Inspection·July 6, 2023

F 0558 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 2. Review of Resident #8's medical record revealed an admission date of 10/05/12 with diagnoses including secondary Parkinsonism, dysphagia, oropharyngeal phase, schizophrenia, and schizoaffective disorder. Review of Resident #8's Annual MDS 3.0 assessment dated [DATE] revealed Resident #8 had severe cognitive impairment. Resident #8 required extensive assistance of one person for bed mobility, transfers, locomotion, and toilet use, Observation on 07/03/23 at 11:30 A.M. of Resident #8 revealed he was sitting in a chair in his room and pleasantly spoke to the surveyor. Further observation revealed a call light cord was on the floor next to Resident #8's chair. The call light cord was missing the plastic holder with the call button to activate the call system and bare wires were dangling from the end of the call light. Interview on 07/03/23 at 11:50 A.M. of the Director of Nursing (DON) confirmed Resident #8's call light cord was missing the call button and bare wires were dangling from the end of the call light. 3. Review of Resident #75's medical record revealed an admission date of 10/18/22 with diagnoses including schizoaffective disorder, mood disorder, and hypertension. Review of Resident #75's Quarterly MDS 3.0 assessment dated [DATE] revealed Resident #75 had moderate cognitive impairment. Resident #75 required supervision for walking in corridor, locomotion on the unit, dressing, and toilet use. Observation on 07/03/23 at 11:40 A.M. of Resident #75 revealed he was standing in his room. Further observation revealed Resident #75 did not have a call light in his room. Resident #75 confirmed he did not have a call light and did not know how long he didn't have a call light. Interview on 07/03/23 at 11:50 A.M. of the DON confirmed Resident #75 did not have a call light in his room. 4. Observation during the screening process on 06/26/23 from 9:30 A.M. through 12:30 P.M. revealed Resident #24 had no call light by her bed. Interview on 06/26/23 at 9:30 A.M. with Resident #24 revealed she never had a call light. Interview on 06/26/23 at 9:37 A.M. with STNA #1031 verified there was no call light in Resident #24's room. 5. Observation during the screening process on 06/26/23 from 9:30 A.M. through 12:30 P.M. revealed Resident #39's call light was missing the end piece where the button should be. Interview on 06/26/23 at 11:13 A.M. with Resident #39 revealed it was missing for at least a week. She stated her roommate activated her call light for when she needed assistance. Interview on 06/26/23 at 11:15 A.M. with Licensed Practical Nurse (LPN) #1022 and STNA #1031 verified the Resident #39's call light was not working. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 2 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0578 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. Based on medical record review, interview, and facility policy review the facility failed to ensure resident wishes regarding end-of-life measures were clearly identified in the medical record. This affected two residents (#81 and #84) of three residents reviewed for Advanced Directives. The facility census was 91. Findings include: 1. Review of the medical record for Resident #81 revealed an admission date of 02/04/23. Diagnoses included chronic kidney disease, heart failure, cirrhosis of the liver, and depression. Review of the physician's orders for June 2023 revealed Resident #81 was a Full Code. Information along the top of the record located near the allergy list also indicated a Full Code status. Review of a progress note dated 04/17/23 revealed Resident #81 changed his code status from Full Code to Do Not Resuscitate Comfort Care Arrest Do Not Intubate (DNR-CCA DNI), and the paperwork had been signed and verified. Interview on 06/28/23 at 3:04 P.M. with the Director of Nursing (DON) verified there was no evidence the change in code status from Full Code to DNRCCA DNI and back to Full Code for Resident #81. Review of an email dated 06/28/23 at 4:51 P.M. from Advanced Practice Registered Nurse (APRN) #1097 revealed Resident #81 was indecisive about his code status and should remain a Full Code. 2. Review of the medical record for Resident #84 revealed an admission date of 01/13/23. Diagnoses included heart disease, cirrhosis of the liver, and diabetes. Review of Resident #84's physician's orders for June 2023 revealed no code status. Information along the top of the record located near the allergy list also indicated no code status. Interview on 06/28/23 at 3:04 P.M. with the DON verified there was no evidence of a code status for Resident #84. Review of the facility policy titled Advance Directives, dated April 2008, revealed the Advance Directive status would be documented in the medical record. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 3 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0582 Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. Level of Harm - Minimal harm or potential for actual harm Based on record review and interview, the facility failed to ensure residents discharged from skilled services were provided appropriate notification of services ending. This affected one resident (#251) of three residents reviewed for beneficiary notification. The facility census was 91. Residents Affected - Few Findings include: Review of Resident #251's Skilled Nursing Facility (SNF) Beneficiary Protection Notification Review form indicated the resident's last covered day of Part A services was on 03/06/23. The form revealed the SNF Advanced Beneficiary Notice (ABN) Form CMS-10055 was provided to Resident #251's son on 03/06/23. Interview on 06/28/23 at 1:40 P.M. with the Social Services Director (SSD) #1070 confirmed the SNF ABN Form CMS-10055 was not provided at least two days before the resident was cut from skilled services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 4 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, record review, and review of the facility policy the facility failed to ensure the temperature on the third-floor nursing units were within the required temperature range of 71 to 81 degrees Fahrenheit. This affected one resident (#19) and had the potential to affect all 54 residents (#3, #4, #5, #7, #9, #10, #11, #13, #14, #15, #16, #18, #19, #20, #21, #23, #24, #25, #33, #36, #37, #39, #40, #41, #42, #43, #44, #45, #46, #47, #49, #50, #54, #56 #57, #58, #59, #60, #63, #66, #67, #68, #70, #71, #72, #75, #79, #80, #82, #83, #85, #88, #89, #195) residing on the third-floor of the facility. The facility census was 91. Findings include: Review of Resident #19's medical record revealed an admission date of 05/17/21 with diagnoses including pseudobulbar affect (inappropriate involuntary laughing and crying due to a nervous system disorder, can be treated, cannot be cured), vascular dementia, social phobia, generalized anxiety, and schizoaffective disorder. Review of Resident #19's Quarterly Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed Resident #19's cognitive status and mood were not assessed. Resident #19 was independent with bed mobility and required supervision for transfers and personal hygiene. Observation 06/26/23 at 10:54 A.M. of the third-floor nursing units revealed the temperature felt very warm. Interview on 06/26/23 at 10:54 A.M. with Licensed Practical Nurse (LPN) #1092 revealed Maintenance Assistant (MA) #1041 was notified about the warm temperature and hopefully it would be fixed soon because the air conditioning was not working. Observation on 06/26/23 at 10:59 A.M. of the third-floor secured unit temperature gauge revealed it did not show the temperature of the nursing unit. Interview on 06/26/23 at 10:59 A.M. of State Tested Nursing Assistant (STNA) #1037 revealed the thermometer was broken, she was not sure for how long, and the gauge was used for the air conditioning on the third floor secured nursing unit. Interview on 06/26/23 at 11:49 A.M. of MA #1041 revealed the facility maintenance director resigned about six weeks ago and he was by himself in the building since that time. MA #1041 confirmed the temperature was very warm on the third-floor nursing units and had been that way since Friday. MA #1041 stated he called the air conditioning company last week and they were either going to come on Friday (06/23/23) or Monday (06/26/23). MA #1041 stated he called the air conditioning company multiple times in the past couple months, they come to the facility, work on the air conditioning, it works for one day then freezes up and stops working. When asked about work orders MA #1041 stated he would not know where to look for work orders for having the air conditioning company come to the facility for maintenance on the air conditioning unit. Observation on 06/26/23 at 11:49 A.M. of MA #1041 revealed he had a temperature recording device, and the device registered the temperature on the third-floor secured nursing unit and the third-floor (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 5 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0584 unsecured nursing unit at 83.5 degrees Fahrenheit. Level of Harm - Minimal harm or potential for actual harm Observation on 06/26/23 at 2:22 P.M. of Resident #19 revealed he waved the surveyor over to speak to him while he was standing outside of his room. Residents Affected - Some Interview on 06/26/23 at 2:22 P.M. of Resident #19 revealed Resident #19 stated it was too hot in his room. Resident #19 pointed to the air vent above his head on the ceiling and said it was blowing hot air. Temperature of the air from the vent felt very warm. Resident #19 stated in a loud voice that the air blowing out was hot air and to fix it right. Resident #19 stated it was entirely too hot! Interview on 06/26/23 at 2:44 P.M. of Air Conditioning Company Representative (ACCR) #1107 revealed work needed done. ACCR #1107 stated there were not enough vents in the halls, there were only 17 on each side and there should be 35 on each side. ACCR #1107 indicated he had been coming to the facility for multiple years related to air conditioning problems. Interview on 06/26/23 