Inspection·November 17, 2022

F 0558 Reasonably accommodate the needs and preferences of each resident. 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, staff interview, and facility policy review the facility failed to ensure the call light was within reach for Resident #177. This affected one resident (Resident #177) of 24 residents observed for call lights within reach. The facility census was 79. Residents Affected - Few Findings include: Review of the medical record revealed Resident #177 was admitted to the facility on [DATE]. Diagnoses included diabetes, anxiety, depression, chronic kidney disease, atrial fibrillation, back and hip pain, bradycardia, supranuclear palsy, and gastroesophageal reflux. Observation on 11/14/22 at 11:46 A.M. revealed the call light for Resident #177 was on the chair on the other side of the bed. Resident #177 stated she could not reach her call light because she was not able to walk over to the chair to get it. Interview on 11/14/22 at 11:47 A.M., Licensed Practical Nurse (LPN) #238 verified the call light for Resident #177 was not within her reach. Observation on 11/15/22 at 8:17 A.M. revealed Resident #177 was up in the wheelchair on the left side of her bed, and her call light was in the chair in the right side of the bed. Interview on 11/15/22 at 11:50 A.M. Corporate Nurse #275 verified the call light for Resident #177 was not within her reach. Review of the facility policy titled Call Lights, dated 04/01/22, revealed call lights would be placed within the residents reach and answered in a timely manner. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366363 If continuation sheet Page 2 of 22 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 366363 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/17/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Laurels of Steubenville The 500 Stanton Boulevard Steubenville, OH 43952 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 0583 Keep residents' personal and medical records private and confidential. 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, and staff interview the facility failed to ensure privacy was maintained during a medical treatment for Resident #176. This affected one resident (Resident #176) of one reviewed for privacy. The facility census was 79. Residents Affected - Few Findings include: Review of the medical record revealed Resident #176 was admitted to the facility on [DATE]. Diagnoses included acute pulmonary edema, restless leg syndrome, hypertensive heart disease, low back pain, osteoarthritis, and intervertebral disc disease. Observation of wound care on 11/17/22 at 1:00 P.M. with Licensed Practical Nurse (LPN) #301 for Resident #176 revealed she provided wound care to both the residents heels without closing her door to the hallway or pulling the privacy curtain to maintain privacy. Interview on 11/17/22 at 1:15 P.M. LPN #301 verified she had not provided privacy to Resident #176 during wound care. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366363 If continuation sheet Page 3 of 22 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 366363 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/17/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Laurels of Steubenville The 500 Stanton Boulevard Steubenville, OH 43952 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 0636 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to ensure a comprehensive bowel and bladder assessment was completed for Resident #67. This affected one (Resident #67) of nine residents reviewed for assessments. The facility census was 79. Finding include: Review of the medical record for Resident #67 revealed an admission date of 12/21/21. Diagnoses included generalized muscle weakness, aphasia, and gastro esophageal reflux disease (GERD). Review of the quarterly Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed Resident #67 had impaired cognition. He was incontinent of bowel and bladder and required extensive assistance of two staff for toilet use. Review of the care plan dated 10/28/22 revealed Resident #67 was incontinent of bowel and bladder due to a developmental delay. Interventions included checking and changing the resident's brief every two hours and changing clothing after incontinence care as needed. Review of the medical record from 12/21/21 through 11/16/22 revealed no documented evidence a comprehensive bowel and bladder assessment was completed. Interview on 11/16/22 at 2:15 P.M. with the Director of Nursing (DON) confirmed a comprehensive assessment was not completed for Resident #67. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366363 If continuation sheet Page 4 of 22 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 366363 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/17/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Laurels of Steubenville The 500 Stanton Boulevard Steubenville, OH 43952 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 0640 Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, review of the Centers for Medicare and Medicaid Services' (CMS) Long-Term Care Facility Resident Assessment Instrument (RAI) User's Manual, and staff interview, the facility failed to ensure Minimum Data Set (MDS) Assessments were completed as required. This affected one (Resident #5) of three residents closed records reviewed. The census was 79. Residents Affected - Few Findings include: Review of the closed medical record for Resident #5 revealed an admission date of [DATE] with diagnoses including heart failure, Parkinson's disease, type two diabetes mellitus, hypertension, and cardiomyopathy. Resident #5 expired on [DATE]. Review of the completed Minimum Data Set (MDS) 3.0 Assessments for Resident #5 revealed an Entry Assessment was completed on [DATE] and an admission Assessment was completed on [DATE]. No other MDS 3.0 Assessments were available in the electronic health record. Review of the progress note dated [DATE] at 7:05 A.M. revealed Resident #5 expired in the facility and her time of death was declared on [DATE] at 7:05 A.M. Review of the Centers for Medicare and Medicaid Services' (CMS) Long-Term Care Facility Resident Assessment Instrument (RAI) User's Manual, dated [DATE], indicated the Death in Facility MDS completion date must be no later than seven days from the event date. On [DATE] at 2:32 P.M., interview with Corporate MDS Nurse #275 verified Resident #5 expired in the facility on [DATE] and there was no Death in Facility MDS 3.0 Assessment completed for Resident #5. