The Residence at Bala Cynwyd.

“An uncovered, unattended 3/4 full trash can was found in the secured dementia care unit kitchenette at 9:23 A.M., which fails to prevent penetration of insects and rodents.”

“Bedside mobility device had an opening of approximately 10 inches wide and 3.5 inches high, which exceeds FDA guidelines for entrapment. The device was loosely covered and not installed/maintained according to manufacturer's instructions.”

“Poisonous materials (Green Scene Squeaky Clean and Scrubbing Bubbles bleach cleaner) were stored on counter in secured dementia care unit kitchenette next to food items including syrup and sugar.”

“Uncovered serving trays containing bacon, eggs, pancakes, sausage links, and breakfast potatoes were stored in the hot bar in the secured dementia care unit kitchenette at 9:25 A.M., exposing food to contamination.”

“Multiple unlabeled and undated food items were found in kitchenette and kitchen storage areas, including crackers, chips, ice cream, fruit, pasta, sauce, cheese, and flour, making it impossible to determine expiration dates.”

“Combustible and flammable materials (cake in cardboard box, iPad, and walkie-talkie) were stored on the secured dementia care unit kitchenette's electric stove, creating a fire hazard.”

“A resident's medical evaluation was not completed within 60 days prior to admission or within 30 days after admission, violating required physician evaluation timelines.”

“Two self-administering residents had medication record deficiencies: one resident's record lacked a current medication list, and another resident's record did not reflect that prescribed medication had been discontinued and should have been removed from the room.”

“Resident's status change assessment for bedside mobility device did not include the specific need for the device, intended use and risks, resident's ability to use safely, device identification, and FDA cover requirements.”

“Resident admitted to Secured Dementia Care Unit had a medical evaluation that did not include documentation of the need for the resident to be served in a secured dementia care unit.”

“A resident requiring assistance with transferring was left unattended in a parked van for approximately 3 hours after a scenic drive outing. Staff became distracted by other residents exiting and forgot to prompt the resident to leave the vehicle. The van was parked in direct sunlight with no weather protection.”

“A resident requiring extensive supervision outside the home and staff accompaniment when leaving the neighborhood was left unattended in a van for approximately 3 hours after a community outing, in violation of their support plan requirements.”

“A resident with cognitive impairment requiring supervision and assistance with transferring was forgotten and left alone in a hot van for approximately 3 hours (02:53 PM to 05:39 PM) following a scenic drive outing. The van had no weather protection and reached internal temperatures potentially exceeding 120°F on a 94°F day. The resident was hospitalized with a body temperature of 102.6°F and later discharged to a skilled nursing facility. This constitutes substantiated neglect.”

“A resident admitted to the Secured Dementia Care Unit had a written cognitive preadmission screening completed, but the cognitive diagnosis section of the Department's preadmission screening form was left blank.”

“A resident's medical evaluation indicated a need for restricted lactose diet, but the resident's assessment and support plan did not document how this dietary need would be met.”

“Staff person denied a resident's designated person access to the resident's record, violating the resident's right to have their designated person access and review records.”

“A resident sitting in a wheelchair was strapped to the chair with a waistband belt by a private duty aide. Staff confirmed this was not the first occurrence and family had previously been told not to provide such a belt.”

“Direct care staff person F does not have a high school diploma, GED, or active registry status on the Pennsylvania nurse aide registry as required by regulation.”

“A tube of Crest toothpaste with a manufacturer's label indicating 'contact poison control' was unlocked, unattended, and accessible to residents. Not all residents in the home, including the specified resident, have been assessed as capable of recognizing and using poisons safely.”

“A resident sitting in a wheelchair inside their apartment was strapped to the chair with a waistband belt by a private duty aide, which is a prohibited procedure. The aide unclicked the belt immediately upon the inspector entering the room.”

“The first aid kits in the kitchen and behind the front desk did not include a thermometer, and staff could not locate a complete first aid kit.”

“The bedside lamp in room 215 could not be turned on.”

“Tupperware containers of corn and tuna were found in the kitchen refrigerator that were labeled but undated.”

“The home's menu for the current week (8/18-8/24/2024) was posted, but the menu for the week in advance was not posted in a conspicuous and public place.”

“Resident's contract contained a statement acknowledging receipt of resident rights, but the resident's signature line had been effaced with correction fluid.”

“One ceiling tile had been removed due to water damage from a roof leak, with a bucket of water placed in the middle of the hallway to contain the leaking.”

“Two prescribed medications for residents were not available on the medication cart on the date of inspection.”

“Correction fluid was used to efface a resident's signature on the list of resident rights in the resident's contract, violating the requirement that records be permanent and legible.”

“The home failed to immediately report suspected abuse of residents to the Area Agency on Aging. A letter alleging verbal and physical abuse involving two residents was found but not reported as required by the Older Adult Protective Services Act.”

“The home failed to immediately report suspected abuse of residents to the Area Agency on Aging. A letter alleging verbal and physical abuse involving two residents was found but not reported as required by the Older Adult Protective Services Act.”

“The home failed to report a significant fall-related injury to the Department within 24 hours. A resident who had an unwitnessed fall was later diagnosed with a closed fracture of multiple ribs on the right side but the incident was not reported to the department.”

“A resident admitted to the Secured Dementia Care Unit had their written cognitive preadmission screening completed after the required 72-hour period prior to admission. The screening must be completed within 72 hours before admission as required by regulation.”

“The home failed to report a significant fall-related injury to the Department within 24 hours. A resident who had an unwitnessed fall was later diagnosed with a closed fracture of multiple ribs on the right side but the incident was not reported to the department.”

“A resident admitted to the Secured Dementia Care Unit had their written cognitive preadmission screening completed after the required 72-hour period prior to admission. The screening must be completed within 72 hours before admission as required by regulation.”

“Emergency telephone numbers for the nearest hospital and fire department were not posted on or by telephones in bedrooms 202 and 406.”

“Memory care freezer temperature was 6 degrees Fahrenheit (should be at or below 0°F) and walk-in freezer temperature was 10 degrees Fahrenheit (should be at or below 0°F) on 6/26/23.”

“Medication administration records were not properly documented at the time medications were administered, including missing staff initials, missing MAR documentation, missing controlled substance log documentation, and delayed MAR documentation.”