Health inspection·April 26, 2024

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, clinical record review, and staff interview, it was determined that the facility failed to ensure that a dignified environment, care, and services were provided to promote quality of life on three of three nursing units and in the dining room for four residents in one of three dining rooms. (Resident 1, 9, 64, 95) Findings include: Observation on the Cloister nursing unit on April 23 and 24, 2024, revealed a white board in the dining room displaying the date of April 20, 2024, and activities listed for that day. Observation on the Sub-Acute nursing unit on April 23 and 24, 2024, revealed the white boards in the residents' rooms displaying the date of April 20, 2024, and the staff listed for that day. Clinical record review revealed that Resident 1 had diagnoses that included dementia and depression. Review of Resident 1's current care plan revealed that the resident was on a restorative nursing program for dining and needed supervision and occasional assistance with meals. Observation on April 23, 2024, from 12:25 p.m. through 12:55 p.m., revealed Resident 1 in the dining room eating chicken parmesan with spaghetti noodles and Italian vegetables with his fingers. At no time did staff redirect or offer assistance to Resident 1. Clinical record review revealed that Resident 9 had diagnoses that included dementia and Alzheimer's disease. Review of the Minimum Data Set (MDS) assessment, dated February 9, 2024, revealed that the resident had cognitive impairment, and required supervision or touch assistance with eating. Review of the current care plan revealed that Resident 9 was on a restorative nursing program for dining and needed supervision and staff cueing. On April 23, 2024, from 12:25 p.m. through 12:55 p.m., Resident 9 was observed eating spaghetti noodles, chicken, and Italian vegetables with her fingers. At no time did staff redirect or offer assistance to Resident 9. Clinical record review revealed that Resident 64 had diagnoses that included dementia and depression. Review the resident's current care plan revealed that Resident 64 was on a restorative nursing program for dining and staff was to provide assistance as needed. Observation on April 23, 2024, from 12:25 p.m. through 12:55 p.m., revealed Resident 64 eating chicken parmesan with spaghetti noodles and Italian vegetables with her fingers. Observation on April 24, 2024, from 12:25 p.m. through 12:45 p.m., revealed Resident 64 eating chicken and vegetables with her fingers. At no time did staff redirect or offer assistance to Resident 64. (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 7 Event ID: 396063 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 396063 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/26/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Seton Manor Nursing and Rehabilitation Center 1000 Seton Drive Orwigsburg, PA 17961 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)