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366363 If continuation sheet Page 5 of 22 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 366363 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/17/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Laurels of Steubenville The 500 Stanton Boulevard Steubenville, OH 43952 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 0679 Provide activities to meet all resident's needs. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, review of the medical record, review of activity calendars, review of activity attendance sheets, and staff interviews revealed the facility failed to provide activities to Resident #68. This affected one (Resident #68) of two residents reviewed for activities. The facility census was 79. Residents Affected - Few Findings include: Review of the medical record revealed Resident #68 was admitted to the facility on [DATE]. Diagnoses included dementia, Down's syndrome, epilepsy, affective mood disorder, bipolar disorder, psychosis, obstructive sleep apnea, peripheral vascular disease, and major depressive disorder. Review of the quarterly Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed Resident #68 had severely impaired cognition. Review of the admission activity assessment dated [DATE] revealed gospel and country music were very important. His favorite activities were preaching and music, but he also enjoyed sports, video games, singing, played the guitar at one time, loves taking rides in the car, watching old programs on television. Review of the plan of care revised on 10/04/22 revealed Resident #68 had the potential for isolation due to the medical condition of Down's syndrome. He preferred an independent leisure routine; he had impaired cognitive status but needed opportunities for socialization. He loved music and preaching, watching wildlife out the window and sitting in the common area socializing with peers and staff. He enjoyed watching television shows for young children. Interventions included offer to provide independent activities in his room, praise his efforts, provide a monthly activity calendar, provide room visits, remind of the activity times, offer to transport him to and from the activities, talk about life events and memories, and use a gentle approach. Review of the August 2022 activity attendance sheet for Resident #68 revealed he attended eight activities on 08/08/22, 08/11/22, 08/17/22, 08/24/22, 08/17/22, 08/24/22, 08/25/22, 08/26/22, 08/27/22 and 08/30/22 all one-on-one visits. Review of the August 2022 activity calendar revealed there were religious activities scheduled on 08/01/22, 08/02/22, 08/03/22, 8/04/22, 08/08/22, 08/07/22, 08/10/22, 08/11/22, 08/14/22, 08/17/22, 08/21/22, 08/24/22, 08/25/22, 08/28/22 and 08/31/22. Review of the September 2022 activity attendance sheet for Resident #68 revealed he attended activities on 09/07/22 and 09/26/22, both one on one visits. Review of the September 2022 activity calendar revealed there were religious activities scheduled on 09/04/22, 09/07/22, 09/08/22, 09/11/22, 09/14/22, 09/18/22, 09/21/22, 09/22/22, 09/25/22, and 09/28/22. Review of the October 2022 activity attendance sheet for Resident #68 revealed he attended activities on 10/03/22, 10/04/22, 10/05/22, 10/11/22, 10/17/22, 10/21/22, 10/24/22, and 10/25/22, all one on one visits. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366363 If continuation sheet Page 6 of 22 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 366363 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/17/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Laurels of Steubenville The 500 Stanton Boulevard Steubenville, OH 43952 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 0679 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Review of the October 2022 activity calendar revealed there were religious activities scheduled on 10/02/22, 10/05/22, 10/06/22, 10/09/22, 10/12/22, 10/16/22, 10/19/22, 10/20/22, 10/23/22, 10/26/22, and 10/30/22. Review of the November 2022 activity attendance sheet from 11/01/22 to 11/15/22 for Resident #68 revealed he attended zero activities. Review of the activity calendar from 11/01/22 to 11/15/22 revealed there were religious activities scheduled on 11/02/22, 11/03/22, 11/06/22, 11/09/22, and 11/13/22 Observations on 11/14/22 at 9:08 A.M., 10:30 A.M., 11:56 A.M. and 3:00 P.M. and on 11/15/22 at 9:55 A.M., 11:30 A.M. and 1:40 P.M. revealed Resident #68 was in bed with no music or television playing. On 11/15/22 at 3:39 P.M. an interview with the Administrator revealed the facility had an activity aide working in May 2022 who had not documented the resident's activity and another one in September 2022 who did not document the resident's activities. She verified there was very little documentation of activities being done with Resident #68. On 11/15/22 at 3:41 P.M. an interview with Activity Director #214 revealed she did one-on-one with Resident #68. She stated he enjoyed music, talking about sports, and praying. On 11/15/22 at 4:16 P.M. an interview with Activity Director #214 revealed Resident #68 had no activities documented for November 2022. She stated her new activity aide did not have access to Point Click Care (PCC), so Resident #68's activity attendance was not documented in PCC. She stated she could have done it but did not have enough time to get it done. She stated they do pray and play music with him while they are doing his one-on-one. She stated they tried to bring him out to activities when he was up, but he was not always up out of bed. She stated her assistant quit at the end of September 2022, and she has been borrowing staff from dietary and housekeeping to help in activities. She indicated they do have recorded sermons from area pastors they could play for him. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366363 If continuation sheet Page 7 of 22 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 366363 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/17/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Laurels of Steubenville The 500 Stanton Boulevard Steubenville, OH 43952 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 review of the medical record and staff interview the facility failed to ensure daily weights for Resident #176 were obtained as ordered. This affected one (Resident #176) of 24 resident records reviewed. The facility census was 79. Residents Affected - Few Findings include: Review of the medical record revealed Resident #176 was admitted to the facility on [DATE]. Diagnoses included acute pulmonary edema, restless leg syndrome, hypertensive heart disease, low back pain, osteoarthritis, and intervertebral disc disease. Review of the medical record revealed at the time of the survey there was not Minimum Data Set (MDS) 3.0 assessment available. Review of the November 2022 physician's orders revealed Resident #176 had an order dated 11/07/22 to obtain a daily weight for congestive heart failure. Review of the daily weights in Point Click Care (PCC) revealed no documentation on weights for Resident #176 on 11/08/22, 11/09/22, 11/10/22, 11/11/22, 11/12/22, 11/13/22, and 11/14/22. Review of the November 2022 medication administration record (MAR) revealed no weights documented for Resident #176. On 11/16/22 at 11:41 A.M. an interview with the Director of Nursing (DON) revealed all monthly weights were documented in PCC and weekly and daily weights were documented on the residents MARs or Treatment Administration Record (TARs). She verified there were no weights documented in PCC, on the MARs or TARs for Resident #176 on 11/08/22, 11/0922, 11/10/22, 11/11/22, 11/12/22, 11/13/22 and 11/14/22. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366363 If continuation sheet Page 8 of 22 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 366363 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/17/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Laurels of Steubenville The 500 Stanton Boulevard Steubenville, OH 43952 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 0686 Provide appropriate pressure ulcer care and prevent new ulcers from developing. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of a medical record, observations, and staff interviews the facility failed to ensure a deep tissue injury (DTI) was assessed and an order was obtained timely for Resident #176. This affected one (Resident #176) of two residents reviewed for pressure ulcers. The facility census was 79. Residents Affected - Few Findings include: Review of the medical record revealed Resident #176 was admitted to the facility on [DATE]. Diagnoses included acute pulmonary edema, restless leg syndrome, hypertensive heart disease, low back pain, osteoarthritis, and intervertebral disc disease. Review of the medical record revealed at the time of the survey there was not Minimum Data Set (MDS) 3.0 assessment available. There was no skin assessment for Resident #176 from her day of admission on [DATE]. Review of the medical record revealed there were no progress notes from admission on [DATE] or 11/06/22. The first progress notes and assessment were dated 11/07/22. Review of the Nursing Comprehensive assessment dated [DATE] revealed Resident #176 had the following skin conditions on admission: petechia on her chest and bilateral lower extremities, excoriation under her right breast, and redness to her mid spine. Review of the skin assessment completed on 11/07/22 revealed Resident #176 had a DTI (A purple or maroon localized area of discolored intact skin or blood-filled blister due to damage of underlying soft tissue due to pressure and/or shear. The area may be preceded by tissue that is painful, firm, mushy, boggy, warmer or cooler as compared to adjacent tissue.) to her right heel which measured 3.0 centimeters (cm) in length by 2.9 cm in width with no applicable depth. She was admitted with the wound. There was no skin assessment for the left heel on admission or on 11/07/22. Review of the progress note dated 11/07/22 at 4:10 P.M. revealed a clarification to nursing comprehensive assessment during full body skin assessment the resident was noted to have DTI to right and left heel which were present on admission. The physician was notified, and a new order given. Review of the November 2022 physician's orders revealed Resident #176 had an order dated 11/07/22 for Skin-Prep (liquid film-forming dressing that forms a protective film to help reduce friction) to the spine, right and left heels and cover with a foam dressing every other day. On 11/16/22 at 11:41 A.M. interview with the Director of Nursing (DON) revealed there were no progress notes dated prior to 11/07/22, the admission assessment was dated 11/07/22, and there was no treatment order documented until 11/07/22 with no treatment to Resident #176's left and right heel until 11/08/22 She stated she would find out why. Observation of wound care on 11/17/22 at 1:00 P.M. with