Inspection·June 20, 2025

F 0604 Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. Level of Harm - Minimal harm or potential for actual harm Based on observations; review of clinical records, policies, and procedures; and staff interviews; it was determined that the facility failed to ensure that a resident was free from physical restraints for one out of 35 residents reviewed (Resident R156). Residents Affected - Few Findings include: Review of Resident R156's clinical record revealed that the resident was admitted in the facility on June 1, 2024, with diagnoses including Unspecified Dementia, Unspecified Severity, Without Behavioral Disturbance, Psychotic Disturbance, Mood Disturbance, and Anxiety (Dementia is the loss of cognitive functioning - thinking, remembering, and reasoning - to such an extent that it interferes with a person's daily life and activities), Parkinson's Disease with Dyskinesia (neurological disorder that primarily affects movement, causing symptoms like tremors, stiffness, and slowness of movement), Anxiety Disorder (Anxiety disorders are a group of mental health conditions characterized by excessive, persistent, and uncontrollable feelings of worry and fear), and Depression (major loss of interest in pleasurable activities). Review of Resident R156's physician orders revealed an order, dated October 25, 2024, to check placement of bed alarm for placement and function every shift for safety. Review of Resident R156's care plan, revealed; Chair alarm in place, date-initiated April 18, 2025, and Bed Alarm in place while in bed. Check for proper function daily, date-initiated July 2, 2024. Review of Resident R56's Minimum Data Set (MDS- assessment of resident care needs) dated May 6, 2025, indicated that bed alarm and chair alarm were used daily. Continued review of the MDS revealed that the resident was assessed as requiring partial to moderate assistance for sit to lying in bed, sit to stand and for lying to sitting on side of bed. Observation conducted on June 17, 2025, at 12: 36 p.m., revealed that Resident R156's has a bed alarm in placed. Review of Resident R156's clinical records of Resident R156 revealed no documented evidence that the resident was evaluated for the use of a chair/bed alarm. Interview with Employee E6, the Unit Manager, a Registered Nurse, on June 17, 2025, at 12:39 p.m., confirmed the findings. 28 Pa Code 211.8(f) Use of restraints 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 6 Event ID: 396078 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 396078 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/20/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Horsham Center for Jewish Life 1425 Horsham Road North Wales, PA 19454 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)