Health inspection·January 22, 2026

F 0552 Ensure that residents are fully informed and understand their health status, care and treatments. Level of Harm - Minimal harm or potential for actual harm Based on clinical record review and staff interview, it was determined that the facility failed to discuss the risks/benefits and obtain consent for psychotropic medications for two of two resident records reviewed (Residents 48 and 49).Findings include: Review of Resident 48's clinical record revealed diagnoses that included major depressive disorder severe with psychotic features (a severe form of depression characterized by the presence of psychotic symptoms, such as hallucinations or delusions, alongside typical depressive symptoms) and generalized anxiety disorder (a mental health condition that causes fear, a constant feeling of being overwhelmed and excessive worry about everyday things). Review of Resident 48's physician's orders revealed the use of quetiapine (an antipsychotic medication) with an ordered date of April 15, 2025; and lorazepam (an antianxiety medication) with an ordered date of October 17, 2025. Review of Resident 48's physician order history revealed that he had been on these types of medications since January 24, 2025. Review of Resident 48's clinical record revealed a Psychotropic Medication Treatment Consent, which indicated that Resident 48 was being treated for Tracheotomy/Brain Damage and the medications being used line was blank. The consent was signed by Resident 48's Representative on September 9, 2024. Further review of Resident 48's clinical record failed to reveal any documentation of the facility providing education to the Resident or Representative of the risks and benefits associated with the use of the antipsychotic and antianxiety medications, including side effects and other adverse reactions. Review of Resident 49's clinical record revealed diagnoses that included schizoaffective disorder bipolar type (schizoaffective disorder is a mental health condition that is marked by a mix of schizophrenia symptoms, such as hallucinations and delusions, and mood disorder symptoms, such as depression, mania and a milder form of mania called hypomania; bipolar type includes bouts of hypomania or mania and sometimes major depression), generalized anxiety disorder, and major depressive disorder. Review of Resident 49's physician's orders revealed the use of olanzapine (an antipsychotic medication) with an ordered date of March 5, 2024; buspirone (an antianxiety medication) with an ordered date of October 23, 2025; and escitalopram (an antidepressant medication) with an ordered date of July 30, 2025. Review of Resident 49's clinical record revealed a Psychotropic Medication Treatment Consent, which revealed that the condition Resident 49 was being treated for and the medications being used were blank. The consent was signed by Resident 49's Representative on July 16, 2021. Further review of Resident 49's clinical record failed to reveal any documentation of the facility providing education to Resident 49 or his Representative of the risks and benefits associated with the use of the antipsychotic, antianxiety, or antidepressant medications, including side effects and other adverse reactions. During a staff interview with the Nursing Home Administrator (NHA) and the Director of Nursing on January 22, 2026, at 11:20 AM, the NHA indicated that the facility practice was to have the Resident or their Representative sign the Psychotropic Medication Treatment Consent as part of the admission process to the facility. He further indicated that the facility practice was not to get another consent signed. He said Residents Affected - Some (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: 396122 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 396122 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/22/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Fox Subacute at Mechanicsburg 120 South Filbert St Mechanicsburg, PA 17055 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)