Licensed Practical Nurse (LPN) #301 for Resident #176 revealed a DTI to the left heel, which was dark purple with red edges, mushy, and covered (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366363 If continuation sheet Page 9 of 22 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 366363 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/17/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Laurels of Steubenville The 500 Stanton Boulevard Steubenville, OH 43952 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 0686 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few the whole heel. She also had a DTI to the right heel, which was dark purple with red edges, mushy, and was the size of a 50-cent piece. On 11/16/22 at 1:33 P.M. an interview with Registered Nurse (RN) #202 revealed when she came to work on 11/07/22 she noticed there was an admission nursing assessment for Resident #176 which had been done earlier in the day. She stated she heard from the nurse working that Resident #176 was having pain in her heels. She spoke to the resident, and the resident asked her if she had an open area to her heels. She stated that was when she assessed them and found she had DTIs to both heels. She stated she received an order for a treatment and applied it; however, the order was carried over to 11/08/22. She verified at this time there was no documented evidence a treatment was completed on 11/06/22 or 11/07/22 or assessment of the wound from admission on [DATE]. She also verified there was no documented evidence of the residents left heel, and she documented the right heel twice by mistake. On 11/16/22 at 1:35 P.M. an interview with the DON revealed the admission assessment should have been completed within 24 hours of admission. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366363 If continuation sheet Page 10 of 22 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 366363 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/17/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Laurels of Steubenville The 500 Stanton Boulevard Steubenville, OH 43952 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 observation, medical record review, and interview the facility failed to implement appropriate care plan interventions and/or orders for fall prevention for two (Residents #29 and #63) of five residents reviewed for accidents. The facility census was 79. Findings include: 1. Review of Resident #29's medical record revealed diagnoses including dementia, chronic obstructive pulmonary disease, type two diabetes mellitus, chronic kidney disease, hypertension, and Parkinson's disease. A care plan initiated 01/05/22 indicated Resident #29 was at risk for falls related injuries and weakness, Parkinson's disease, dementia, and poor safety awareness. The care plan indicated Resident #29 chose not to seek staff assistance with transferring at times and chose to self-ambulate and self-transfer. Interventions included keeping the environment as safe as possible with even floors. Another intervention which was added was use of a mat to the floor. Review of the nursing notes and/or Situational Background Assessment Recommendation (SBAR) on 03/08/22 at 9:58 A.M., 04/27/22 at 11:45 A.M., 04/28/22 at 9:00 A.M., 04/30/22 at 9:50 A.M., 05/11/22 at 6:35 P.M., 05/17/22 at 7:26 P.M., 05/24/22 at 12:25 P.M., 06/18/22 at 11:00 A.M., 06/18/22 at 11:00 A.M., and 06/22/22 at 1:34 P.M. indicated Resident #29 fell and/or was observed on the floor. Review of the Resident at Risk note dated 06/23/22 at 11:56 A.M. revealed Resident #29 was educated to use the call light to seek staff assistance but chose not to do so at times. Review of the medical record revealed Resident #29 was hospitalized [DATE] with a urinary tract infection and esophageal varices. Review of the nursing note dated 07/06/22 at 7:39 P.M. indicated Resident #29 returned from the hospital and was placed in bed at low position and a mat was placed on the floor. Review of the quarterly Minimum Data Set (MDS) 3.0 assessment dated [DATE] indicated Resident #29 was moderately cognitively impaired with fluctuating disorganized thinking. Resident #29 required extensive assistance with transfers, and she did not walk. Review of the SBAR note dated 11/03/22 at 4:34 A.M. indicated Resident #29 had fallen and had pain. A recommendation was made to transfer Resident #29 to the emergency room (ER) for evaluation and treatment related to decreased range of motion to the right upper extremity. Review of the nursing note dated 11/03/22 at 7:42 A.M. indicated Resident #29 returned to the facility. Resident #29 presented with a right humerus fracture and right shoulder sling. Resident #29 was positioned in bed and mats were placed at the bedside on the floor. Review of the nursing note dated 11/03/22 at 9:10 A.M. indicated the interdisciplinary team (IDT) reviewed the fall from 11/03/22. Resident #29 was observed on her forearms and knees facing down on the floor next to her bed. After the fall, Resident #29 stated she was getting up to get a snack and slipped on the floor mat. Resident #29 was sent to the ER after the fall and confirmed to have a fracture of the right humeral head shoulder fracture. Fall interventions were reviewed, in place and (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366363 If continuation sheet Page 11 of 22 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 366363 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/17/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Laurels of Steubenville The 500 Stanton Boulevard Steubenville, OH 43952 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 remained appropriate. Level of Harm - Minimal harm or potential for actual harm Interview on 11/14/22 at 11:09 A.M., Resident #29 stated she had fallen and broke her arm. Resident #29 