Cadia Rehabilitation Broadmeadow
CADIA REHABILITATION BROADMEADOW in MIDDLETOWN, DE — inspection on May 29, 2026.
Found 4 citations. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
authorities.
reviewed for abuse and injury of unknown origin, the facility failed to recognize and consequently
R5 was admitted to the facility. 5/1/26 11:45 PM - An admission assessment documented the following skin conditions for R5: right elbow skin tear closed; coccyx (tail bone) redness; left forearm skin tear with dressing in place (unable to assess); multiple discolorations to bilateral upper extremities and right chest; redness to sacrum (buttocks); right forearm closed skin tear with scabbed area; small discoloration to bilateral lower extremities; upper arm skin tear with transparent dressing in place. 5/14/26 1:22 PM - A weekly skin assessment documented the following skin conditions for R5: bruising to face, upper chest, and bilateral upper extremities; fading bruises bilateral lower extremities, abdomen, and bilateral tops of feet; skin tear left upper extremity; Multiple scabs to bilateral upper extremities; redness to sacrum; and scab left lower and upper lip. 5/28/26 2:22 PM -
During an interview, E33 (LPN) stated she completed the skin check on R5 and recalled having faded bruises on the abdomen. E33 stated the expectation was when staff identifies a new skin area to document on the skin assessment, initiate risk management (internal incident report), initiate treatment and notify management. 5/29/26 11:24 AM -
During an interview, E34 (LPN) stated that he completed the admission assessment for R5 and any skin areas noted on admission would have been documented in the assessment. E34 stated he recalled R5 having multiple areas noted to bilateral arms and bilateral legs. E34 stated he did not recall seeing any bruises noted on the abdomen when the assessment was completed and also stated he would have a CNA complete the skin assessment so all areas would be identified. 5/29/26 12:00 PM -
During an interview, E3 (ADON) stated that an internal risk management report was not initiated for any skin areas for R5.Based on interview and review of clinical records it is unclear if R5 had abdominal bruising noted on admission or if the bruising occurred between 5/1/26 and 5/14/26 when it was identified.
The facility lacked evidence that an injury of unknown origin was reported to the State Agency. 5/29/26 2:15 PM - Findings were reviewed with E1 (NHA) and E2 (DON) during the exit conference.
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 TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE
085050 05/29/2026
Cadia Rehabilitation Broadmeadow 500 South Broad Street Middletown, DE 19709
actions that can be measured.
reviewed for dysphagia, the failed to develop a person - centered care plan to address R1's identified
R1 was admitted to the facility with diagnoses including stroke, GERD, dysphagia.1/26/24 - During an initial Speech Evaluation, R1 was observed to be at risk for aspiration during PO (by mouth) intake.
Strategies and/or maneuvers for safe oral intake were identified by the speech therapist including alternation of liquid/solids, general swallow techniques/precautions, cyclic ingestion technique, rate modification and bolus size modifications upright posture during meals and upright posture for > (more) 30 mins (minutes) after meals.11/24/24 - A Speech Therapy Treatment Note documented R1 verbalized to both the speech therapist and his primary nurse that he has had some trouble tolerating his medications within the last 5 days. 12/3/24 - A Speech Therapy Note documented . [R1] reports to have occasional episodes of larger pills being struck, however, indicating towards proximal region of esophagus and states that with multiple intake of water is able to clear medications and reports when in seated in WC (wheelchair) is able to tolerate it better .educated patient to be seated upright in wheelchair for the medication if possible .
Educated [R1] on the risk of aspiration/choking and reviewed on safe swallow strategies to be implemented with meals and medication mainly small sips/bites, slow rate, upright seating, and alternate solids/liquids, additionally, medication may be taken with puree consistency as well.12/12/24 - A Speech Discharge Summary for R1 documented that it was recommended for R1 to use the following strategies and/or maneuvers during oral intake: general swallow techniques/precautions upright posture during meals and upright posture for > 30 minutes after meals. 5/19/26 11:35 AM - In an interview, E19 (LPN) stated, [R1] eats in the dining room or sometimes in his bed, based on his preference. I am not aware that he has any issues with eating or that he eats very fast. I did not know about his swallowing precaution instructions.5/19/26 11:50 AM -
During an interview, E16 (RN, UM) stated, I never saw him having trouble with chewing or swallowing .Monitoring for signs of dysphagia did not necessarily mean it will be acted or documented in the task.
Staff observations will be documented if necessary. I did not know about his swallowing precaution instructions.
