Health inspection·December 15, 2023

F 0572 Give residents a notice of rights, rules, services and charges. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of facility residents record, review of facility documentation, and interviews with staff, it was determined that the facility failed to inform residents of their rights, rules, regulations, and responsibilities prior to and/or upon the resident's admission for nine out of 34 residents reviewed. (R1, R2, R6, R7, R10, R18, R35, R36, R37) Residents Affected - Some Findings Include: Review of facility documentation given to residents titled, Your Rights and Protections as a Nursing Home Resident undated revealed What are my rights in a nursing home? As a nursing home resident, you have certain rights and protections under Federal and state law that help ensure you get the care and services you need. You have the right to be informed, make your own decisions, and have your personal information kept private. The nursing home must tell you about these rights and explain them in writing in a language you understand. They must explain in writing how you should act and what you're responsible for while you're in a the nursing home. This must be done before or at the time you're admitted , as well as during your stay. You must acknowledge in writing that you got this information. Review of Residents R1, R2, R6, R7, R10, R18, R35, R36, R37's clinical records revealed no documented evidence that the resident rights and resident conduct and responsibilities were reviewed during the residents' stay as follows: Review of thirty-four resident records revealed one out of thirty-four did not have resident rights reviewed upon admission. (R1) Review of Resident R1's clinical record revealed that the resident was admitted on [DATE]. There was no documented evidence that the resident rights not reviewed until December 14, 2023 with Resident R1's wife. Review of Resident R36's clinical record revealed an admission date of June 24, 2018. There was no documented evidence that the resident rights were reviewed again with the resident until December 14, 2023. Review of Resident R10's clinical record revealed an admission date of November 18, 2021. There was no document evidence that the resident rights were reviewed again with the resident until December 14, 2023. Review of Reisdent R37's clinical record revealed an admission date of October 14, 2020. There was (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 8 Event ID: 396107 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 396107 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/15/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Ann's Choice 16000 Ann's Choice Way Warminster, PA 18974 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)