stated she had a mat on the floor. Resident #29 stated she had been told the mat was supposed to help protect her from injury if she fell, but she believed it was more of a hazard than a help. Resident #29 stated she had gotten out of bed to do something, and the mat was wobbly to walk on, so she fell. Residents Affected - Few Observation on 11/14/22 at 2:44 P.M., Resident #29 was lying in bed with a mat on the floor. The mat extended from the side of the bed outward toward the center of the room. One of the corners of the mat did not lie flat on the floor, but the corner rested in the air against the recliner. Interview on 11/14/22 at 2:47 P.M., Registered Nurse (RN) #235 verified the mat was not lying flat. Interview on 11/15/22 at 2:25 P.M., State Tested Nursing Assistant (STNA) #248 verified the mat Resident #29 had been using was not able to be positioned flat onto the floor. Interview on 11/15/22 at 2:58 P.M., RN #234 stated the mat that had been used during the timeframe of the fall/fracture curved up due to spatial issues although she had always seen it curving up at the bed and not the chair. RN #234 indicated she was not working when the fracture occurred. When RN #234 was asked if she ever considered the mat not lying flat a safety hazard, she stated she felt the nurse aides were more at risk of tripping on the mat because Resident #29 did not get up and stand by herself. Interview on 11/16/22 at 3:06 P.M., STNA #254 verified the mat Resident #29 had been using either curved up at the bed or the chair because of its size. Interview on 11/16/22 at 6:10 P.M., Licensed Practical Nurse (LPN) #243 stated on 11/03/22 when Resident #29 fell and fractured her shoulder she had gotten up and got a snack and was headed back to the bed. Resident #29 was found on the floor mat closer to the chair on her hands and knees like she caught her foot on the mat. The mat was thick. That night the curved portion of the mat was against the bed, and the part Resident #29 was on was flat on the floor. LPN #243 stated she only considered the mat a risk when it was curved up against the chair. 2. Review of Resident #63's medical record revealed diagnoses included dementia, muscle wasting, age-related osteoporosis, arthritis, difficulty walking, and glaucoma. A care plan initiated 04/27/22 indicated Resident #63 was at risk for falls and fall related injury related to a recent fall. The care plan indicated Resident #63 attempted to self-transfer/ambulate without seeking staff assistance. Interventions included providing assistive devices as needed such as a mat to the floor and Dycem (non-slip material) to the wheelchair seat. Physician orders dated 04/27/22 revealed orders for a mat on the floor and Dycem to the wheelchair. Review of the quarterly MDS 3.0 assessment dated [DATE] indicated Resident #63 was cognitively intact. On 11/16/22 at 1:22 P.M., RN #300 was observed exiting the bathroom where Resident #63 was sitting (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366363 If continuation sheet Page 12 of 22 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 366363 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/17/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Laurels of Steubenville The 500 Stanton Boulevard Steubenville, OH 43952 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 in her wheelchair. Upon request, Resident #63 stood and was observed not to have Dycem in the wheelchair. RN #300 verified there was no Dycem in the wheelchair at the time. Interview on 11/16/22 at 3:10 P.M., STNA #254 stated Resident #63 would sometimes remove the Dycem from her wheelchair because she did not like that it stuck to her clothing. STNA #254 indicated she was not certain if Resident #63 was still supposed to have a mat by her bed. STNA #261 who was present did not indicate she was certain about mat use either. On 11/17/22 at 7:11 A.M., Resident #63 was observed lying in bed. There was no mat on the floor. This was verified by STNA #246 who found the mat folded and by the closet on the opposite side of the room. On 11/17/22 at 1:15 P.M., while discussing the failure of staff to implement orders/interventions for fall prevention for Resident #63 including use of Dycem and the floor mat, the Administrator indicated Resident #63 would remove the Dycem herself. When asked if the resident was known to be non-compliant with the Dycem if she was evaluated for alternate means to prevent sliding no direct response was received. This deficiency represents non-compliance investigated under Complaint Number OH00135565. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366363 If continuation sheet Page 13 of 22 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 366363 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/17/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Laurels of Steubenville The 500 Stanton Boulevard Steubenville, OH 43952 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 0697 Provide safe, appropriate pain management for a resident who requires such services. Level of Harm - Actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, medical record review, policy review, and interview, the facility failed to adequately address residents' complaints of pain for two (Residents #29 and #326) of five residents reviewed for pain. Residents Affected - Few Actual Harm occurred to Resident #326 on 11/13/22 after staff assessed her with pain which was almost constant with a severity of nine on a scale of zero to ten with acknowledgment Resident #326 had no pain interventions in place, but did not pursue attempts to provide pain relief. Actual Harm occurred to Resident #29 on 11/14/22 after she was noted crying with interview revealing she was having pain from a fractured shoulder and requested ordered pain medication which the nurse refused to administer