Pennsylvania Department of Health
CHAPEL MANOR
Patient Care Inspection Results

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Severity Designations


Minimal Citation - No Harm	Minimal Harm	Actual Harm	Serious Harm

CHAPEL MANOR
Inspection Results For:

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CHAPEL MANOR - Inspection Results	Scope of Citation Number of Residents Affected By Deficient Practice

Initial comments:Based on a Medicare/Medicaid Recertification Survey, Civil Rights Compliance Survey, State Licensure Survey and an Abbreviated survey in response to one complaint, completed on June 26, 2026, it was determined that Chapel Manor, was not in compliance with the requirements of 42 CFR part 483, Subpart B, Requirements for Long Term Care Facilities and the 28 PA Code, Commonwealth of Pennsylvania Long Term Care Licensure Regulations related to the health portion of the survey process.

Plan of Correction:

483.60(d)(1)(2) REQUIREMENT Nutritive Value/Appear, Palatable/Prefer Temp:

This is a less serious (but not lowest level) deficiency and affects more than a limited number of residents, staff, or occurrences. This deficiency is one that results in minimal discomfort to the resident or has the potential (not yet realized) to negatively affect the resident's ability to achieve his/her highest functional status. This deficiency was not found to be throughout this facility.

�483.60(d) Food and drink
Each resident receives and the facility provides-

�483.60(d)(1) Food prepared by methods that conserve nutritive value, flavor, and appearance;

�483.60(d)(2) Food and drink that is palatable, attractive, and at a safe and appetizing temperature.

Observations:
Based on observations, facility policy, and resident and staff interviews, it was determined that the facility failed to provide food and drink that were served at palatable temperatures for one of one meal tray tested on the first floor nursing unit.

Findings include:

Review of facility policy "Food: Preparation", revised 2026, revealed all foods will be held at appropriate temperatures, greater than 135 Fahrenheit (F) (or as state regulation requires) for hot holding, and less than 41 F for cold food holding.

Interview with Resident R154 on June 23, 2026, at 11:00 a.m. revealed "food always served cold".

Interview with Resident R113 on June 23, 2026 at 11:05 a.m. revealed " food is cold, they took away the microwave so we have no choice but to eat it cold now".

Interview with Resident R83 on June 23, 2025 at 11:10 a.m. revealed "food is terrible, it is always cold".

Interview with Resident R14 on June 23, 2025 at 11:15 a.m. revealed "food could be better, sometimes it is cold".

Interview with Resident R137 on June 24, 2026 at 12:05 p.m. revealed " food tends to be served on the colder side a lot".

Observation of test tray on June 24, 2026, at 12:10 p.m. with Food Service Director, Employee E11, revealed the following food temperatures:

Tomato Stew- 122 F
Ham- 105 F
Macaroni and Cheese- 100 F
Apple Juice- 48 F

Follow-up interview with Food Service Director, Employee E11, at 12:12 p.m. confirmed that these food items were outside the acceptable temperature range and therefore not palatable.

28 Pa. Code 201.14(a) Responsibility of licensee

28 Pa. Code 201.18(b)(3) Management

Plan of Correction - To be completed: 08/12/2026

1.The meal tray that was cited was replaced with food that met acceptable temperatures.

2.Food Service Director educated dietary staff on proper food holding temperatures, and the importance of serving food at palatable temperatures.

3. The Food Service Director/designee will take food temperatures at the beginning and the middle of the tray line service to ensure food temperatures are maintained at appropriate temperatures. FSD will notify each nursing unit when food trucks arrive on the unit to ensure distribution of trays is timely.

4.Food Service Director/Designee will complete weekly random temperatures audits at Point of Service x 4 weeks then monthly X 2

5.Food Service Director will report the audit results to QAPI monthly x3.

483.10(i)(1)-(7) REQUIREMENT Safe/Clean/Comfortable/Homelike Environment:

This is a less serious (but not lowest level) deficiency and is isolated to the fewest number of residents, staff, or occurrences. This deficiency is one that results in minimal discomfort to the resident or has the potential (not yet realized) to negatively affect the resident's ability to achieve his/her highest functional status.