at 2:44 P.M. of Maintenance Director (MD) #1096 revealed he was filling in at the facility until a Maintenance Director could be hired. MD #1096 stated he was the Maintenance Director for a sister facility and came to the facility as often as possible to assist MA #1041. MD #1096 indicated the cold air return on the third floor was in a room with the door kept in a closed position, and that could be contributing to the freezing up of the air conditioning unit. Review of the facility policy titled Quality of Life - Homelike Environment, revised 05/2017, included residents were provided with a safe, clean, comfortable, and homelike environment and encouraged to use their personal belongings to the extent possible. The facility staff and management should maximize, to the extent possible, the characteristics of the facility that reflect a personalized, homelike setting. These characteristics included comfortable and safe temperatures (71°F - 81°F). FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 6 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0657 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, interview, and facility policy review the facility failed to provide a written invitation or conduct an interdisciplinary team care plan meeting for Residents #22, #76, #48, #3, #11, #21, #33, #40, #45, #49, #51, #16, #44, #7, #24, #58, and #75. This affected 17 residents (#22, #76, #48, #3, #11, #21, #33, #40, #45, #49, #51, #16, #44, #7, #24, #58 and #75) out of 91 residents screened for plan of care meetings. The facility census was 91. Findings include: 1a. Review of the medical record for Resident #3 revealed an admission date of 06/01/18. Diagnoses included cerebral infarction, encephalopathy, dysphagia, and alcohol abuse. Resident #3 was cognitively intact. Review of the record revealed no evidence of a care plan meeting. b. Review of the medical record for Resident #11 revealed an admission date of 11/04/21. Diagnoses included chronic obstructive pulmonary disease, cerebral ischemia, and depression. Resident #11 was cognitively impaired. Review of the record revealed no evidence of a care plan meeting. c. Review of the record for Resident #16 revealed an admission date of 04/23/15. Diagnoses included congestive heart failure, chronic obstructive pulmonary disease, and type two diabetes mellitus. Resident #16 was cognitively intact. Review of the record revealed no evidence of a care plan meeting. d. Review of the medical record for Resident #21 revealed an admission date of 02/26/13. Diagnoses included heart disease, congenital mitral insufficiency, and rhabdomyolysis. Resident #21 was cognitively impaired. Review of the record revealed no evidence of a care plan meeting. e. Review of the medical record for Resident #44 revealed an admission date of 01/21/20. Diagnoses included congestive heart failure, atrial fibrillation, and muscle wasting and atrophy. Resident #44 had impaired cognition. Review of the record revealed no evidence of a care plan meeting. f. Review of the medical record for Resident #49 revealed an admission date of 11/18/19. Diagnoses included major depressive disorder, Parkinson's disease, and anemia. Resident #49 was cognitively impaired. Review of the record revealed no evidence of a care plan meeting. g. Review of the medical record for Resident #75 revealed an admission date of 10/18/22. Diagnoses included schizoaffective disorder, hypertension, and mood disorder. Resident #75 was cognitively impaired. Review of the record revealed no evidence of a care plan meeting. Interviews on 06/26/23 during the screening process revealed Resident #7, Resident #24 and Resident #58 were not aware of care plan meetings. Interview on 06/28/23 at 9:54 A.M. with Minimum Data Set Nurse (MDS) #1069 revealed she verbally invited the responsible party and resident to the care plan meetings. Interview on 06/29/23 at 11:00 A.M. with the guardian of the above residents (#3, #11, #16, #21, #44, #49 and #75) revealed she had not received any verbal or written invitation to care plan meetings (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 7 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0657 but rather she self-initiated and requested meetings for her wards. Level of Harm - Minimal harm or potential for actual harm 2a. Review of the medical record for Resident #33 revealed an admission date of 01/12/18. Diagnoses included other schizophrenia, major depressive disorder, and chronic viral hepatitis. Resident #33 was cognitively impaired. Review of the record revealed no evidence of a care plan meeting. Residents Affected - Some b. Review of the medical record for Resident #40 revealed and admission date of 11/08/19. Diagnoses included dementia, aphasia, and cognitive communication deficit. Resident #40 was cognitively impaired. Review of the record revealed no evidence of a care plan meeting. c. Review of the medical record for Resident #45 revealed an admission date of 11/08/19. Diagnoses included Alzheimer's Disease, difficulty walking, and cognitive communication deficit. Resident #45 had impaired cognition. Review of the record revealed no evidence of a care plan meeting. d. Review of the medical record for Resident #51 revealed and admission date of 02/21/20. Diagnoses included residual schizophrenia, hypoosmolality, and cognitive communication deficit. Review of the record revealed no evidence of a care plan meeting. Interviews on 06/26/23 during the screening process revealed Resident #7, Resident #24 and Resident #58 were not aware of care plan meetings. Interview on 06/28/23 at 9:54 A.M. with MDS #1069 revealed she verbally invited the responsible party and resident to the care plan meetings. Interview on 06/29/23 at 11:15 A.M. with the guardian of the above residents (#33, #40, #45 and #51) revealed he had not received any verbal or written invitation to care plan meetings. He stated he became their guardian 04/01/23. Further review of the record revealed each of the residents had an MDS due after he became the guardian and prior to this survey. 3. Resident #76 was admitted on [DATE] with diagnoses including paraplegia secondary to spinal cord injury following a motor vehicle accident, chronic pain syndrome, neuromuscular bowel and bladder, benign prostatic hypertrophy, gastroesophageal reflux disease, dry eye syndrome, polyneuropathies, anxiety, and depression. A review of Resident #76's clinical record revealed no documentation an interdisciplinary team plan of care meeting or of an invitation to attend a plan of care meeting. An interview with Resident #76 on 06/26/23 at 11:27 A.M. revealed a concern with conducting plan of care conference meetings to discuss his medical and discharge needs. Resident #76 stated the facility had not conducted any plan of care conferences since his admission to the facility. An interview with Social Service Designee (SSD) #1070 on 06/27/23 at 2:03 P.M. revealed the MDS nurse (MDS Registered Nurse (RN) #1069) should invite residents, guardians and/or responsible party to the plan of care meeting quarterly to discuss Resident #76's discharge needs and other care concerns. SSD #1070 verified there was no documentation in Resident #76's record of an invitation to the plan of care conference. An interview with MDS RN #1069 on 06/28/23 at 10:50 A.M. revealed she did not routinely document the plan of care meetings in the resident's record. MDS RN #1069 stated any notification of the plan (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 8 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0657 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some of care meetings was communicated to the resident, guardian and/or responsible party verbally. MDS RN #1069 verified there was no documentation in Resident #76's record of providing an invitation verbally or written of the plan of care meetings. MDS RN #1069 verified there was not documentation of the interdisciplinary team discussion during plan of care meetings in Resident #76's clinical record. 4. Resident #48 was admitted on [DATE] with diagnoses including cerebral infarction, cognitive communication deficit, tachycardia (rapid heart rate), tremors, depression, overactive bladder, left and right foot and shoulder pain, Alzheimer's dementia, cervical disc degeneration, left hand contraction, and muscle wasting and atrophy. A review of Resident #48's clinical record indicated no documentation an interdisciplinary team meeting was conducted with Resident #48, Resident #48's representative or other staff in the facility. There was no documentation Resident #48 or representative were invited to a plan of care meeting. An interview with Resident #48 on 06/26/23 at 1:58 P.M. indicated the facility had not conducted a plan of care meeting with her to discuss her discharge needs and/or care in the facility with her representative or other staff in the facility. 5. Review of Resident #22's medical record revealed an admission date of 05/28/21 and diagnoses included type 1 diabetes mellitus with ketoacidosis without coma, post-traumatic stress disorder, unspecified psychosis not due to a substance or known physiological condition, disorder of the brain, vascular dementia, with other behavioral disturbance, and major depressive disorder. Review of Resident #22's progress notes from 05/07/23 through 06/29/23 did not reveal documentation related to Resident #22's care plan meeting. Review of Resident #22's Annual MDS 3.0 assessment dated [DATE] revealed Resident #22 had severe cognitive impairment. Resident #22 required supervision for bed mobility, transfers, locomotion on unit, and toilet use. Interview on 06/28/23 at 10:52 A.M. of RN/MDS #1069 revealed she was responsible for resident care plan meetings. RN/MDS #1069 indicated the residents received verbal invitations for care plan meetings, and there was no documentation of meeting invitations or plan of care meetings in their medical records. Interview on 06/29/23 at 3:52 P.M. of RN/MDS #1069 revealed she arranged care plan meetings and Resident #22 had a care plan meeting around the time of the last care plan update. RN/MDS #1069 stated she went with SSD #1070 to talk to Resident #22. RN/MDS #1069 stated Resident #22's Power of Attorney was not invited to attend the meeting. Interview on 06/29/23 at 3:55 P.M. of Power of Attorney (POA) #1108 revealed she was Resident #22's Durable Power of Attorney. POA #1108 stated she had never been invited to Resident #22's care plan meetings. An interview with SSD #1070 on 06/27/23 at 2:03 P.M. revealed the MDS/RN #1069 should invite residents, guardians and/or responsible party to the plan of care meeting quarterly to discuss Resident #22's discharge needs and other care concerns. SSD #1070 verified there was no documentation in Resident #76's record of an invitation to the plan of care conference. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 9 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0657 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some An interview with MDS RN #1069 on 06/28/23 at 10:50 A.M. revealed she did not routinely document the plan of care meetings in the resident's record. MDS RN #1069 stated any notification of the plan of care meetings was communicated to the resident, guardian and/or responsible party verbally. MDS RN #1069 verified there was no documentation in Resident #22's record of providing an invitation verbally or written of the plan of care meetings. MDS RN #1069 verified there was not documentation of the interdisciplinary team discussion during plan of care meetings in Resident #76's clinical record. The facility's Care Planning/Interdisciplinary Team was responsible for the development of an individualized comprehensive care plan for each resident. The undated facility policy titled Policy Interpretation and Implementation indicated the following guidelines for conducting the plan of care meetings in the facility: A comprehensive care plan for each resident is developed within seven (7) days of completion of the resident assessment (MDS). The care plan is based on the resident's comprehensive assessment and is developed by a Care Planning/Interdisciplinary Team which includes, but is not necessarily limited to the following personnel: The resident's Attending Physician. The Registered Nurse who has responsibility for the resident. The Dietary Manager/Dietician. The Social Services Worker responsible for the resident. The Activity Director/Coordinator. Therapists (speech, occupational, recreational, etc.), as applicable. Consultants (as appropriate). The Director of Nursing (as applicable). The Charge Nurse responsible for resident care. Nursing Assistants responsible for the resident's care; and Others as appropriate or necessary to meet the needs of the resident. The resident, the resident's family and/or the resident's legal representative/guardian or surrogate are encouraged to participate in the development of and revisions to the resident's care plan. Every effort will be made to schedule care plan meetings at the best time of the day for the resident and family. When a resident has no family, the ombudsman will be invited to attend the care plan meeting if desired by the resident. The mechanics of how the Interdisciplinary Team meets its responsibilities in the development of (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 10 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0657 the interdisciplinary care plan (e.g., face-to-face, teleconference, written communication, etc.) is at the discretion of the Care Planning Committee. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 11 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0677 Provide care and assistance to perform activities of daily living for any resident who is unable. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, record review, and review of facility policy the facility failed to ensure Resident #88 did not have very long, dirty, yellow toenails. This affected one resident (#88) out of three residents reviewed for long toenails. In addition, the facility failed to ensure shower/bed baths were given to Resident #58 according to the physician's orders and plan of care. This affected one resident (#58) of six residents reviewed for activities of daily living (ADL). The facility census was 91. Residents Affected - Few Findings include: 1. Review of Resident #88's medical record revealed an admission date of 04/25/23 with diagnoses including unspecified sequelae of other cerebrovascular disease, other specified disorders of the brain, and alcohol abuse. Review of Resident #88's Quarterly Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed Resident #88 was cognitively intact. Resident #88 was independent and required no set up or physical help from staff for bed mobility and transfers. Resident #88 required supervision and set up help for personal hygiene. Review of Resident #88's care plan dated 04/26/23 included Resident #88 had an ADL self-care deficit related to sequelae of CVA (cerebrovascular accident), atrophy and periventricular leukomalacia, and other diagnoses. Resident #88 would receive assistance necessary to meet ADL needs. Resident #88 would be clean, dressed, and well-groomed daily to promote dignity and psychosocial well-being. Interventions included Resident #88 required supervision and verbal cues for dressing and bathing. Observation on 06/26/23 at 11:42 A.M. of Resident #88 revealed he was sleeping in his bed with no covers on and observation of his feet revealed he had very long, yellow toenails, about three quarter of an inch in length. Interview on 06/26/23 at 11:42 A.M. of Licensed Practical Nurse (LPN) #1092 confirmed Resident #88's toenails were really long. LPN #1092 stated Resident #88 needed a podiatrist. Interview on 06/28/23 at 9:00 A.M. of Social Services Designee (SSD) #1070 revealed the podiatrist comes to the facility on a regular basis about every two to three months. SSD #1070 stated Resident #88 had not been seen by the podiatrist since he was admitted . SSD #1070 stated neither the nurses or aides had notified her Resident #88 needed to see a podiatrist, and if they had she would have made sure the podiatrist was notified that Resident #88 needed his toenails cut. Interview on 06/28/23 at 11:57 A.M. of Registered Nurse (RN) #1007 revealed she did not remember any aides telling her Resident #88 needed his toenails cut. Interview on 06/28/23 at 11:59 A.M. of State Tested Nursing Assistant (STNA) #1106 revealed she noticed Resident #88 had long toenails and she told the nurse about it. STNA #1106 did not remember which nurse she told. Observation on 06/29/23 at 10:19 A.M. with RN #1007 confirmed Resident #88's toenails were long. RN #1007 stated Resident #88 really needed his toenails cut. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 12 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Review of the facility policy titled Activities of Daily Living (ADLs), Supporting, revised 03/2018, included residents who were unable to carry out activities of daily living independently would receive the services necessary to maintain good nutrition, grooming and personal and oral hygiene. Appropriate care and services would be provided for residents who were unable to carry out ADL independently, with the consent of the resident and in accordance with the plan of care, including appropriate support and assistance with hygiene (bathing, dressing, grooming, and oral care). 2. Review of the medical record for Resident #59 revealed an admission date of 07/01/22. Diagnosis included Alzheimer's disease, diabetes, arthritis, and hepatitis. Review of the quarterly MDS 3.0 assessment dated [DATE] revealed Resident #58 was severely cognitively impaired. He required extensive assistance of one person for bed mobility, transfers, dressing, toilet use, and hygiene. It was very important for him to choose between a bed bath, shower, or sponge bath. Review of the physician's orders for June 2023 revealed Resident #58 was to receive a shower on Sundays and Thursdays and refusals were to be documented. Review of the plan of care dated 06/22/23 revealed Resident #58 had an ADL self-care performance deficit related to dementia and low back pain. Interventions included assisting with ADL, baths, and showers as needed. Review of the shower sheets for April, May, and June 2023 revealed Resident #58 received a shower 04/03/23, 04/06/23, 04/10/23, 04/13/23, 04/20/23, 04/24/23, 05/04/23, 05/11/23, 05/18/23, 05/25/23, 05/28/23, 06/01/23, 06/08/23, 06/22/23, and 06/23/23. Interview on 06/20/23 at 10:00 A.M. with Resident #59 revealed he only gets a shower once every other week. Interview on 06/28/23 at 3:04 P.M. with the Director of Nursing (DON) confirmed Resident #59 was not receiving showers based on the physician's order and the resident preference. Review of the facility policy titled Activities of Daily Living, (ADL)'s supporting, dated March 2018, revealed residents would receive the care and services needed to maintain ADL. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 13 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, record review, and review of facility policy the facility failed to ensure Resident #82's urine culture was collected and sent to the lab per physician's orders. This affected one resident (#82) out of three residents reviewed for urine cultures. The facility census was 91. Residents Affected - Few Findings include: Review of Resident #82's medical record revealed an admission date of [DATE] with diagnoses including cerebral infarction, personality disorder, and altered mental status. Review of Resident #82's Quarterly Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed Resident #82 had moderate cognitive impairment. Resident #82 was independent for bed mobility, required supervision and set-up help only for transfers, toileting, and eating. Review of Resident #82's physician's orders dated [DATE] revealed urinalysis with culture and sensitivity, one time only for urinary frequency until [DATE]. Review of Resident #82's Treatment Administration Record (TAR) revealed a urinalysis with culture and sensitivity one time for urinary frequency was collected on [DATE] at 8:42 A.M. Review of Resident #82's lab results from [DATE] through [DATE] did not reveal results of urine culture and sensitivity ordered on [DATE]. Review of Resident #82 care plan dated [DATE] included Resident #82 had the potential risk for altered nutrition, hydration status due to diagnoses. Resident #82 utilized diuretic therapy. Resident #82 displayed significant weight loss. Resident #82's skin to remain intact, no signs and symptoms of edema, dehydration, or electrolyte imbalance, continue adequate oral intake of meals and maintain current body weight of 138 pounds plus or minus one to five pounds through the next review. Interventions included to monitor lab, diagnostic work as ordered and report results to the physician and follow up as indicated; provide and serve diet as ordered and monitor intake and record every meal. Observation on [DATE] at 8:54 A.M. of Resident #82 revealed she was sitting in the common area. Resident #82 was pleasant and answered questions. Observation on [DATE] at 3:33 P.M. of Resident #82's water pitcher in her room revealed it was empty. Interview on [DATE] at 3:33 P.M. of State Tested Nursing Assistant (STNA) #1106 revealed Resident #82's water pitcher was empty and had been empty all day. STNA #1106 stated Resident #82's water pitcher was supposed to be kept full at her bedside because she was dehydrated and needed to drink water. Interview on [DATE] at 9:05 A.M. of the Director of Nursing (DON) revealed Resident #82's urine culture on [DATE] was not sent to the lab for analysis. The DON stated the staff obtained the urine sample for culture and sensitivity on [DATE] and put it in the locked specimen box for pick-up by a courier. The DON indicated typically the courier arrived at the facility and picked up specimens from the locked box, but the courier on [DATE] said he was not allowed in the building and staff needed to (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 14 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few meet him at the door with the specimens. The DON stated there was miscommunication and the staff did not meet the courier at the door to give him the specimens in the box. The DON stated Clinical Supervisor (CS) #1003 found Resident #82's urine specimen in the locked specimen box and spoke with the courier's supervisor regarding appropriate protocol for specimen pick up. The DON stated Resident #82's urine specimen was expired and CS #1003 was supposed to ensure another urine specimen was collected from Resident #82 for a urine culture, but the culture was not collected and sent to the lab. The DON stated she did not know where the communication broke down between staff, but Resident #82's urine specimen for culture and sensitivity was never collected and sent to the lab. The DON stated Resident #82's sister-in-law asked for a urine culture because Resident #82 had frequency of urination. Interview on [DATE] at 10:34 A.M. of CS #1003 confirmed Resident #82's urine specimen was not picked up by the courier on [DATE]. CS #1003 confirmed she was aware Resident #82 needed another urine specimen sent for culture and sensitivity. CS #1003 indicated she told a nurse but could not remember which nurse that Resident #82 needed a urine culture, and she forgot to follow up to ensure this was completed. CS #1003 confirmed the urine specimen was never collected sent to the lab. CS #1003 confirmed the sister-in-law requested the specimen due to increased frequency of urination. CS #1003 stated the urine specimen would be collected today ([DATE]). CS #1003 stated neither Resident #82's Nurse Practitioner or physician asked about the results of her urine culture. Review of the facility policy titled Specimen Collection, revised 04/2007, included all specimens, sputum's, etcetera, ordered for testing should be obtained in accordance with established nursing service procedures. Specimen collections must be placed in their proper container, securely sealed, and properly labeled for transfer to the laboratory. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 15 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, interview, and facility policy review the facility failed to prevent Resident #35's fall in the facility and failed to ensure fall prevention interventions were in place for Resident #8. This affected two residents (#35 and #8) out of five residents reviewed for falls. The facility census was 91. Findings include: 1. Resident #35 was admitted on [DATE] and re-admitted on [DATE] with diagnoses including alcohol abuse, attention-deficit hyperactivity disorder, bipolar disorder, morbid obesity with a body mass index of 38 to 38.9, need for assistance with personal care, abnormality of gait and mobility, major depressive disorder, right below the knee amputation, muscle wasting and atrophy with generalized muscle weakness. A review or Resident #35's Minimum Data Set (MDS) assessment dated [DATE] indicated Resident #35 needed extensive assistance with transfers. Resident #35's fall assessment dated [DATE] indicated Resident #35 had a moderate risk for falls. Resident #35's plan of care initiated on 06/20/18 indicated a risk for falls related to history of fall, medication side effects, and Resident #35's instability with toileting and transfer requiring staff assistance. Interventions on the plan of care did not include the use of a Hoyer (mechanical) lift for transferring. Resident #35's nursing progress note dated 06/14/23 indicated while transporting resident from her bed to her wheelchair via mechanical lift (Hoyer Lift), the lift pad tore and Resident #35 fell to the floor. Resident #35 informed the nurse she had struck her head and lower back on the floor and Hoyer Lift. A head-to-toe assessment was performed and Resident #35 sustained a bruise on the back of her scalp with no raised or broken skin visible. Resident #35 had a red area on her lower back and complained of lower back pain rating a three out of ten with ten indicating severe pain. The physician was notified and Resident #35 was sent to the hospital for evaluation and treatment. An interview with Resident #35 on 06/26/23 at 9:54 A.M. indicated the staff was assisting her with a transfer using a Hoyer Lift when the sling tore and she fell to the floor on her buttocks. A review of the fall investigation dated 06/15/23 indicated the events described above in the nursing progress note and implemented and audit of all Hoyer Lift pads to ensure safety and any found to be unsafe would be discarded. An interview with State Tested Nursing Assistant (STNA) #1024 on 06/28/23 at 9:38 A.M. stated he and another STNA were assisting Resident #35 out of bed using a Hoyer Lift when the strap located by Resident #35's head tore and dumped Resident #35 out of the sling to the floor. STNA #1024 stated the sling used for the transfer was old and worn looking and should have been discarded and not used for the transfer. STNA #1024 stated Resident #35 was sent to the hospital. A review of the hospital documentation dated 06/14/23 revealed upon examination Resident #35 was hemodynamically stable, able to move all extremities, and normal range of motion with no sensory deficits. A computerized tomography (CT) scan was performed of the lower back region and found a subtle fracture of the lumber-1 vertebral body without compression which could be acute or subacute. Resident #35 was instructed to consume Tylenol (analgesic) for pain and to follow-up with neurosurgery and (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 16 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0689 primary care physician further tests. Level of Harm - Minimal harm or potential for actual harm An interview with Director of Nursing (DON) on 06/27/23 at 2:50 P.M. verified the above findings. Residents Affected - Few A review of the facility policy and procedure titled Falls and Fall Risk, Managing, dated April 2007, indicated staff and physician should identify appropriate interventions to reduce the risk of falls. Review of resident's functional ability and implement exercise and balance training including possible rearrangement of room furniture as necessary. If falling occurs despite interventions, implement additional interventions, or indicate why current interventions remain relevant. Monitor and document each resident's response to interventions intended to reduce falling or the risks of falling. If underlying causes cannot be readily identified or corrected, staff will try various interventions, based on assessment of the nature or category of falling, until falling is reduced or stopped, or until the reason for the continuation of the falling is identified as unavoidable. If the resident continues to fall. staff will re-evaluate the situation and weather it is appropriate to continue or change current interventions. As needed, the attending physician will help the staff reconsider possible causes that may not previously have been identified. 