stating Resident #29 had been medicated earlier. Findings include: 1. Review of Resident #326's medical record revealed diagnoses including type two diabetes mellitus and diabetic neuropathy (type of nerve damage which can cause pain). An admission Minimum Data Set (MDS) 3.0 assessment dated [DATE] indicated Resident #326 was able to make herself understood and was cognitively intact. The MDS indicated Resident #326 had not received any scheduled pain medication or pain medication ordered on an as necessary basis. Nor did she receive any non-medication interventions for pain. A pain interview revealed Resident #326 reported she had almost constant pain over the previous five days which interfered with sleep at night and limited her day-to-day activities. The severity of the worst pain over the prior five days was rated at nine on a scale of zero to ten. There was no documentation indicating the pain was addressed with the physician or any attempts were made to address pain relief. Interview on 11/14/22 at 9:09 A.M., Resident #326 stated she had pain in the right shoulder that she had been having since prior to admission. Resident #326 indicated she had discussed the pain with staff, and her pain was not effectively managed. Interview on 11/14/22 at 9:14 A.M. with Licensed Practical Nurse (LPN) #238 indicated Resident #326 was admitted [DATE] but this was the first time she was assigned to care for her. After review of the medication orders, LPN #238 stated Resident #326 received Lyrica for pain. (Lyrica is a medication used to treat pain from nerve damage.) LPN #238 indicated she had not received any information in her shift report indicating Resident #326 had concerns with pain. At 9:37 A.M., LPN #238 was observed going to Resident #326's room and asking about pain. LPN #238 offered Resident #326 Tylenol (analgesic) and informed the resident she planned to call the physician and ask about a potential x-ray. LPN #238 was observed returning to the medication cart and preparing medication (labels not observed) before returning to Resident #326's room. A nursing note dated 11/14/22 at 9:31 A.M. indicated Resident #326 was complaining of pain in the right shoulder. Resident #326 stated it was an aching pain in her right shoulder and rated it a severity of six on a scale of zero to ten. Resident #326 reported the pain had been going on for some time prior to admission. Resident #326 denied trauma to the right shoulder. No bruising, swelling or redness was noted upon skin assessment. Resident #326 requested an x-ray be obtained. The primary care provider ordered an x-ray of the right shoulder. Results of the right shoulder x-ray obtained 11/14/22 indicated there was no acute fracture or (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366363 If continuation sheet Page 14 of 22 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 366363 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/17/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Laurels of Steubenville The 500 Stanton Boulevard Steubenville, OH 43952 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 0697 dislocation. The osseous structures appeared intact. Joint spaces were narrowed. Soft tissues were unremarkable. No acute findings were identified. Degenerative changes were recorded. Level of Harm - Actual harm Residents Affected - Few On 11/15/22 at 9:48 A.M., Resident #326 was observed propelling herself in the hall and stopped outside the therapy room to talk. Resident #326 stated the facility got an x-ray of her right shoulder on 11/15/22 but there had been no changes in pain management. Resident #326 stated she hoped it got figured out soon because she was tired of waking up at night from the pain. Resident #326 was holding onto her right shoulder as she spoke. At 1:40 P.M., Resident #326 reported she still had not received results of the shoulder x ray. The availability of the results in the electronic health record were discussed with a nurse (name unknown) before she discussed them with Resident #326. At 2:05 P.M., Resident #326 stated she had been receiving Tylenol approximately every six hours, but it was ineffective. Resident #326 stated she believed the pain was also limiting her participation in therapy. Resident #326 stated the nurse told her she was going to inquire if the physician would give an order for gel or cream to put on the shoulder for pain relief. On 11/15/22, an order was written for Tylenol 650 milligrams (mg) every six hours as needed for pain. Interview on 11/15/22 at 2:25 P.M. with State Tested Nursing Assistant (STNA) #248 indicated Resident #326 did complain of pain at times and would usually ask for Tylenol. STNA #248 stated she made the complaints and requests known to the nurses when they were voiced to her. Interview on 11/15/22 at 2:58 P.M. with Registered Nurse (RN) #234 indicated the facility had no standing orders for Tylenol. Nurses had to request an order. On 11/15/22 at 4:22 P.M., Resident #326's concerns about pain were discussed with the Director of Nursing (DON) along with her statements she had discussed the pain with staff with a Tylenol order not written until 11/15/22. On 11/16/22, Unit Manager (UM) #202 documented a late entry nursing note dated 11/15/22 at 10:45 A.M. which indicated the Nurse Practitioner was made aware of the results of the shoulder x-ray and that Resident #326 was complaining of chronic discomfort. The pain was rated at a five on a scale of zero to ten. An order was received for Tylenol on a as necessary basis and administered by the staff nurse. UM #202 also documented a late entry for 11/15/22 at 11:45 A.M. indicating Resident #326 verbalized relief of right should discomfort with a pain severity of two. On 11/16/22 at 9:00 A.M., UM #202 verified she documented the administration of the Tylenol by another nurse on 