�483.10(i) Safe Environment.
The resident has a right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

The facility must provide-
�483.10(i)(1) A safe, clean, comfortable, and homelike environment, allowing the resident to use his or her personal belongings to the extent possible.
(i) This includes ensuring that the resident can receive care and services safely and that the physical layout of the facility maximizes resident independence and does not pose a safety risk.
(ii) The facility shall exercise reasonable care for the protection of the resident's property from loss or theft.

�483.10(i)(2) Housekeeping and maintenance services necessary to maintain a sanitary, orderly, and comfortable interior;

�483.10(i)(3) Clean bed and bath linens that are in good condition;

�483.10(i)(4) Private closet space in each resident room, as specified in �483.90 (e)(2)(iv);

�483.10(i)(5) Adequate and comfortable lighting levels in all areas;

�483.10(i)(6) Comfortable and safe temperature levels. Facilities initially certified after October 1, 1990 must maintain a temperature range of 71 to 81�F; and

�483.10(i)(7) For the maintenance of comfortable sound levels.

Observations:
Based on observations, and interviews with residents, it was determined that the facility failed to provide a safe, clean, comfortable and homelike environment for the main lobby and two out of four nursing units (B and D wing).

Findings Include:

Observations on June 23, 2026, during a tour on the first-floor nursing unit (B-Wing) revealed the following:

-Room 100B: Over-bed light inoperable for approximately two months, per an interview with Resident R1.

-Room 104A: Wallpaper peeling behind the head of the bed; bathroom toilet soiled with feces; ceiling tile displaced exposing pipes; ceiling vent heavily soiled with crusted debris; stained ceiling tiles; night light missing protective cover exposing the light bulb.

-Room 107: Bathroom ceiling tiles stained.

-Room 114: Floor mat visibly dirty with a large slit in the center.

-Wing B Hallway Bathroom: Brown-stained ceiling tiles observed.

Continued observations on June 24, 2026, on B-Wing nursing unit revealed:

-Room 127: Bathroom ceiling tiles stained with an approximately silver-dollar-sized blackened area. Missing floor tile to the left of sink, and area behind faucets the rear apron of the sink was buckled, and faucets corroded.

-Room 129: Curtain rod and curtains falling off window.

Observation of 1st floor main lobby on June 23, 2026, at 9:00 a.m. revealed strong odor of urine throughout.

Observation of Unit D on June 23, 2026, at 10:34 a.m. revealed strong odor of urine throughout hallway.

Observation of 1st floor main lobby on June 24, 2026, at 9:00 a.m. revealed strong odor of urine throughout.

Observation of Unit D on June 24, 2026, at 10:15 a.m. revealed strong odor of urine throughout hallway.

Observation of 1st floor main lobby on June 25, 2026, at 9:00 a.m. revealed strong odor of urine throughout.

Observation of Unit D on June 25, 2026, at 12:25 a.m. revealed strong odor of urine throughout hallway.

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

Plan of Correction - To be completed: 08/12/2026

1. All identified environmental concerns were placed on maintenance urgent work order. The over-bed light in B100B was repaired. In B 104A, the wallpaper was repaired, the toilet and vent were cleaned, the displaced and stained ceiling tiles were replaced, and the night light cover was replaced. The stained ceiling tiles in B107 and the B Wing hallway bathroom were replaced. The damaged floor mat in Room 114 was replaced. In B 127, the stained ceiling tiles, missing floor tile, sink apron, and corroded faucets were repaired. The curtain rod in B129 was repaired.

2. NHA/Designee will complete an initial environmental inspection audit of resident rooms and common areas.

3. NHA/designee will re-educate maintenance, housekeeping and department managers on timely reporting of environmental concerns, prompt completion of repairs and environmental cleanliness

4. NHA/designee will conduct weekly random environmental room rounds and common areas x4 then monthly x2

5.Results of audits will be reviewed with the QAPI committee monthly X 3.

