Health inspection·February 12, 2026

F 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Based on review of clinical records, as well as staff interviews, it was determined that the facility failed to ensure that resident-centered care plans were implemented for one of six residents reviewed (Resident 2) regarding nutritional interventions. Findings include: A comprehensive Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs) for Resident 2, dated September 4, 2025, revealed that the resident was cognitively impaired and dependent on staff for daily care tasks, including feeding. The resident's care plan, most recently updated September 4, 2025, indicated that the resident had increased nutrition risk related to needing to be fed by staff and having swallowing difficulties. The resident's care plan indicated that the resident was to be offered an alternative meal if she consumed less than fifty percent of the meal.According to Resident 2's meal intake record, dated November 2025, the resident ate less than fifty percent for supper on November 1, for lunch on November 2, for breakfast and lunch on November 3, for breakfast and lunch on November 6, for breakfast and lunch on November 8, for dinner on November 10, for lunch on November 11, for lunch on November 14, for breakfast and lunch on November 15, for breakfast and dinner on November 16, for breakfast and lunch on November 17, for breakfast and lunch on November 18, for breakfast on November 20, and for breakfast and lunch on November 21.There was no documented evidence that the resident was offered an alternative meal on the dates mentioned above. Interview with the Director of Nursing on February 12, 2026 at 2:14 p.m. revealed that there was no indication that Resident 2 was offered an alternative meal on those dates and that she should have been according to her care planned intervention.28 Pa. Code 201.24(e)(4) admission Policy. Page 1 of 2 395985 395985 02/12/2026 Midtown Oaks Health & Rehab Center 1020 Green Avenue Altoona, PA 16601

F 0692 Provide enough food/fluids to maintain a resident's health. Level of Harm - Minimal harm or potential for actual harm Based on clinical record reviews and staff interviews, it was determined that the facility failed to initiate nutritional interventions to assure that residents were offered sufficient food and fluid intake to maintain proper hydration and health for one of six residents reviewed (Resident 2). Findings include:A comprehensive Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs) for Resident 2, dated September 4, 2025, revealed that the resident was cognitively impaired and dependent on staff for daily care tasks, including feeding. The resident's care plan, most recently updated September 4, 2025, indicated that the resident had increased nutrition risk related to needing to be fed by staff and having swallowing difficulties. The resident's care plan indicated that the resident was to be offered an alternative meal if she consumed less than fifty percent of the meal. The resident was to be spoon fed nectar thick liquids by staff.According to Resident 2's meal intake record, dated November 2025, the resident ate less than fifty percent for supper on November 1, for lunch on November 2, for breakfast and lunch on November 3, for breakfast and lunch on November 6, for breakfast and lunch on November 8, for dinner on November 10, for lunch on November 11, for lunch on November 14, for breakfast and lunch on November 15, for breakfast and dinner on November 16, for breakfast and lunch on November 17, for breakfast and lunch on November 18, for breakfast on November 20, and for breakfast and lunch on November 21.A nursing note for Resident 2, dated November 23, 2025 at 2:09 p.m., revealed that the resident's sister was concerned regarding her recent poor intake and lethargy. A nursing note for Resident 2, dated November 23, 2025 at 3:24 p.m. revealed that the resident was found unresponsive, in respiratory distress, and was transferred to the hospital for further evaluation.A nursing note for Resident 2, dated November 23, 2025 at 8:48 p.m. revealed that the resident was admitted to the hospital with hyponatremia (low sodium), urinary tract infection and pneumonia. There was no documented evidence that the resident was offered an alternative meal or fluids for hydration on the dates mentioned above. Interview with the Director of Nursing on February 12, 2026 at 2:14 p.m. revealed that there was no indication that Resident 2 was offered an alternative meal or fluids on those dates and that she should have been 28 Pa. Code 211.12(d)(3) Nursing services.28 Pa. Code 211.12(d)(5) Nursing services. Residents Affected - Some 395985 Page 2 of 2