Amoroso Healthcare And Rehabilitation Woodridge

F 0627 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

indicated that Resident 1 was provided her medications, medication summary, and discharge paperwork, which was explained to Resident 1 and her family. The note failed to indicate Resident 1's living arrangement post discharge. Review of Resident 1's clinical record revealed no evidence that her discharge destination was identified or assessed to ensure it would meet Resident 1's health and safety needs, that a member of the interdisciplinary team had reviewed the final discharge plan with the Resident and Representative or family at least 24 hours before her discharge, that home health services or private duty services were set up prior to Resident 1's discharge from the facility, or that her Discharge Summary was provided to her care providers for continuity of care purposes. Review of Resident 1's facility Discharge summary dated [DATE REDACTED], at 2:40 PM, but with actual discharge date of Resident left blank, indicated that the reason for Resident 35's admission to the facility was falls. The instructions indicated that the form and the Order Summary Report must be printed and given to the Resident/Responsible Party upon discharge, and that it must be documented in the progress notes that these items were given to the resident. Further

review of Resident 1's facility Discharge Summary revealed in the Social Services section that Resident 35 was documented as being occasionally confused; needing occasional cueing; was being discharged home alone and not with a relative or friend; that a referral for home health was made on September 29, 2025, with an order summary sent to the accepting agency; and that she needed to follow up with her primary care physician in 7-10 days after discharge. There was no documentation noted that included the name or contact information for the home health agency or for her primary care physician.Further review of Resident 1's facility Discharge Summary revealed in the Nursing section that Resident 1 ambulated with a walker, needed assistance with activities of daily living, and that the discharge instructions were provided to Resident 1 as family member/representative was not marked. This section failed to include any documentation about Resident 1 having an unresponsive episode or that this could be a possible care concern at home.Further review of Resident 1's facility Discharge Summary revealed in the Dietary Services section was incomplete except for documentation of Resident 1's admission height and weight.Further review of Resident 1's facility Discharge Summary revealed in the Rehabilitation Services section that she was able to ambulate 250 feet with a rolling walker and stand-by assistance; able to negotiate 8 steps with bilateral handrails and stand-by assistance; that she needed stand-by assist with transfers, dressing, and toileting needs with cueing for completion of tasks; and that she needed minimal assistance with light meal prep.During an interview with the NHA and the Director of Nursing (DON) on October 21, 2025, at 1:25 AM, the NHA indicated that at the time of Resident 1's discharge, that he and the facility admission Coordinator were covering Social Service activities as the facility was in the process of hiring a new Social Worker. He said that he had just spoken to the Admissions Coordinator and she indicated that she had forgotten to document the home health referral information for Resident 1. He further indicated that he was aware that Resident 1's Representative (which he identified as a friend of Resident 1) had wanted Resident 1 to apply for a waiver program to receive care assistance at home, but that Resident 1 did not qualify financially. He said that he provided Resident 1's Representative with a list of private duty care providers that she could contact for care assistance at home. He confirmed that he was not aware if

this was set up by Resident 1's Representative or not at time of Resident 1's discharge from the facility. He further confirmed that there was no documentation of a review of Resident 1's discharge plan or the assessment of it to determine if Resident 1 would have all necessary measures in place that she required to be safe. 28 Pa. Code 201.14(a) Responsibility of licensee28 Pa. Code 201.18(b)(1) Management28 Pa.

Code 211.12(d)(1)(3)(5) Nursing services

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Printed: 04/13/2026 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

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

11/24/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Amoroso Healthcare and Rehabilitation Woodridge

3625 North Progress Ave Harrisburg, PA 17110

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)

F 0745 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

was explained to Resident 1 and her family. The note failed to indicate Resident 1's living arrangement post discharge or any information about services that had been organized for her transition back to the community.During an interview with the NHA and the Director of Nursing (DON) on October 21, 2025, at 1:25 AM, the NHA indicated that at the time of Resident 1's discharge, that he and the facility admission Coordinator were covering social service activities as the facility was in the process of hiring a new Social Worker. He said that he had just spoken to the Admissions Coordinator and she indicated that she had forgotten to document the home health referral information for Resident 1. He further indicated that he was aware that Resident 1's Representative (which he identified as a friend of Resident 1) had wanted Resident 1 to apply for a waiver program to receive care assistance at home, but that Resident 1 did not qualify financially. He said that he provided Resident 1's Representative with a list of private duty care providers that she could contact for care assistance at home. He confirmed that he was not aware if this was set up by Resident 1's Representative or not at time of Resident 1's discharge from the facility. He further confirmed that there was no documentation of a review of Resident 1's discharge plan or the assessment of

the discharge plan to determine if Resident 1 would have all necessary measures in place that she required to be safe. He also confirmed that no social services assessment was completed during Resident 1's stay at the facility between September 11, 2025, and October 2, 2025, which would have helped with her discharge planning. He revealed that a new social worker had been hired on October 7, 2025. 28 Pa. Code 201.14(a) Responsibility of licensee28 Pa. Code 201.18 (b)(1)(3) Management28 Pa. Code 211.12(d)(1)(3)(5) Nursing services

Event ID:

Facility ID:

If continuation sheet