications could be administered prior to dialysis and/or upon return from dialysis. A quarterly MDS assessment for Resident 2, dated June 2, 2025, revealed that the resident was cognitively intact, required assistance from staff for daily care needs, had a diagnosis which included end-stage renal disease (ESRD - a permanent condition that occurs when the kidneys are no longer able to function properly), and was receiving dialysis.Physician's orders for Resident 2, dated July 24, 2025, included an order that the resident was to receive dialysis on Tuesday, Thursday, and Saturday at 11:00 a.m. Physician's orders for Resident 2, dated July 24, 2025, included an order that on dialysis days staff could administer the resident's medications prior to dialysis. Physician's orders for Resident 2, dated July 24, 2025, included an order that on dialysis days staff could administer the resident's medications upon return from dialysis. There was no documented evidence that Resident 2's physician was contacted to clarify which medications could be administered prior to dialysis and/or upon return from dialysis. Interview with the Director of Nursing on August 6, 2025, at 4:30 p.m. confirmed that there was no documented evidence that Resident 1 and Resident 2's physicians were contacted to clarify which medications could be administered prior to dialysis and/or upon return from dialysis. 28 Pa. Code 211.12(d)(1)(3)(5) Nursing Services. Residents Affected - Some 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 8 Event ID: 395985 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 395985 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/06/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Midtown Oaks Health & Rehab Center 1020 Green Avenue Altoona, PA 16601 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)