483.21(b)(1)(3) REQUIREMENT Develop/Implement Comprehensive Care Plan:

�483.21(b) Comprehensive Care Plans
�483.21(b)(1) The facility must develop and implement a comprehensive person-centered care plan for each resident, consistent with the resident rights set forth at �483.10(c)(2) and �483.10(c)(3), that includes measurable objectives and timeframes to meet a resident's medical, nursing, and mental and psychosocial needs that are identified in the comprehensive assessment. The comprehensive care plan must describe the following -
(i) The services that are to be furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being as required under �483.24, �483.25 or �483.40; and
(ii) Any services that would otherwise be required under �483.24, �483.25 or �483.40 but are not provided due to the resident's exercise of rights under �483.10, including the right to refuse treatment under �483.10(c)(6).
(iii) Any specialized services or specialized rehabilitative services the nursing facility will provide as a result of PASARR recommendations. If a facility disagrees with the findings of the PASARR, it must indicate its rationale in the resident's medical record.
(iv)In consultation with the resident and the resident's representative(s)-
(A) The resident's goals for admission and desired outcomes.
(B) The resident's preference and potential for future discharge. Facilities must document whether the resident's desire to return to the community was assessed and any referrals to local contact agencies and/or other appropriate entities, for this purpose.
(C) Discharge plans in the comprehensive care plan, as appropriate, in accordance with the requirements set forth in paragraph (c) of this section.
�483.21(b)(3) The services provided or arranged by the facility, as outlined by the comprehensive care plan, must-
(iii) Be culturally-competent and trauma-informed.

Observations:
Based on review of facility policy, review of clinical record, and staff interviews it was determined that the facility failed to develop a comprehensive care plan for one of 34 residents reviewed (Residents R17).

Findings include:

Review of the facility policy, " Person-Centered Care Plan," last revised in September 15, 2025, revealed, the center must develop and implement a person-centered care plan for each patient/resident consistent with patient rights measurable objectives and timeframes to meet a patient's medical, nursing and mental and psychosocial needs and all services that meet professional standards of quality.

Review of the facility policy, "Restorative Nursing" revised August 7, 2023, revealed practice standards include "Develop restorative nursing programs appropriate to the patient's identified needs. Develop specific measurable goals and document goals and interventions on the patient's restorative care plan. Implement the restorative nursing program according to the specifics on the care plan".

Review of Resident R17's clinical record revealed the resident was admitted to the facility on April 16, 2026, with diagnoses of left hip pain, muscle wasting.

Review of Resident R17's Physical Therapy discharge summary, dated May 15, 2026, indicated discharge recommendations and status includes Restorative nursing program including LE/UE (Lower extremity and Upper Extremity) exercise and bed mobility with extensive assistance.

Review of Resident R17's comprehensive care plan, no documented evidence of implementation of care plan for restorative nursing program.

Interview on June 25, 2026, at 12:00 p.m. with Director of Nursing, Employee E2, confirmed no care plan developed for Resident R17 restorative nursing program.

28 Pa Code 211.10(c) Resident care policies

28 Pa. Code 211.12(d)(5) Nursing services

Plan of Correction - To be completed: 08/12/2026

1.Resident R17 Care Plan was immediately updated to include a restorative nursing program based on resident's need and Therapy recommendations.

2.NHA/Designee completed an audit of current residents receiving restorative nursing to ensure an appropriate comprehensive care plan is included.

3.DON/designee will re-educate nursing staff managers and MDS coordinators on the requirement of developing and implementing a care plan that includes a restorative program.

4.DON/designee will conduct weekly audits of 4 random residents receiving restorative nursing x 4, then monthly X 2
Results of audits will be reviewed with the QAPI committee monthly X 3.

483.25(d)(1)(2) REQUIREMENT Free of Accident Hazards/Supervision/Devices:

�483.25(d) Accidents.
The facility must ensure that -
�483.25(d)(1) The resident environment remains as free of accident hazards as is possible; and

�483.25(d)(2)Each resident receives adequate supervision and assistance devices to prevent accidents.

Observations:
Based on review of clinical records, observations, and staff interviews, it was determined that the facility failed to maintain an environment that was free of accidents and hazards for one of six residents and one of four nursing units reviewed (Resident R163 and D Wing).

Findings include:

Clinical record review revealed Resident R163 was admitted to the facility March 23, 2021 with a diagnosis of hemiplegia and hemiparesis (paralysis/weakness of one side of the body), heart failure (heart muscle does not pump as well as it should), and protein calorie malnutrition (the state of inadequate intake of food).

