Pennsylvania Department of Health
CENTENNIAL HEALTHCARE AND REHABILITATION CENTER
Patient Care Inspection Results

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Minimal Citation - No Harm	Minimal Harm	Actual Harm	Serious Harm

CENTENNIAL HEALTHCARE AND REHABILITATION CENTER
Inspection Results For:

There are 158 surveys for this facility. Please select a date to view the survey results.

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CENTENNIAL HEALTHCARE AND REHABILITATION CENTER - Inspection Results	Scope of Citation Number of Residents Affected By Deficient Practice

Initial comments:

Based on an Abbreviated Survey in response to one complaint completed on March 12, 2025, it was determined that Centennial Healthcare and Rehabilitation was not in compliance with the following 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:

483.25 REQUIREMENT Quality of Care:

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.

§ 483.25 Quality of care
Quality of care is a fundamental principle that applies to all treatment and care provided to facility residents. Based on the comprehensive assessment of a resident, the facility must ensure that residents receive treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan, and the residents' choices.

Observations:

Based on observations, review of facility policy, staff interviews, and the review of clinical records, it was determined that the facility failed to ensure that medications were administered on time, as ordered by the physician for 3 out of 3 residents reviewed (Resident R1, R2 and R3).

Findings include:

Review of the facility policy, "Medication Administration and Disposition, with a revision date of June 2023 indicated that medications must be administered within one hour of their prescribed time, unless otherwise specified (for example, before and after meal orders).

During an observation on March 12, 2025 st 10:50 a.m. Employee E3 (licensed nurse) was observed standing at her medication cart, and confirmed that she was still administering medications to residents and that she had some rooms in 219-233, in addition to other rooms in which she still had to administer medications. Employee E3 reported that she did not start medication administration because she "got into work later."

Review of March 2025 physician orders for Resident R1 included diagnoses of respiratory failure (a condition in which an individual does not have oxygen or too much carbon dioxide in your body; atrial fibrillation (an irregular and often very rapid heart rhythm); heart failure (a long-term condition that happens when your heart can't pump blood well enough to give your body a normal supply); chronic obstruction pulmonary disorder (COPD-a lung condition that limits airflow an oxygen exchange).
Continued review of the resident's March 2025 physician orders included medications and treatments that included, but were not limited to the following:

Eliquis Oral Tablet - give 1-2.5 milligram (mg) tablet by mouth every 12 hours (9:00 a.m. and 9:00 p.m.) for the treatment of atrial fibrillation.

Buspirone HCl Oral Tablet- give 1-10 mg tablet by mouth one time a day (9:00 a.m.) for anxiety, forgetfulness.

Symbicort Inhalation Aerosol 160-4.5 MCG/ACT (Budesonide- Formoterol Fumarate Dihydrate)-1 puff inhale 1 puff orally every 12 hours (9:00 a.m. and 9:00 p.m.) for shortness of breath.

During an observation of medication administration on March 12, 2025 at 11:10 a.m. Employee E3 was observed administering 9:00 a.m. physician ordered medication to Resident R1 which included, but not limited to the administration of the above referenced medications, Symbicort Inhalation Aerosol; Buspirone HCl Oral Tablet; and Eliquis Oral Tablet.

Review of the March 2025 physician orders for Resident R2 included, but not limited to the following diagnosis: diabetes (a condition that happens when your blood sugar/glucose) is too high); and chronic obstruction pulmonary disorder (COPD-a lung condition that limits airflow an oxygen exchange) and epilepsy (a brain disorder that causes recurring seizures).

Continued review of the resident's March 2025 physician orders included medications and treatments that included, but not limited to the following:

Levetiracetam : 1-750 milligram (mg) tablet of the medication to be administered by mouth every 12 hours (9:00 a.m. and at 9:00 p.m) for treatment of the resident's epilepsy.

Lidocaine External Cream, 4%: cream to be applied to the resident's right arm every 12 hours (9:00 and 9:00 p.m.) for mild pain.

Docusate Sodium Capsule: 1-100 mg capsule to be given by mouth 2 times a day (9:00 a.m. and 5:00 p.m.) for constipation.

Metformin HC Tablet: 1-500 mg tablet given by mouth 2 times a day times a day for diabetes.
During an observation of medication administration on March 12, 2025 at 11:29 a.m.

Employee E3 was observed administering medication to Resident R2, which included, but not limited to the above referenced 9:00 a.m. physician ordered medications, levetiracetam; Lidocaine External Cream; Calcium Carbonate; Docusate Sodium and Metformin.

During an observation on March 12, 2025 st 11:00 a.m. Employee E4 (licensed nurse) was observed standing at his medication cart, and confirmed that he was still administering medications to residents. Employee E4 reported that Resident R3's medications still needed to be administered.

Review of the March 2025 physician orders for Resident R3 included, but not limited to the following diagnosis: chronic kidney disease (gradual loss of kidney function); hypertension (high blood pressure); convulsions (uncontrollable muscle contractions that can happen during or without seizures).

Continued review of the resident's March 2025 physician orders included medications and treatments that included, but were not limited to the following:

Lacosamide: 1-150 mg tablet taken orally two times a day (9:00 a.m. and 5:30 p.m.) for convulsions

Levetiracetam: 1-500 mg tablet to be administered by mouth every 12 hours (9:00 a.m. and at 9:00 p.m.) for treatment of convulsions.

Eliquis Oral Tablet: give 1-5 mg tablet by mouth every 12 hours (9:00 a.m. and 9:00 p.m. for Atrial fibrillation

During an observation of medication administration on March 12, 2025 at 11:19 a.m. Employee E4 was observed administering 9:00 a.m. physician ordered medications to Resident R3 which included, but was not limited to the above referenced medications, Lacosamide, Levetiracetam, and Eliquis.

28 Pa. Code 211.10(c) Resident care policies

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

Plan of Correction - To be completed: 05/02/2025

R1, R2 and R3's physicians were notified of the medications administered outside of the medication ordered timeframes.

Employee E3 and E4 received follow up training regarding administering medications in timeframes ordered.

An audit was conducted identifying like residents.

Licensed nurses will be re-educated regarding administering medications per timeframes ordered.

The Director of Nursing or designee will perform audits (of following physician orders in regard to medication timeframes) weekly for 1 month, then monthly x 3 months.

Audits will be reviewed at QAPI meeting.

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