Susquehanna Health And Wellness Center
SUSQUEHANNA HEALTH AND WELLNESS CENTER in COLUMBIA, PA — inspection on March 31, 2026.
Found 1 citation. 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
Review of documentation provided by the facility indicated LPN Employee E3 was suspended and will return to assignment once additional mentoring and a medication administration is completed.
Review of Resident R1's hospital records dated March 21, 2026, revealed Resident R1 was admitted on [DATE].
Hospital record revealed under section Impression/Plan Accidental drug ingestion: pt (patient) residents at Susquehanna N&R (Nursing&Rehabilitation) and was accidentally given (his/her) roommates medications including Ativan (lorazepam), Keppra (levetiracetam), Gabapentin, Morphine, and Xcorpi with resultant lethargy and hypotension.
Improving with Narcan, IVF (intravenous fluids) and time.
Monitor Telemetry.
May need additional fluids and reversal agents.
Interview conducted with the Nursing Home Administrator on March 31, 2026, at 12:30pm confirmed the above findings.
The facility self-identified the deficient practice at the time of the incident, March 21, 2026.
The facility implemented a corrective action of education and medication pass audits.
The facility's immediate action plan included the following: QAPI (Quality Assurance Performance Improvement) conducted March 21, 2026.
Reviewed LPN Employee E3's file to ensure she had received education on Medication Administration prior to the incident.
This was verified as completed on March 19, 2026.
Evaluated all other residents on the same unit as Resident R1 who had received medication from Employee E3 to observe for adverse effects, which included obtaining vitals.
This was verified and completed March 21, 2026.
Education was initiated for all facility nursing on the policy of Medication Administration, which includes proper identification of residents prior to medication administration and documentation of medication administration.
All nurses completed training by March 23, 2026.
Education was completed on March 23, 2026, by the DON (Director of Nursing) with RN supervisor Employee E4 regarding notification of the DON for significant medication errors and the RN's ability to transfer a resident to the hospital when a significant change in condition is noted.
Medication pass audits for competency will be completed by all current licensed nurses.
This was verified and completed March 28, 2026.
During an interview on March 31, 2026, at 10:20 a.m. LPN Employee E5 verified he received education on Medication Administration and was able to verbalize understanding.
During an interview March 31, 2026, at 10:30a.m. RN Employee E6 verified that she had received education on Medication Administration and was able to verbalize understanding.
During an interview on March 31, 2026, at 10:40 a.m. LPN Employee E7 verified that she had received education on Medication Administration and was able to verbalize understanding.
She added that all residents have an updated picture in their chart, and that if you cannot identify the resident, you can ask another staff member.
The facility has demonstrated compliance with the above since March 28, 2026.28 Pa Code 201.18(b)(1)(e)(1) Management28 Pa Code: 211.10 (c) Resident care policies
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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.