Neffsville Nursing And Rehabilitation

Based on facility documentation, clinical records review and staff interview, it was determined that the facility failed to provide care and services in accordance with professional standards when the facility failed to notify the physician of recommendations following a specialist consultation for one out of 1 resident reviewed (Resident 2).

Review of Resident 2's clinical records reveal medical diagnoses that include: Spina bifida (a birth defect that mainly affects the spine), hydrocephalus (a complication that can be associated with spina bifida causing the abnormal buildup of the fluid that surrounds the brain), neurogenic bladder (a problem with the brain, nerves, or spinal column that causes loss of control of the bladder that can be associated with spina bifida), and neurogenic bowel (difficulty moving or controlling the bowels because of nerve damage that can be associated with spina bifida).Review of Resident 2's clinical record revealed an after-visit summary dated January 3, 2025 from a Spina bifida specialist to the attention of the Nursing Supervisor stating: Please see attached order for daily SS enema (soap suds enema: a medical procedure that involves administering fluid with soap or mild detergent into the rectum to flush out the contents of the bowel.)Review of Resident 2's clinical record revealed the following order recommendation from the provider at Spina Bifida Specialist: Perform a rectal soap suds enema daily with 300-500mL warm, soapy water, with a diagnosis of Neurogenic bowel to be started on 1/24/25.Review of Resident 2's facility record reveals no progress note reflecting Resident 2's consultation with the Spina Bifida clinic.Review of Resident 2's facility record reveals no contact with Resident 2's primary care provider communicating these new orders.Review of Resident 2's physician's history and physical note dated 2/26/2025 does not reflect being informed of any consultation recommendations.Review of resident 2's medication administration record (MAR) reveal that no order was entered for a soap suds enema to be started on January 24, 2025.During an interview on September 10, 2025 at approximately 2:00 p.m. with the DON, it was confirmed that there is no evidence that the consultation recommendations were addressed with the primary care provider for Resident 2.28 Pa Code 211.12(d)(5) Nursing Services

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

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

09/10/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Neffsville Nursing and Rehabilitation

2829 Lititz Pike Lancaster, PA 17601

SUMMARY STATEMENT OF DEFICIENCIES