Review of Resident R163's care plan, revised August 05, 2025, revealed the resident is at risk for falls related to impaired mobility, impulsive behavior, and poor safety awareness. Interventions included bilateral floor mat to be implemented for safety.

Observation on June 23, 2026, at 10:43 a.m., revealed Resident R163 was lying in bed and did not have left side floor mat next to the bed.

Follow-up observation on June 24, 2026 at 9:25 a.m. revealed Resident R163 was lying in bed and did not have left side floor mat next to the bed.

Interview on June 24, 2026 at 9:27 a.m. with Nurse Aide, Employee E12, confirmed Resident R163 did not have a left side floor mat next to the resident's bed.

Review of facility's emergency management plan revealed "This center monitors potential fire risk. Any unsafe condition is reported to a supervisor immediately so corrective measures can be taken promptly." "Upon discovering fire or smoke, center staff: i. Remove residents from immediate danger according to evacuation guidelines; ii. make announcement; iii. implement R.A.C.E (rescue, alarm, confine, extinguish/evacuate).

Observation of resident room, D216, on June 23, 2026, at 11:15 a.m. revealed room cluttered with resident belongings, piles of clothing stacked in front of PTAC unit (heating and air conditioning unit designed for installation through an exterior wall), and a trash can in close proximity.

Continued observation of resident room D216 on June 23, 2026, at 11:20 a.m. revealed odor of burning rubber. Upon further investigation, it was observed that the PTAC unit was smoking.

Review of facility investigation revealed "At approximately 11:15 AM on 6/23/2026 a burning odor was detected coming from resident room D216A. Staff responded immediately, the fire alarm was activated, and code red was initiated per facility protocol. The odor was identified coming from the air conditioning unit. The unit was immediately unplugged, and residents were promptly and safely removed from the room by staff. No flames were noted and no resident was injured. Following emergency protocols, all residents in the surrounding area were evacuated from their rooms and sheltered in a designated safe area. A head count was conducted, and all residents were accounted for."

Interview on June 24, 2026, at 11:45 a.m. with Maintenance Director, Employee E13, revealed "the smoke was being produced by a piece of trash bag that had been sucked up into the intake. This was discovered upon removal of the encasement and inspection of the air conditioning unit. Out of abundance of caution, the entire unit was changed out." Employee E13 demonstrated that the bag from the trash can likely was sucked up through the intake because it was left too close to the PTAC unit.

Follow up observations during a tour of the facility on June 25, 2026, at 11:30 a.m. revealed the following rooms with trash can left next to the PTAC unit; Room D212, D209, D205, D204 and D215. Findings confirmed on June 25, 2026, at 11:30a.m. with Employee E14, Unit Manager.

Interview with Employee E1, Nursing Home Administrator on June 25, 2026, at 2:00 p.m. confirmed plastic was found in the PTAC unit which caused incident on June 23, 2026, in room D216A.

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

28 Pa. Code 211.12 (d)(5) Nursing Services.

Plan of Correction - To be completed: 08/12/2026

1.Resident R163's care plan was immediately reviewed and the required L-side floor mat was placed. Trash can placed next to the PTAC unit in identified rooms were corrected.

2.NHA/Designee completed an initial audit for all residents with floor mats as a fall intervention to ensure the mats are in place and also inspected all residents rooms for trash cans placed near PTAC units.

3.NPE/designee will educate nursing staff on compliance with proper placement of floor mats and maintaining trash cans away from PTAC units.

4.DON/designee will conduct weekly audits x 4 of 4 residents with fall mat intervention to ensure proper placement. And trash cans away from PTAC units. then monthly X 2
Results of audits will be reviewed with the QAPI committee monthly X 3.

483.25(g)(1)-(3) REQUIREMENT Nutrition/Hydration Status Maintenance:

�483.25(g) Assisted nutrition and hydration.
(Includes naso-gastric and gastrostomy tubes, both percutaneous endoscopic gastrostomy and percutaneous endoscopic jejunostomy, and enteral fluids). Based on a resident's comprehensive assessment, the facility must ensure that a resident-

�483.25(g)(1) Maintains acceptable parameters of nutritional status, such as usual body weight or desirable body weight range and electrolyte balance, unless the resident's clinical condition demonstrates that this is not possible or resident preferences indicate otherwise;

�483.25(g)(2) Is offered sufficient fluid intake to maintain proper hydration and health;

�483.25(g)(3) Is offered a therapeutic diet when there is a nutritional problem and the health care provider orders a therapeutic diet.

