Immaculatemarycenter For Rehabilitation&healthcare

Review of care plan for Resident R2 dated November 7, 2024, revealed that the resident had communication problems related to hearing loss/deafness and language barrier.

The interventions included communication device, use hearing aids.Review of clinical record revealed no evidence that the resident was seen by an audiologist or scheduled to visit an audiologist to manage hearing impairment or potentially replacing lost hearing aids.Review of an audiology consult report dated March 10, 2025, revealed that the audiology consult was cancelled and a comment was provided patient could not understand.

Italian is her main language.Interview with Director of Nursing, Employee E2, on September 15, 2025, at 2:30 p.m. confirmed that the resident was not seen by an audiologist and the resident did not have hearing aids.28 Pa.

Code 211.12 (d)(1)(3)(5) Nursing services28 Pa.

Code: 201.18 (b)(2) Management28 Pa.

Code: 211.10 (d) Resident care policies

395338 09/15/2025

Immaculatemarycenter for Rehabilitation&healthcare 2990 Holme Avenue Philadelphia, PA 19136

the emergency department from a doctor's appointment for wound infection.

Review of the clinical

2025, at 2:30 p.m. confirmed that the podiatry recommendations for diabetic management for Resident

Nursing services

395338 09/15/2025

Immaculatemarycenter for Rehabilitation&healthcare 2990 Holme Avenue Philadelphia, PA 19136

high-contact resident care activities to reduce the transmission of MDRO's(Multi drug Resistant

include but are not limited to Dressing, Wound care: any skin opening requiring a dressing.According to CDC (Centers for Disease Control and Prevention) guidelines Infection Control Assessment and Response (ICAR) Tool for General Infection Prevention and Control (IPC) Across Settings revealed that Wound care supplies such as dressing materials and equipment should be selected and gathered prior to entering the patient/resident care area to avoid accessing the supply cart/clean storage area during the procedure.

Only the materials needed for an individual patient/resident should be brought into the patient/resident's room or treatment area and placed on a clean surface and away from potential sources of contamination (e.g., away from splash zones of sinks) prior to beginning wound care activities.

Use an alcohol-based hand rub or wash with soap and water for the following clinical indications: Immediately before touching a patient, Before performing an aseptic task (e.g., placing an indwelling device) or handling invasive medical devices, Before moving from work on a soiled body site to a clean body site on the same patient, After touching a patient or the patient's immediate environment, After contact with blood, body fluids or contaminated surfaces, Immediately after glove removalObservation of Resident R5's room on September 15, 2025, at 10.00 a.m. revealed that the resident was sitting in a wheelchair.

Employee E4, Licensed Practical Nurse and Employee E5, Nurse Aide was observed doing wound care.

Both employees were not wearing a gown and gloves. It was observed on the resident door a sign of EBP.

Interview with Licensed nurse, Employee E3, on February 24, 2023, at 10:00 a.m., confirmed that Employee E4, and Employee E5 did not wear appropriate personal protective equipment while providing wound care for Resident R5.A wound care observation of Resident R4 on September 16, 2025, at 11:00 a.m. with Licensed nurse, Employee E6, revealed the employee placed the dressing supplies including gloves, gauze, saline bottle, border dressing and wound care medication on resident's bed at the foot of the bed. It was observed that the employee wore clean gloves, removed old dressing and wound was cleaned with saline, it was observed that the saline was dripping from the gauze to the bed while employee was cleaning the wound.Further observation of the procedure revealed that the employee removed the worn gloves and applied new gloves from the gloves that were on the bed.

There was no hand washing after the wound was cleaned and before applying the new dressing.28 Pa.

Code 201.14(a) Responsibility of licensee.28 Pa.

Code 211.12(d)(1) Nursing services