Health inspection·April 5, 2023

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on a review of facility policies and clinical records, as well as staff interviews, it was determined that the facility failed to obtain weights as ordered by the physician for eight of 11 residents reviewed (Residents 2, 6, 7, 9, 10, 12, 13, 14). Residents Affected - Some Findings include: The facility's policy for weights, dated March 16, 2023, indicated that upon admission, residents would have an admission weight done to record baseline weight. Residents will then be set up on a biweekly weight schedule unless otherwise ordered by physician or deemed necessary by registered nurse. All weights would be documented in the electronic record and on the report sheet. Physician's orders for Resident 2, dated March 22, 2023, included and order for the resident to be weighed every Wednesday and Saturday. A review of Resident 2's weight records from admission on [DATE], to April 5, 2023, revealed that the resident was not weighed three out of three days. Physician's orders for Resident 6, dated March 29, 2023, included an order for the resident to be weighed daily. A review of Resident 6's weight records from admission on [DATE], until April 5, 2023, revealed that the resident was not weighed seven out of seven days. Physician's orders for Resident 7, dated March 28, 2023, included an order for the resident to be weighed on Tuesdays and Fridays. A review of Resident 7's weight records from admission on [DATE], to April 5, 2023, revealed that the resident was not weighed two out of two days. Physician's orders for Resident 9, dated March 25, 2023, included an order for the resident to be weighed on Wednesday and Saturdays. A review of Resident 9's weight records from admission on [DATE], to April 5, 2023, revealed that the resident was not weighed three out of three days. Physician's orders for Resident 10, dated March 18, 2023, included an order for the resident to be weighed on Wednesday and Saturdays. A review of Resident 10's weight records from admission on [DATE], to April 5, 2023, revealed that the resident was not weighed five out of five days. Physician's orders for Resident 12, dated March 30, 2023, included an order for the resident to be weighed every Monday and Thursday. A review of Resident 12's weight records from admission on [DATE], to April 5, 2023, revealed that the resident was not weighed two out of two days. (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: 396102 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 396102 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/05/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Conemaugh Memorial Medical Center Tcu 320 Main Street Johnstown, PA 15901 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)