Observations:
Based on review of clinical records and staff interview it was determined that the facility failed to timely assess nutrition status to maintain acceptable parameters of nutritional status for one of eight residents reviewed (R94).

Findings Include:

Review of Resident R94's Minimum Data Set (MDS -federally mandated resident assessment and care screening) dated May 11, 2026, revealed the resident was admitted to the facility in July 2025 and has diagnoses of hypernatremia (elevated sodium level in the blood), hyperlipidemia (elevated levels of cholesterol and or triglycerides in the blood), dementia (a progressive disorder affecting memory, thinking and the ability to perform daily activities), and malnutrition (inadequate nutritional status resulting from insufficient intake or utilization of nutrients).

Further review of Resident R94's MDS dated May 11, 2026, revealed the resident has a Brief Interview for Mental Status (BIMS) score of 0, indicating severe cognitive impairment, and is dependent on staff for all activities of daily living (ADLs). The MDS documented that the resident weighed 90 pounds and measured 61 inches in height.

Review of resident R94's comprehensive care plan dated July 10, 2025, revealed the resident is at nutritional risk related to the need for a mechanically altered diet, the need for significant assistance with most meals, and a diagnosis of dementia.

Review of Resident R94's clinical record revealed the following documented weight history:

March 3, 2026 - 104.0 pounds (lbs.)
April 2, 2026 - 90.2 lbs.
May 2,2026 - 88.4lbs.
May 4,2026 - 91.6 lbs.
June 1, 2026 - 88.2 lbs.

Review of Resident R94's weight history revealed the resident sustained a significant 13.8-pound weight loss over one month (March 3rd to April 2, 2026).

Continued review of Resident R94's clinical record revealed the weight loss was not addressed until April 30, 2026.

Review of Resident R94's nutrition assessment dated April 30, 2026, revealed the resident triggered for significant weight loss over one, three, and six months. Per the nutrition assessment, recommendations in response to the weight loss included a re-weigh to confirm accuracy of weight loss and weekly weights for monitoring.

Review of Resident R94's clinical record revealed no documented evidence a reweigh was obtained or weekly weights were completed per recommendations.

Interview on June 25, 2026, at 9:16 AM with Registered Dietitian, Employee E15, confirmed Resident R94's weights were not obtained per nutrition recommendations and subsequently was unable to accurately assess weight changes.

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

28 Pa. Code 211.12 (d)(5) Nursing services.

Plan of Correction - To be completed: 08/12/2026

1.Resident R94 was assessed, weights reviewed and interventions updated.

2.Registered Dietitian to conduct an Initial audit X past 30 days of residents with significant weight loss to ensure weight loss identified, assessed and appropriate interventions implemented.

3.NPE/designee will re-educate the Registered Dietitian and licensed nursing staff to ensure weight loss identified, assessed and appropriate interventions implemented.

4.Registered Dietitian/designee will conduct weekly audits X 4, then monthly X 2 of residents with significant weight loss to ensure weight loss identified, assessed and appropriate interventions implemented.

5.Registered Dietitian will report audit results and any corrective actions during QAPI meeting x 3 months.

483.25(k) REQUIREMENT Pain Management:

�483.25(k) Pain Management.
The facility must ensure that pain management is provided to residents who require such services, consistent with professional standards of practice, the comprehensive person-centered care plan, and the residents' goals and preferences.

Observations:
Based on review of clinical records and interview with staff, it was determined the facility failed to ensure pain assessment was completed prior to administration of PRN (as needed) pain medication for one of two residents reviewed for pain management (Resident 134).

Findings include:

Review of Resident R134's clinical record revealed the resident was admitted to the facility on November 08, 2025, with a diagnosis of benign neoplasm of pituitary gland (noncancerous tumors on pituitary gland that may cause hormonal/vision problems), hypertension (high blood pressure), and chronic pain syndrome.

