Legend Personal Care and Memory Care of Lititz

Multiple instances were identified where prescriber orders for blood sugar checks, nutritional supplements, medication administration, and TED sleeve application were not followed.

A resident's Moxifloxacin eye drops pharmacy label instructions did not match the instructions recorded on the Medication Administration Record.

An 8 ounce container of Ensure Chocolate in the medication cart was not labeled with the resident's name.

A resident's narcotic count for Clonazepam was left unlocked, unattended, and accessible in a binder on top of a medication cart.

Two staff members did not receive required annual training regarding resident needs and personal care service needs.

Multiple physical altercations occurred between residents, resulting in injuries such as a fractured nose and various abrasions.

The facility does not provide individual towels or washcloths for each resident, requiring residents to supply their own.

The facility failed to provide immediate access to complete staff lists and resident demographic information, including specific needs like hearing impairments and medication self-administration details.

The home failed to follow prescriber's orders, specifically regarding the failure to apply a prescribed topical medication from 3/13/24 to 3/21/24 and a delay in administering daily vitamins due to medication unavailability.

The home failed to report incidents to the Department, including an unwitnessed fall resulting in hospitalization and a reported monetary loss of approximately $12,000 from a resident's account.

A piece of furniture (buffet) was blocking the egress from the exit hallway in the Secure Dementia Care Unit.

An unidentified small white round pill was found loose in a medication cart, indicating improper storage.

Initial medical evaluations for two residents were not completed within the required regulatory timeframe following admission.

A written cognitive preadmission screening was not completed for Resident 1 prior to their admission to the Secure Dementia Care Unit.