2. Review of the medical record for Resident #8 revealed an admission date of 10/15/12. Diagnoses included Parkinson's disease, muscle wasting, atrial fibrillation, and schizophrenia. Review of the quarterly MDS assessment dated [DATE] revealed Resident #8 had severe cognitive impairment. He required extensive assistance of one staff for bed mobility, transfers, toilet use, and hygiene. Review of the fall risk assessment date 05/27/22 revealed Resident #5 was at high risk for falls. Review of the fall risk care plan dated 04/28/22 for Resident #8 revealed he was at risk for falls due to Parkinson's, involuntary movements, and medication side effects. Interventions included call bell in reach, fall mats bilaterally (both sides) of the bed, bed to remain in lowest position, and nonskid footwear when out of bed. Review of the nurse's note dated 06/14/22 revealed Resident #8 was on the floor in his room. He was sitting up with his back to the chair facing the television with his legs extended. Bright red blood was coming from the top left rear of his head, onto the residents' neck. The wound was cleansed, and pressure was applied; the wound was not actively bleeding. The resident was assessed and was alert with no complaints. He stated he was going to bed when fell. He had white socks on (not nonskid socks). Review of the fall investigation dated 06/15/22 revealed the resident was sitting on floor with his legs extended in front of a sitting chair. A small open area was noted to the top rear of his left head. The call light was in reach but not activated, and he was wearing plain white gym socks. An intervention was added to ensure nonskid footwear was on at all times when out of bed. Review of the care plan dated 07/06/22 revealed Resident #8 was at risk for falls due to involuntary movements, medication side effects, and a history of falls in the facility. Interventions included call bell in reach, bed in lowest position, toileting with rounds and as needed and non-slip strips at bedside. Review of the nursing note dated 07/28/22 revealed Resident #8 was getting out of bed when he fell (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 17 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few to the floor and sustained a small, reddened area to the forehead. His skin was intact. He was alert with baseline confusion and had no complaints of pain. He was wearing shoes at the time of the fall, the resident was assisted back to bed, the call light was placed in reach and the bed was placed in the lowest position. Review of the fall investigation dated 07/29/22 revealed the nurse witnessed the resident get out of bed and attempt to walk unassisted when he lost his balance and fell. No injuries, pain, or discomfort were noted. Nonskid socks were in place, the floor was dry and clean of debris, the bed was placed in the lowest position and the call light was placed in reach. There was no evidence the call bell was in reach, or the bed was in the lowest position at the time of the fall, non-slip strips were in place at the bedside, or when he was last toileted. Interview on 06/28/23 at 13:04 P.M. with the DON verified the investigation was not thorough and did not include if all fall prevention interventions were in place at the time of the falls on 06/14/22 and 07/28/22. Review of the facility policy titled Falls and Fall Risk, Managing, dated April 2007, revealed fall interventions would be initiated as appropriate. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 18 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0692 Provide enough food/fluids to maintain a resident's health. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, record review and review of the facility policy the facility failed to ensure Resident #36 received nutritional supplements and double portions of food per physician orders, failed to ensure weights were obtained per physician orders, failed to ensure Resident #36's meal percentages of food eaten were documented and failed to ensure Resident #36's significant weight loss was monitored from 03/16/23 through 06/26/23. The facility failed to ensure Resident #82 was provided fluids per physician orders, failed to ensure Resident #82's fluid intake was recorded and failed to ensure Resident #82's daily fluid requirements were documented by the facility Dietician in an initial nutritional assessment. The facility also failed to obtain monthly weights as ordered for resident #32. This affected three residents (Resident's #32, #36 and #82) out of three residents reviewed for nutrition. The facility census was 91. Residents Affected - Few Findings include: 1. Review of the medical record for Resident #32 revealed an admission date of 09/01/22. Diagnoses included hyperlipidemia, depression, anxiety and Cerebral Palsy. Review of the quarterly Minimum Data Set assessment (MDS) dated [DATE] revealed the resident was rarely or never understood. He had no oral or dental issues and no weight loss or gain. Review of the medical record revealed the resident weighed 176.9 lbs on 10/27/22. Review of the care plan dated 06/01/23 revealed the resident was at risk for altered nutrition status due to a mechanical soft textured diet depression, anxiety, chronic fatigue and irritable bowel syndrome. Interventions included monitoring intake of meals, monitoring for signs and symptoms of difficulty swallowing and obtaining and recording weight as ordered. Review of the quarterly nutrition assessment dated [DATE] revealed the resident had no significant weight change in the past month and was weighed monthly. Recommendations were to continue monitoring weights, labs and tolerance of diet texture. Review of the quarterly nutrition assessment dated [DATE] revealed the resident had no significant weight change in the past month and was weighed monthly. Recommendations were to continue monitoring weights, labs and tolerance of diet texture. Interview on 06/29/23 at 8:43 A.M. with Registered Dietician (RD) #1095 revealed Resident #32 should be weighed monthly. She reviewed monthly weights that were not obtained the previous month and submitted a list to facility staff, but confirmed she did not follow up with the list to ensure those weights were obtained. She confirmed Resident #32 had not been weighed since 10/27/22. 2. Review of Resident #36's medical record revealed an admission date of 02/20/23 and diagnoses included dementia with other behavioral disturbance, schizoaffective disorder, bipolar type, and mood disorder. Review of Resident #36's weights from 02/20/23 (180 pounds) through 06/01/23 (166.8 pounds) revealed Resident #36 had a 7.33 percent weight loss. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 19 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0692 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Review of Resident #36's physician orders dated 02/28/23 revealed monthly weight, document refusal, every day shift starting on the third and ending on the third every month. Review of Resident #36's dietary progress notes dated, 03/16/23 revealed Resident #36 had a weight change of greater than five percent over 30 days. Resident #36's current body weight on 03/13/23 was 170.4 pounds. Resident #36 was on a regular diet, regular texture and consistency. Fluids and snacks were offered between meals. No chewing or swallowing concerns were noted per current diet order. Secondary to significant weight loss receiving house supplement twice a day at lunch and dinner. Continue to monitor. Review of Resident #36's physician orders dated 03/16/23 revealed house supplement, two times a day at lunch and dinner. Review of Resident #36's progress notes and evaluations from 03/16/23 through 06/26/23 did no reveal dietary progress notes or nutritional evaluations. Review of Resident #36's weights from 03/13/23 through 05/03/23 did not reveal a weight was documented. Review of Resident #36's Quarterly Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed Resident #36 had severe cognitive impairment. Resident #36 required supervision and set up help only for bed mobility and transfers, and was independent with set up help only for eating. Resident #36 had a weight loss of five percent or more in the last month or loss of 10 percent or more in the last six months. Review of Resident #36's care plan dated 05/18/23 included Resident #36 had a nutritional problem or potential nutritional problem related to nutrition, and diagnoses. Resident #36 displayed significant weight loss. Resident #36 would maintain adequate nutritional status as evidenced by maintaining weight within 10 percent of 171 pounds, no signs and symptoms of malnutrition, and consuming at least greater than 50 percent of at least two to three meals daily through review date. Interventions included to receive house supplement two times a day, monitor, record, and report to the physician as needed signs and symptoms of malnutrition: emaciation (cachexia), muscle wasting, significant weight loss: three pounds in one week, greater than five percent in one month, greater than seven and a half percent in three months, greater than ten percent in six months, Registered Dietician to evaluate and make diet change recommendations as needed. Review of Resident #36's Activity of Daily Living aide charting for meal percentages eaten from 06/01/23 through 06/26/23 revealed mostly zeros in the daily areas for breakfast and lunch. Review of 06//01/23, 06/02/23, 06/13/23 and 06/14/23 lunch meal revealed a 100 percent was documented for percentage of meal eaten, but the rest of the days had zeros. Review of Resident #36's physician orders dated 06/22/23 revealed nutrition evaluation and treat resident needs double portions, every day shift for nutrition. Observation on 06/28/23 at 12:35 P.M. of Wife #1105 revealed meal trays arrived to the floor, and Wife #1105 assisted Resident #36 to the dining area. Wife #1105 stated Resident #36 ate 100 percent of whatever food was on his plate during meals. Observation on 06/28/23 at 12:45 P.M. of Resident #36 revealed he was sitting in the dining area (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 20 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0692 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few with his meal tray in front of him. Resident #36's meal tray did not have a house supplement on it and his meal tray did not contain double portions of the meal served. Interview on 06/28/23 at 12:45 P.M. of Registered Nurse (RN) #1007 and State Tested Nursing Assistant (STNA) #1106 confirmed Resident #36 did not have a house supplement or double portions of food on his meal tray. Review of Resident #36's meal ticket on 06/28/23 for the lunch meal revealed the very top of the ticket stated house supplement, but the bottom of the ticket did not have house supplement or double portions listed. Interview on 06/28/23 at 12:52 P.M. of Dietary Director (DD) #1057 revealed review of Resident #36's meal ticket did not have double portions listed on it. DD #1057 stated Registered Dietitican (RD) #1095 would email her if she updated a resident meal ticket and she did not receive an email from RD #1095 about Resident #36's double portions. DD #1057 stated she was not aware Resident #36 should have double portions on his meal ticket. DD #1057 stated Resident #36 did not receive a house supplement because the house supplement was not listed at the bottom of the ticket and that was where the dietary staff referred to