Review of Resident R134's physician order, dated May 12, 2026, revealed an order for Hydromorphone (opioid medication) 2 milligram tablet- give 3 tablets by mouth every 12 hours as needed for pain for 30 days.

Review of Resident R134's Medication Administration Record (MAR) for the month of June revealed the resident received PRN Hydromorphone on the following dates:

-June 1, 2026
-June 3, 2026
-June 4, 2026
-June 6, 2026
-June 7, 2026
-June 8, 2026
-June 9, 2026

Review of Resident R134's pain assessments, nursing notes, and MAR documentation revealed there was no documented pain level assessment prior to administration of the PRN Hydromorphone.

Interview on June 26, 2026, at 9:38 a.m. with Employee E2, Director of Nursing, confirmed no pain level was documented prior to the pain medication administration in Resident R134's clinical record.

28 Pa. Code 211.10(c) Resident care policies

28 Pa. Code 211.12(d)(1) Nursing services

Plan of Correction - To be completed: 08/12/2026

1.There was no adverse effect on resident R134

2.DON/designee to conduct an initial audit of residents receiving PRN hydromorphone to ensure a pain level is documented prior to administration.

3.NPE/designee will re-educate licensed nursing staff on the facility's policy requiring a completed/documented pain level assessment on residents prior to medication administration

4.DON/designee will conduct random weekly PRN Hydromorphone administration audits X 4, then monthly X 2 to ensure a pain level assessment is completed/documented prior to administration.

5.DON/designee will review audit findings and any corrective actions during QAPI meetings x 3 months.

483.45(g)(h)(1)(2) REQUIREMENT Label/Store Drugs and Biologicals:

�483.45(g) Labeling of Drugs and Biologicals
Drugs and biologicals used in the facility must be labeled in accordance with currently accepted professional principles, and include the appropriate accessory and cautionary instructions, and the expiration date when applicable.

�483.45(h) Storage of Drugs and Biologicals

�483.45(h)(1) In accordance with State and Federal laws, the facility must store all drugs and biologicals in locked compartments under proper temperature controls, and permit only authorized personnel to have access to the keys.

�483.45(h)(2) The facility must provide separately locked, permanently affixed compartments for storage of controlled drugs listed in Schedule II of the Comprehensive Drug Abuse Prevention and Control Act of 1976 and other drugs subject to abuse, except when the facility uses single unit package drug distribution systems in which the quantity stored is minimal and a missing dose can be readily detected.

Observations:
Based on observation and staff interview, the facility failed to ensure medications were stored according to required temperature ranges on two of four nursing units (B and C Wing).

Findings Include:

Review of facility documentation "Medication Room Temperature Log" states, "temperatures are to remain between 36-46 degrees".

Observations on June 23, 2026, at 10:30 am, with Nurse Manager, Employee E10, of Wing B Medication Room Refrigerator (located behind the Nurses Station) revealed ten out of thirty-one days in the month of May 2026, May 3, May 4, May 5, May 10, May 11, May 16, May 17, May 29, May 30, and May 31, the refrigerator temperatures were not documented.

Observations on June 24, 2026, at 10:30 am, with Nurse Manager, Employee E11, of Wing C Medication Room Refrigerator revealed three out of twenty-four days in June 2026, June 10, June 12, and June 23, the refrigerator temperature was documented below the acceptable range of 36-46 degrees.

Interview on June 24, 2026, at 1:47 p.m., Nursing Home Administrator, Employee E1, confirmed that the facility failed to notify maintenance of the temperature variance and failed to remove or quarantine medications exposed to out of range temperatures.

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

Plan of Correction - To be completed: 08/12/2026

1.Cited refrigerator was inspected to ensure the refrigerator is in proper working condition, after consultation with pharmacist no medication found to be affected.

2.DON completed an initial audit on all medication refrigerator temperature logs for compliance.

3.NPE/designee will educate nursing staff and maintenance department on the policy and procedure as it pertains to documenting refrigerator temperatures and follow up when temperatures are not in compliance.

4.DON/designee will conduct weekly audits X 4, then monthly X 2 of all medication refrigerators to ensure proper temperatures and appropriate follow up if necessary.

5.DON/designee will review audit findings and any corrective actions during QAPI meetings x 3 months.

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