Nothing was reported to me by the staff so there was nothing to document - intervention stated, ?monitor as needed' only.5/19/26 10:19 AM - In an interview, E18 (CAN) stated There were no instructions in his task in our computer to tell me what to watch out or monitor or even say that he should eat in the dining room all the time so he can be observed. I did not know about his swallowing precaution instructions. 5/27/26 1:55 PM -
During an interview, E20, stated that [R1] was always eating fast . I was with the impression that nurses and the other CNAs are aware that he eats so fast and puts a lot of food in his mouth at a fast rate that he could have trouble chewing that's why we keep him in the dining room so we can all watch and remind him to slowdown and eat smaller bites. I witnessed him cough before while in the middle of eating. I don't sign it off in our CNA task as it's not indicated for us to sign.
There were no instructions for us to watch him closely for signs and symptoms of choking or that he has to take small bites and alternate his meal with water or anything liquid. I think it would have been helpful if the instructions were clearly added in our CNA task so we can all be aware specially those who are working part time or PRN who may not know a lot about the residents. It would have been better if those specific swallow precautions/ instructions and unsafe eating and feeding behaviors were documented as task for all of us to now. 5/29/26 2:00 PM - Findings were discussed with E1 (NHA) and E2 (DON).5/29/26 2:15 PM - Findings were reviewed with E1 and E2 during the Exit Conference.
085050 05/29/2026
Cadia Rehabilitation Broadmeadow 500 South Broad Street Middletown, DE 19709
quality by having Licensed Practical Nurses (LPN) complete admission assessments.
Findings
Assessments * - RN .* = Once a care plan is established, the LPN may do assessments .Review of R5's clinical record revealed:5/1/26 - R5 was admitted to the facility. 5/1/26 11:45 PM - An admission assessment documented the following skin conditions for R5: right elbow skin tear closed; coccyx (tail bone) redness; left forearm skin tear with dressing in place (unable to assess); multiple discolorations to bilateral upper extremities and right chest; redness to sacrum (buttocks); right forearm closed skin tear with scabbed area; small discoloration to bilateral lower extremities; upper arm skin tear with transparent dressing in place. 5/29/26 11:24 AM -
During an interview, E34 (LPN) stated that he completed the admission assessment for R5 and any skin areas noted on admission would have been documented in the assessment. E34 stated he recalled R5 having multiple areas noted to bilateral arms and bilateral legs. E34 stated he did not recall seeing any bruises noted on the abdomen when the assessment was completed and also stated he would have a CNA complete the skin assessment so all areas would be identified. 5/29/26 10:47 AM -
During an interview, E16 (RN) stated that the nurse assigned to the resident's room is responsible to complete the following assessments: fall risk, pain, skin, braden, oral and full admission assessment when the resident is admitted . E16 stated that an LPN can not complete an admission assessment without an RN oversight. 5/29/26 11:53 AM -
During an interview, E36 (RN) stated that she was working on 5/1/26 when R5 was admitted and was responsible for inputting new physician orders into the system. E36 confirmed that she did not complete any assessments when R5 was admitted . 5/29/26 2:15 PM - Findings were reviewed with E1 (NHA) and E2 (DON) during the exit conference.
085050 05/29/2026
Cadia Rehabilitation Broadmeadow 500 South Broad Street Middletown, DE 19709
residents. 5/29/26 - In a telephone interview, E9 (former part time SLP) stated that it's been a long
jeopardy to resident health or therapy session on 12/3/24. E9 stated that what she wrote on her notes where shared to the nursing safety staff. E9 further stated, When we find somethings, we notify the nurses and the Rehab Director verbally or in writing.the expectation was for the nurses to share the information such as swallowing
no issues with oropharyngeal but .when he complained of occasional larger pills being stuck in his throat. it was near the esophagus and that was the reason why I recommended for a GI consult for esophageal dysphagia evaluation - and R1 also had GERD.
The GI specialists are the ones looking into this.
With [R1] saying that with multiple intakes of water he was able to clear medications and when seated in wheelchair he was able to tolerate it better . he had to be cued and reminded of the safe swallow strategies with meals and medications [small sips/bites, slow rate, upright seating, and alternate solids/liquids]. 5/29/26 2:00 PM - Findings were discussed with E1 (NHA) and E2 (DON).5/29/26 2:15 PM - Findings were reviewed with E1 NHA and E2 DON during the Exit Conference.
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Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.
Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.
Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.