Lock Haven Rehabilitation and Senior Living

In the surveyor’s words

From the most serious findings on record at Lock Haven Rehabilitation and Senior Living, in the surveyor’s own words.

• Actual harm, isolatedF578Jan 9, 2025

  Based on clinical record review and staff interview, it was determined that the facility failed to establish clear and consistent resident wishes regarding advance directives for one of six residents reviewed resulting in actual harm (Resident CR1). Findings include: Closed clinical record review for Resident CR1 revealed Durable Health Care Power of Attorney and Health Care Treatment Instructions (Living Will) for the resident dated [DATE], in which the resident appointed a sister as his health care agent to make decisions on his behalf per terms and conditions described in the document. […]

• Actual harm, isolatedF684Jan 9, 2025

  Based on closed clinical record review and staff interview, it was determined that the facility failed to provide the highest practicable care for a resident's change in condition that resulted in death for one of six residents reviewed causing actual harm (Resident CR1). Findings include: Closed clinical record review for Resident CR1 revealed that the resident had been a long-term resident of the facility with an admitted [DATE]. Review of Resident CR1's closed clinical record revealed a nursing note dated [DATE], at 8:25 PM noting the resident had complaints of nausea and not feeling well. A nursing note followed dated [DATE], at 2:38 AM noting no further emesis, and a clear liquid tray was ordered for breakfast. […]

• Actual harm, isolatedF600Mar 1, 2023

  Based on observation, clinical record review, review of facility documents, and staff interview, it was determined that the facility failed to protect the rights of a resident to be free from neglect by not providing the services necessary to avoid physical harm resulting in injury for one of four residents reviewed that sustained two fractures (Resident 1). Findings include: An observation of Resident 1 on March 1, 2023, at 12:45 PM revealed the resident lying in bed with a sling on her left arm. Clinical record review for Resident 1 revealed the [AGE] year-old resident had resided in the facility since 2012, and had resided in the same room on the same Unit 2 since October 2021. […]

• Actual harm, isolatedF689Nov 18, 2022

  Based on closed clinical record review, review of facility documentation, and staff interview, it was determined that the facility failed to implement assessed interventions to prevent accidents for one of two residents reviewed for falls, resulting in harm with a fractured femur (Resident CR1). Findings include: Closed clinical record review for Resident CR1 revealed the resident was admitted to the facility on [DATE], with a diagnosis of dementia, abnormal gait and mobility, and a history of falling. Repeated falls was listed as a diagnosis on [DATE]. […]

• No harm, potential for more than minimal, widespreadF802Sep 19, 2025

  Based on observations, review of facility documents, and resident and staff interview, it was determined that the facility failed to provide sufficient staff to carry out the functions of the food and nutrition services in the main kitchen and one of four nursing units (Unit 3, Residents 37 and 38).Findings include: During an interview and observation in the facility's main kitchen on September 16, 2025, at 9:00 AM Employee 2, food service director, indicated he was working as a dietary aide because he had to fill in for the position. Employee 2 stated regular staffing for the shift would include one cook, four dietary aides, and himself as the director, but currently, they only had one cook, himself, and one additional dietary aide. […]