when they were preparing the meal trays on the tray line. DD #1057 stated to her knowledge Resident #36 had not received a house supplement with any meal since it was ordered on 03/16/23. DD #1057 stated the dietary staff would not know to put a house supplement on Resident #36's tray because it was not listed at the bottom of the meal ticket. DD #1057 stated the way the meal tickets were arranged during tray line revealed only the bottom of the ticket (not the top) so it was important for the correct infomation to be on the bottom of the ticket. DD #1057 stated usually the dietician would update the meal ticket, list the house supplement at the bottom of the ticket, and notify her it was updated by email or verbally. Interview on 06/28/23 at 2:47 P.M. of the Director of Nursing (DON) revealed when the physician, Nurse Practitioner or Dietician placed an order Registered Dietician (RD) #1095 reviewed all new orders and the nursing staff updated new orders in resident records. Interview on 06/28/23 at 3:35 P.M. of State Tested Nursing Assistant's (STNA)'s #1028 and #1106 confirmed Resident #36's meal percentages were not documented in the Activity of Daily Living Binder area for meal percentages for breakfast and lunch. STNA #1106 stated there was a zero in the area that should have percentage of meals eaten documented in it. STNA #1106 stated Resident #36 was independent for eating and a zero was the code for independent. STNA #1106 stated education was needed for the aides to correctly chart Resident #36's meal percentages, and it would be nice to have a meeting once in a while to tell them about these things. Interview on 06/29/23 at 8:40 A.M. of Registered Dietician (RD) #1095 revealed she worked in the facility every Thursday. RD #1095 stated Resident #36 did not trigger for a weight loss because she charts at one, three and six months and those were the only months that would pop up as a trigger and she had already charted for the weight loss from february to march. RD #1095 stated she could send an updated meal ticket for Resident #36 but instead she sent an email to DD #1057, Clinical Supervisor (CS) #1003, Dietary Technician (DT) #1094, and Clinical Supervisor (CS) #1005 about Resident #36's weight loss and the need for a house supplement to promote weight stability. RD #1095 stated one of them could update Resident #36's meal ticket. RD #1095 stated Resident #36's weight had been stable even though he had a significant weight loss from 02/20/23 through 06/01/23. RD #1095 stated she was not aware Resident #36 had an order for double portions, she did not have an email from CS #1003 about double portions, and might have received a text but she did not have her phone with her and (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 21 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0692 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few could not check the messages. RD #1095 stated she was aware there were zeros documented in the Activity of Daily Living aide charting for meal percentages eaten. RD #1095 stated she asked the aides and nurses if Resident #36 was eating his meals and they told her he was eating enough. Interview on 06/29/23 at 9:05 A.M. of the DON confirmed the aides were documenting a zero for Resident #36's percentage of food eaten and should be writing the percentage of the meal eaten. Interview on 07/03/23 at 8:18 A.M. of the DON revealed RD #1095 was in the facility every Thursday and residents weights were reported to her and weights were also documented in residents electronic record and RD #1095 pulled the weekly weights for review. The DON stated RD #1095 would be able to see a resident had a weight loss. The DON stated Resident #36 was not a resident who they discussed about weight loss. The DON reviewed the Risk Meeting information and Resident #36 was not documented in the information and she would have to call RD #1095 about Resident #36's weight loss and why he was not discussed in the Risk Meeting information. Review of the facility policy titled Weight Assessment and Intervention revised 09/2008 included the multidisciplinary team would strive to prevent, monitor, and intervene for undesirable weight loss for the residents. Any weight change of five percent or more since the last weight assessment would be retaken the next day for confirmation. If the weight was verified, nursing would immediately notify the Dietitian in writing. Verbal notification must be confirmed in writing. The Dietitian would respond within 24 hours of receipt of written notification. 3. Review of Resident #82's medical record revealed an admission date of 12/15/22 and diagnoses included cerebral infarction, personality disorder and altered mental status. Review of Resident #82's medical record including progress notes from 12/15/22 through 06/26/23 did not reveal an initial Nutritional Assessment was completed including fluid requirements per day. Review of Resident #82's Quarterly Nutritional Assessments documented in the progress notes on 01/01/23 and 04/08/23 did not reveal documentation related to Resident #82 daily fluid intake needs. Review of Resident #82's Quarterly Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed Resident #82 had moderate cognitive impairment. Resident #82 was independent for bed mobility, required supervision and set up help only for transfers and eating. Resident #82 had a five percent or more weight loss in the last month or loss of ten percent or more in the last six months. Resident #82 was not on a prescribed weight-loss regimen. Review of Resident #82's lab results dated 05/17/23 included a Blood Urea Nitrogen of 22 (normal range was 7 to 18 mg/dL (milligram per decilitre)). Review of Resident #82's physician orders dated 05/19/23 revealed encourage oral hydration, every shift for oral hydration. The orders did not state minimum amount of fluids to encourage per shift. Review of Resident #82's progress notes dated 05/19/23 at 7:03 A.M. revealed Resident #82's Nurse Practitioner was made aware of a critical lab of BUN (used to assist with identification of dehydration). Nurse Practitioner stated to make sure Resident #82 was hydrated. Review of Resident #82's dietary progress note dated 06/01/23 at 9:09 A.M. included Resident #82's intakes were noted good per nursing, fluids and snacks offered between meals. Continue current (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 22 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0692 nutrition, monitor and make recommendations as needed. Level of Harm - Minimal harm or potential for actual harm Review of Resident #82's Activity of Daily Living aide charting for fluid intake from 06/01/23 through 06/26/23 did not reveal documentation regarding fluid intake. Residents Affected - Few Review of Resident #82's Medication Administration Record and Treatment Administration Record from 06/01/23 through 06/26/23 did not reveal documentation regarding fluid intake. Review of Resident #82 care plan dated 06/15/23 included Resident #82 had the potential risk for altered nutrition, hydration status due to diagnoses. Resident #82 utilized diuretic therapy. Resident #82 displayed significant weight loss. Resident #82's skin to remain intact, no signs and symptoms of edema, dehydration, or electrolyte imbalance, continue adequate oral intake of meals and maintain current body weight of 138 pounds plus or minus one to five pounds thorugh the next review. Interventions included to monitor lab, diagnostic work as ordered and report results to the physician and follow up as indicated; provide and serve diet as ordered and monitor intake and record every meal. Observation on 06/28/23 at 8:54 A.M. revealed Resident #82 was sitting in the common area with the Speech Therapist with no water on the table in front of her. Observation on 06/28/23 at 8:54 A.M. of Resident #82's room did not reveal a cup of water or a pitcher of water on the bedside table or over the over bed table. Further observation of Resident #82's room revealed an empty water pitcher with her roommates name written on it. Observation on 06/28/23 at 10:26 A.M. of Resident Resident #82's room revealed no pitcher of water or cup of water. Observation on 06/28/23 at 10:26 A.M. of Resident #82 revealed she was sitting in common area, and she did not have a cup of water or any fluids in front of her Interview on 06/28/23 at 2:44 P.M. of the Director of Nursing (DON) revealed aides documented in an Activity of Daily Living binder located at the nurses station. The DON stated aides told the nurses if a resident was not eating or drinking and the nurse would report it to the unit manager. Interview on 06/28/23 at 3:33 P.M. of State Tested Nursing Assistant (STNA) #1106 confirmed Resident #82's water pitcher in her room was empty and had been empty all day. STNA #1106 stated most of the residents were given water in small cups because the water pitchers get spilled. STNA #1106 stated Resident #82's water pitcher should have been filled with water and left at the bedside because she was dehydrated and they were supposed to keep water in it for her to drink. Interview on 06/28/23 at 3:35 P.M. of STNA's #1028 and #1106 revealed they did not track and document fluids for Resident #82. STNA's #1028 and #1106 stated they only documented fluids if residents were on a fluid restriction. STNA's #1028 and #1106 confirmed they passed out water for some of the residents, but not all of them including Resident #82 since they arrived at 7:00 A.M. Interview on 06/28/23 at 3:38 P.M. of Registered Nurse (RN) #1007 revealed Resident #82's fluid intake was not documented in the aide charting or the nurses charting on the Medication Administration Record or the Treatment Administration Record. RN #1007 stated only nutritional supplement fluid intake was recorded. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 23 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0692 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Interview on 06/29/23 at 8:52 A.M. of Registered Dietician (RD) #1095 revealed she documented her Annual and Quarterly nutritional assessments in Resident #82's progress notes. RD #1095 stated she monitored Resident #82's fluid intake. RD #1095 stated Resident #82 needed encouragement to drink fluids and it was hard when the fluids were not documented and she had to rely on the staff. RD #1095 stated she was aware there were no fluids documented by the aides for Resident #82 in the Activity of Daily Living binder. When asked how she monitored the fluids if they were not documented, RD #1095 stated she asked the nurse and aides if Resident #82 was drinking adequate fluids. Interview on 06/29/23 at 9:05 A.M. with the DON revealed the aides should be documenting Resident #82's fluid intake in the Activity of Daily Living binder. The DON confirmed Resident #82 did not have fluids documented by the aides in the binder, and confirmed there was no area for aides to document Resident #82's fluids in the binder and there should be. Review of the facility policy titled Resident Hydration and Prevention of Dehydration revised 12/2008 included the facility would endeavor to provide adequate hydration and to prevent and treat dehydration. The Dietitian would assess all residents for hydration adequacy at least quarterly, and more often as necessary per resident need. Minimum fluid needs would be calculated and documented on initial, annual, and significant change assessments, using current Standards of Practice. Nurses' Aides would provide and encourage intake of bedside, snack and meal fluids, on a daily and routine basis as part of daily care. Intake would be documented in the medical records. Aides would report intake of less than 1200 milliliters (ml) per day to nursing staff. Orders might be written for extra fluids to be encouraged between meals and, or with medication passes. A specific minimum amount should be included in the order (for example, 240 ml fluids twice a day with medication pass). Force fluids was not an appropriate order. Encourage fluids was not an adequate order. Nursing would monitor and document fluid intake and the Dietitian would be kept informed of status. Interdisciplinary Team will update care plan and document resident response to interventions until team agrees that fluid intake and relating factors were resolved. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 24 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0698 Provide safe, appropriate dialysis care/services for a resident who requires such services. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview the facility failed to obtain Resident #6's laboratory results during dialysis treatments as ordered by the physician. This affected one resident (#6) out of one resident reviewed for hemodialysis care. The facility census was 91. Residents Affected - Few Findings include: Resident #6 was admitted on [DATE] and re-admitted on [DATE] with diagnoses including end stage renal disease, anemia, renal osteodystrophy (a bone disease that occurs in adults and children with chronic kidney disease), and chronic viral hepatitis C. Resident #6's medical record indicated on 12/02/21 a physician order to arrange transportation to the dialysis center for hemodialysis treatments on Tuesdays, Thursdays, and Saturdays. Resident #6's physician order dated 05/30/23 indicated to obtain a complete blood count, and basic metabolic panel every three months starting on the last day of the month. Further review of Resident #6's clinical record revealed no laboratory results were obtained on 05/31/23. An interview with Clinical Supervisor (CS) #1005 on 06/29/23 at 12:13 P.M. indicated he assumed responsibility to ensure the communication between the dialysis center and the facility was documented on Resident #6's dialysis communication form. CS #1005 stated the nurse caring for Resident #6 on 05/30/23 failed to notify the dialysis center of the need to obtain the complete blood count and basic metabolic panel during his dialysis treatment. CS #1005 stated the nurse should have notified the dialysis center via phone and sent the requisition to the dialysis center via facsimile to the dialysis center. CS #1005 verified Resident #6's laboratory tests were not obtained on 05/31/23. The facility agreement between the facility and the contracted dialysis center indicated under item 3.3.3 the facility would agree to cooperate facilitating and communicating information to the dialysis center which was useful or necessary for the care of the resident. Item number 3.5 indicated the facility shall assume full responsibility for obtaining services that meet professional standards and principles that apply to professionals providing services in such a facility and timeliness of services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 25 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0727 Level of Harm - Minimal harm or potential for actual harm Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. Based on record review and interviews the facility failed to have a registered nurse (RN) for eight consecutive hours on 06/18/23. This had the potential to affect all 91 residents. Residents Affected - Many Findings include: Review of the schedule while completing the staffing tool for the week of 06/18/23 revealed there was no RN present in the building for 06/18/23. Interview on 07/03/23 at 11:38 A.M. with Staffing Coordinator (SC) #1067 verified there was no RN coverage per the schedule. Interviews on 07/03/23 from 11:44 A.M. through 1:39 P.M. with management who were on a rotating on-call schedule including Minimum Data Set Nurse (MDS) #1069, Unit Manager #1003 and Unit manager #1005 revealed they did not work on 06/18/23. Interview on 07/03/23 at 4:00 P.M. with the Director of Nursing (DON) revealed she did not work on 06/18/23. She stated there was no RN that day as the one who was scheduled was hospitalized . Review of the punch details revealed there was no RN on 06/18/23. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 26 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0756 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to ensure medications were reviewed monthly. This affected one resident (#8) of five resident reviewed for unnecessary medications and had the potential to affect all residents in the facility. The facility census was 91. Findings include: Review of the medical record for Resident #8 revealed an admission date of 10/15/12. Diagnoses included Parkinson's disease, muscle wasting, atrial fibrillation, and schizophrenia. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #8 had severe cognitive impairment. He required extensive assistance of one staff for bed mobility, transfers, toilet use, and hygiene. Review of the physician's orders for June 2023 revealed Resident #8 was ordered Seroquel (antipsychotic) 100 milligrams (mg) two times a day (BID) and Seroquel 200 mg once per day (QD), Duloxetine (antidepressant) 20mg QD, Metoprolol (medication to treat high blood pressure, chest pain, and heart failure) 25 mg QD, Trihexyphenidyl (medication to treat Parkinson's disease) 5mg three times a day (TID) and Ativan (antianxiety) 0.5 mg every four hours as needed (prn). Review of the monthly pharmacy reviews reveled the resident's medications were reviewed in May 2022, June 2022, November 2022, December 2022, February 2023, March 2023, May 2023, and June 2023. Interview on 06/28/23 at 3:04 P.M. with the Director of Nursing (DON) confirmed medication reviews were not completed monthly. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 27 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0758 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, interview, and review of the facility policy the facility failed to ensure non-pharmacological interventions were utilized, behavioral symptoms were monitored, and anti-anxiety medications were not used for longer than 14 days without a rationale. This affected one resident (#8) of five residents reviewed for unnecessary medications. The facility census was 91. Findings include: Review of the medical record for Resident #8 revealed an admission date of 10/15/12. Diagnoses included Parkinson's disease, muscle wasting, atrial fibrillation, and schizophrenia. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed the Resident had severe cognitive impairment. He required extensive assistance of one staff for bed mobility, transfers, toilet use and hygiene. Review of the physician's orders for June 2023 revealed Resident #8 was ordered Seroquel (antipsychotic) 100 milligrams (mg) two times a day (BID) and Seroquel 200 mg once per day (QD), Duloxetine (antidepressant) 20mg QD, Metoprolol (medication to treat high blood pressure, chest pain, and heart failure) 25 mg QD, Trihexyphenidyl (medication to treat Parkinson's disease) 5mg three times a day (TID) and Ativan (antianxiety) 0.5 mg every four hours as needed (prn) which began 02/13/23. Review of the medical record revealed no evidence non-pharmacological interventions were attempted prior to the administration of Ativan, no evidence behavioral symptoms were monitored, and no evidence the physician provided a rationale for the continued use of Ativan. Interview on 06/21/23 at 11:14 A.M. with Licensed Practical Nurse (LPN) #1014 confirmed she did not document any interventions attempted prior to administering prn anti-anxiety medications such as Ativan and did not document any behavioral concerns. Interview on 06/29/23 at 9:02 A.M. with the Director of Nursing (DON) confirmed there was no stop date for the prn Ativan and the physician had not provided a rationale for its continued use. Review of the facility policy titled Antipsychotic Medication Use, dated December 2016, revealed staff would document information such as behaviors and prn medications extended past 14 days would include a rationale for continued use. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 28 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0804 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Level of Harm - Minimal harm or potential for actual harm Based on record review, interviews and observations, the facility did not ensure food was served in a manner to maintain quality and palatability of all food served to the residents. This had the potential to affect all residents receiving meals from the kitchen. The facility census was 91. Residents Affected - Some Findings include: Review of the resident council minutes revealed during the meeting on 12/29/22 council presented concerns regarding the food not looking appealing to the residents stating the food was unrecognizable and terrible. Twelve residents attended, ten of which were current residents (#1, #3, #11, #14, #20, #24, #25, #31, #32 and #67). Review of the grievance log, dated 06/27/22, revealed the Director of Nursing purchased pizza for all the residents because they were not satisfied with the dinner. Interview on 07/03/23 at 1:30 P.M. with the DON verified the residents were dissatisfied with the meatloaf served on 06/27/23. Interviews on 06/26/23 with Residents (#7, #9, #11 #14, #24, #41, #58 and #68) revealed the food did not look appealing and within the past month they had been served frozen French fries. Additional concerns identified during the interviews included the food could not always be identified by looking at it. Interviews on 06/26/23 between 12:07 P.M. and 12:38 P.M. with Licensed Practical Nurse (LPN) #1022 and State Testing Nursing Assistants (STNA's) #1031 and #1039 revealed the food did not look appetizing a lot of the time. They mentioned meatloaf, ravioli, French fries. They also stated they could not always identify the food by looking at it. Observation and interviews on 06/27/23 at 5:00 P.M. of the dinner tray line with [NAME] #1059 and Food Service Director (FSD) #1057 revealed they were serving French fries that were smashed up and falling apart and did not look like a French fry. [NAME] #1059 and FSD #1057 stated they would send the fries back had they received them at a restaurant looking like that. FSD #1057 stated there was nothing she could do about it. During the same dinner service chili dogs were being served. A four-ounce scoop of chili sauce was added on top of the hot dog which saturated the entire hot dog bun so it could not be picked up to eat without soiling fingers. [NAME] #1059 and FSD #1057 stated they thought they were to use a large ladle (four ounces) of chili sauce, and both verified the entire bun was smothered with sauce and could not be picked up to eat without using utensils. [NAME] #1059 started using half a ladle but it was still covering the bun. Additional concerns related to palatability included the peas and carrots served were not drained well so water from the vegetable was on the plate with the chili dog. FSD #1057 stated they had not used monkey dishes for vegetables since prior to the pandemic. Interview on 06/29/23 at 8:59 A.M. with Registered Dietitian (RD) #1095 revealed the chili sauce served was to be one to two ounces, not four ounces. This violation represents non-compliance under Complaint Number OH00142951. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 29 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, interview, and facility policy review the facility failed to ensure staff washed their hands to prevent possible cross contamination of infections during Resident #23's incontinence care and wound care. This affected one resident (#23) out of three residents reviewed for wounds and incontinence care. The facility census was 91. Residents Affected - Few Findings include: Resident #23 was admitted on [DATE] with diagnoses including iron deficiency anemia, gastrointestinal hemorrhage, Alzheimer's disease, diabetes mellitus, skin cancer, contracture of the right hip, major depression, dementia, and anxiety. Resident #23's wound documentation dated 06/26/23 indicated she had a cancer lesion located on the right trochanter measuring 1.2 centimeter (cm) in length by 1.1 cm width with no undermining or tunneling. The wound had serous exudate with edges flush with wound bed. Additional care needs included to provide incontinence management and nutrition/dietary supplementation. The wound was stable with no decline or improvement in the wound assessment. An observation of State Tested Nursing Assistant (STNA) #1018 on 06/29/23 at 1:39 P.M. perform Resident #23's incontinence care revealed a concern with following infection control standards related to handwashing. STNA #1018 donned a pair of disposable gloves removed Resident #23's incontinence brief and cleaned feces on the perineal area using disposable body wipes. STNA #1018 did not wash her hands or change her gloves. STNA #1018 proceeded to search for moisture barrier cream and clothing in Resident #23's bed side drawer and clothing dresser with the same gloved hands used for cleaning feces from Resident #23's perineal area. STNA #1018 applied the moisture barrier cream to Resident #23's perineal area and assisted Resident #23 with donning clean clothing items with the same gloved hands used during the incontinence care. An interview with STNA #1018 on 06/29/23 at 1:50 P.M. verified the above findings and agreed she did not follow infection control standards. An observation of Registered Nurse (RN) #1012 on 06/29/23 at 1:50 P.M. perform Resident #23's wound treatment revealed a concern with following infection control standards. RN #1012 washed her hands and donned a pair of disposable gloves prior to performing Resident #23's wound care. RN #1012 removed Resident #23's wound dressing and placed the soiled wound dressing in a bio-hazard bag. RN #23 then cleaned the wound with normal saline applied to a gauze pad and patted the area dry with a dry gauze pad. RN #23 did not remove her gloves and wash her hands before applying the wound treatment (apply skin prep and cover with foam dressing) to Resident #23's right trochanter wound. RN #1012 removed her gloves and did not wash her hands. RN #1012 exited the room and discarded the soiled wound dressing in bio-hazard bag in the appropriate waste receptacle. RN #1012 re-entered the room and assisted with transferring Resident #23 up to her wheelchair. An interview with RN #1012 on 06/29/23 at 2:10 P.M. verified the above findings. A review of the infection control policy and procedure titled Handwashing/Hand Hygiene, revised 08/2019, indicated the following guidance: (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 30 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0880 This facility considers hand hygiene the primary means to prevent the spread of infections. Level of Harm - Minimal harm or potential for actual harm The Policy Interpretation and Implementation procedure indicated: Residents Affected - Few 1. All personnel shall be trained and regularly in-serviced on the importance of hand hygiene in preventing the transmission of healthcare-associated infections. 2. All personnel shall follow the handwashing/hand hygiene procedures to help prevent the spread of infections to other personnel, residents, and visitors. 3. Hand hygiene products and supplies (sinks, soap, towels. alcohol-based hand rub. etc.) shall be readily accessible and convenient for staff use to encourage compliance with hand hygiene policies. 4. Triclosan-containing soaps will not be used. 5. Residents, family members and/or visitors will be encouraged to practice hand hygiene through the use of fact sheets. pamphlets and/or other written materials provided at the time of admission and/or posted throughout the facility. 6. Wash hands with soap (antimicrobial or non-antimicrobial) and water for the following situations: a. When hands are visibly soiled; and b. After contact with a resident with infectious diarrhea including, but not limited to infections caused by norovirus, salmonella, shigella and C. difficile. 7. Use an alcohol-based hand rub containing at least 62% alcohol; or, alternatively, soap (antimicrobial or non-antimicrobial) and water for the following situations: a. Before and after coming on duty. b. Before and after direct contact with residents. c. Before preparing or handling medications. d. Before performing any non-surgical invasive procedures. e. Before and after handling an invasive device (e.g., urinary catheters, IV access sites). f. Before donning sterile gloves. g. Before handling clean or soiled dressings, gauze pads, etc. h. Before moving from a contaminated body site to a clean body site during resident care. i. After contact with a resident's intact skin. J. After contact with blood or bodily fluids. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 31 of 32 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365185 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Center Healthcare and Rehabilitation 5665 South Ave Youngstown, OH 44512 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0880 k. After handling used dressings, contaminated equipment, etc. Level of Harm - Minimal harm or potential for actual harm I. After contact with objects (e.g., medical equipment) in the immediate vicinity of the resident. m. After removing gloves. Residents Affected - Few n. Before and after entering isolation precaution settings. o. Before and after eating or handling food. p. Before and after assisting a resident with meals. q. After personal use of the toilet or conducting your personal hygiene. 8. Hand hygiene is the final step after removing and disposing of personal protective equipment. 9. The use of gloves does not replace hand washing/hand hygiene. Integration of glove use along with routine hand hygiene is recognized as the best practice for preventing healthcare-associated infections. 10. Single-use disposable gloves should be used: a. Before aseptic procedures. b. When anticipating contact with blood or body fluids. c. When in contact with a resident, or the equipment or environment of a resident, who is on contact precautions. 11. Wearing artificial fingernails is strongly discouraged among staff members with direct resident-care responsibilities and is prohibited among those caring for severely ill or immunocompromised resident The Infection Preventionist maintains the right to request the removal of artificial fingernails at any time: he or she determines that they present an unusual infection control risk. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365185 If continuation sheet Page 32 of 32