Health inspection·April 22, 2025

F 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Based on the review of clinical record, facility investigation, policies and procedures interview with staff, it was determined that the facility failed to ensure resident environment was free of accident hazard related to providing appropriate technique during resident care which resulted in resident falling from the bed during care for one of five residents reviewed (Resident R1) Findings Include: Review of facility policy Fall Management Program dated December 17, 2024, revealed that The community will maintain systems designed and implemented to identify hazards and individual resident risk; evaluate hazards and risks; implement interventions to reduce hazards and risks; and monitor the effectiveness of measures implemented in an attempt to eliminate or reduce the risk of accidents as much as possible. Review of Resident R1's clinical record revealed the diagnoses of lack of coordination, unsteadiness on the feet, obesity and muscle weakness. Review of Resident R1's quarterly Minimum Data Set (MDS- assessment of resident care needs) dated January 28, 2025, revealed that the resident required partial/moderate assistance on bed mobility and required substantial/maximum assistance on transfers to and from bed to chair. MDS also revealed that substantial/maximum assistance status coding indicated helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort. Partial/moderate assistance status coding indicated helper does less than half the effort. Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort. Review of care plan for Resident R1 dated July 22, 2024, revealed that Resident R1 required assistance with ADL's (Activities of Daily Living- bed mobility/transfers/eating/dressing/bathing and hygiene) Review of facility investigation dated March 30, 2025, revealed that the nursing supervisor heard Resident R1 cry out then the Nurse Aide, Employee E3, called out that she needed help. Upon arrival resident's bed was in high position and the resident was laying on her right side with her head towards the top of the bed, she was complaining of severe right-side pain, resident stated from my shoulder to my hip. Nurse Aide, Employee E3 was in the room at the time of the incident performing morning care. Nurse Aide, Employee E3 stated she resident was holding on the half side rail used for turning and repositioning her hands slipped off the rail rolling to the floor. Further review of the investigation indicated that resident was an assist of one for bed mobility. (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 2 Event ID: 396120 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 396120 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/22/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wyncote Care Center 208 Fernbrook Avenue Wyncote, PA 19095 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)