11/15/22 because she noticed the nurse failed to document the administration. A request was made for UM #202 to accompany the surveyor to Resident #326's room to discuss the pain and the effectiveness of Tylenol and the discrepancies between the effectiveness of Tylenol in documentation and interviews. Resident #326 was sitting in her room and reported she had another rough night related to right shoulder pain. UM #202 asked if Resident #326 had received Tylenol that morning, and Resident #326 indicated she had not. When asked if she would like some, Resident #326 indicated she would try it but stated the Tylenol never helped relieve the pain. Resident #326 stated the Lyrica was effective in managing her neuropathy but did not help the shoulder pain. On 11/17/22 at 10:14 A.M., Registered Nurse (RN) #300 stated she was cognizant of the assessment reference date (ARD) when she completed the MDS and stated she ensured she has her interviews completed within two days of the ARD. RN #300 verified Resident #326 told her she was having almost constant (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366363 If continuation sheet Page 15 of 22 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 366363 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/17/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Laurels of Steubenville The 500 Stanton Boulevard Steubenville, OH 43952 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 0697 Level of Harm - Actual harm Residents Affected - Few pain that interfered with sleep and day-to-day activities with a severity level of 9 on a scale of zero to ten over the five days prior to the ARD and that Resident #326 was not receiving any medication or non-pharmacological interventions for pain. RN #300 stated she was new to the MDS role and did not know for sure what to do with concerns that arose from the interviews. RN #300 stated she did not know nurses were not aware of Resident #326 having pain and she was not sure if therapy was addressing the pain. RN #300 verified she should have communicated the resident's concerns about pain timelier. Review of the facility's pain management policy, last revised 07/09/21, indicated residents were to be observed for indicators or pain including moaning, crying, or other vocalizations, wincing or frowning and other facial expression, body posture such as guarding or protecting an area of the body or lying very still, and decrease in usual activities. The Nursing Assistant would communicate to the licensed nurse when a resident was experiencing pain. The licensed nurse would communicate any new onset of resident pain or change in pain to the physician and to the interdisciplinary team (IDT) through the 24-hour report/dashboard process. Staff would implement the care plan for pain, monitor the resident, and administer therapeutic interventions for pain. 2. Review of Resident #29's medical record revealed diagnoses including dementia, Parkinson's disease, and depression. A nursing note dated 11/03/22 at 7:42 A.M. indicated Resident #29 returned from the hospital with a right humerus fracture after a fall. Orders were received for Tylenol and Ibuprofen (analgesic) on an as necessary basis for pain. A nursing note dated 11/03/22 at 7:00 P.M. indicated Resident #29 complained of pain with a severity of ten on a scale of zero to ten for the right affected arm. Resident #29 reported Tylenol was ineffective. Facial grimacing and crying out in pain were noted. Resident #29 had pain with any provided care. The physician was notified, and staff were awaiting response. A nursing note dated 11/03/22 at 9:00 P.M. indicated a new order was received for Oxycodone IR (opioid pain medication) 5 milligrams (mg) every four hours as necessary for pain. A care plan initiated 11/03/22 indicated an alteration in musculoskeletal status related to Resident #29 had a fracture of the right humerus. The goal was for Resident #29 to remain free from pain or at a level of discomfort acceptable to the resident. Interventions included administering analgesics as ordered by the physician. On 11/14/22 at 10:18 A.M., Resident #29 was observed sitting in the wheelchair in her room crying with tears running down her face. Resident #29 stated she was crying because of pain in her right arm. Resident #29 indicated she was unaware when she last had pain medication. With Resident #29's permission, her pain and inquiry as to whether she could have a pain pill was discussed with RN #235. RN #235 stated Resident #29 already had Oxycodone and Tylenol, stating Resident #29 had periods where she cried and screamed for no apparent valid reason such as that morning when she started crying and screaming about jelly. The behavior was not congruent with what was occurring at the time. RN #235 stated she had elevated Resident #29's arm on a pillow that morning. Review of the November 2022 Medication Administration Record (MAR) revealed Oxycodone was administered on 11/14/22 at 4:16 A.M. for pain at a severity level of eight. There was no documentation of Tylenol being administered the morning of 11/14/22. On 11/15/22 at 11:30 A.M., Resident #29 stated she had not slept well the previous night because of pain. Resident #29 indicated having a pillow under her right arm did little to help with pain from the fracture. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366363 If continuation sheet Page 16 of 22 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 366363 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/17/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Laurels of Steubenville The 500 Stanton Boulevard Steubenville, OH 43952 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 0697 On 11/15/22 at 2:25 P.M., State Tested Nurse Aide (STNA) #248 indicated Resident #29 had complained of pain since the fracture occurred. The only behavior she was aware of was Resident #29 crying out in pain. Level of Harm - Actual harm Residents Affected - Few On 11/15/22 at 2:58 P.M., RN #234 stated if residents requested pain medication and it was ordered they should have it administered when requested. RN #234 stated the only behaviors she had noticed were when Resident #29 was in pain. Once the pain was controlled the behavior subsided. On 11/15/22 at 4:22 P.M., the request regarding pain medication and the nurse response were discussed with the Director of Nursing (DON) with no explanation provided. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366363 If continuation sheet Page 17 of 22 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 366363 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/17/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Laurels of Steubenville The 500 Stanton Boulevard Steubenville, OH 43952 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 ensure a clinical assessment was completed before and after each dialysis session for Resident #51. This affected one (Resident #51) of one resident reviewed for dialysis. The census was 79. Residents Affected - Few Findings include: Review of the medical record for Resident #51 revealed an admission date of 07/09/22 with diagnoses including type two diabetes mellitus, end stage renal disease, and dependence on renal dialysis. Review of the physician's orders for November 2022 identified orders for hemodialysis every Tuesday, Thursday, and Saturday. Review of the quarterly Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed Resident #51 had no cognitive impairment. The assessment indicated Resident #51 received dialysis treatments. Review of the Hemodialysis Communication Forms dated 08/16/22 through 11/15/22 revealed Resident #51 was not clinically assessed before going to dialysis or upon returning from dialysis treatment on 08/23/22, 08/27/22, 08/30/22, 09/06/22, 09/08/22, 09/10/22, 09/13/22, 09/15/22, 09/17/22, 09/22/22, 09/24/22, 09/27/22, 10/04/22, 10/08/22, 10/13/22, 10/25/22, 11/05/22, and 11/10/22. Review of the progress note dated 10/25/22 at 11:11 A.M. revealed Resident #51 was transported to dialysis. A progress note dated 10/25/22 at 5:05 P.M. revealed Resident #51 was sent to the emergency department from the dialysis center. A progress note dated 10/25/22 at 8:33 P.M. revealed Resident #51 was admitted to the hospital due to hypertension. Review of the communication from the dialysis center dated 10/25/22 revealed Resident #51 had the complication of hypertension during dialysis treatment with a blood pressure reading of 224/97 millimeters of mercury (mm Hg). On 11/14/22 at 11:48 A.M., interview with Resident #51 stated he went to dialysis three times per week as scheduled. On 11/17/22 at 11:46 A.M., interview with the Director of Nursing (DON) verified clinical assessments were not completed before and after dialysis treatments on 08/23/22, 08/27/22, 08/30/22, 09/06/22, 09/08/22, 09/10/22, 09/13/22, 09/15/22, 09/17/22, 09/22/22, 09/24/22, 09/27/22, 10/04/22, 10/08/22, 10/13/22, 10/25/22, 11/05/22, and 11/10/22. The DON stated the nurse on duty was responsible for completing the Hemodialysis Communication Form before and after dialysis treatments. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366363 If continuation sheet Page 18 of 22 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 366363 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/17/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Laurels of Steubenville The 500 Stanton Boulevard Steubenville, OH 43952 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 Residents Affected - Many 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 review of schedules and interviews, the facility failed to ensure the Director of Nursing (DON) did not work as a charge nurse when the facility census was greater than 60. This had the potential to affect all 79 residents residing in the facility. Findings include: Review of nursing schedules from 10/15/22 to 11/17/22 revealed the DON worked as a charge nurse on 11/12/22 between 6:00 P.M. and 10:00 P.M. when the census was 80 and on 11/13/22 between 3:00 P.M. and 6:00 P.M. when the census was 79. On 11/15/22 at 4:22 P.M., the DON verified she worked as a charge nurse on the evening of 11/12/22 and the afternoon of 11/13/22. The DON stated she was unaware she was unable to work as a charge nurse if the census was greater than 60. On 11/17/22 at 12:15 P.M., the DON verified when she worked as a charge nurse on 11/12/22 the census was 80. On 11/17/22 at 12:41 P.M., the Administrator verified when the DON worked as a charge nurse on 11/13/22 the census was 79. The Administrator stated she was not aware the DON could not fulfill charge nurse requirements if census was greater than 60. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366363 If continuation sheet Page 19 of 22 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 366363 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/17/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Laurels of Steubenville The 500 Stanton Boulevard Steubenville, OH 43952 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 0757 Ensure each resident’s drug regimen must be free from unnecessary drugs. 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 staff interview the facility failed to ensure non-pharmacological interventions were attempted prior to the administration of pain medication, for Residents #34 and #58. This affected two (Residents #34 and #58) of six residents reviewed for unnecessary medication use. The facility census was 79. Residents Affected - Few Findings include: 1. Review of the medical record for Resident #34 revealed an admission date of 12/13/16. Diagnoses included chronic obstructive pulmonary disease (COPD), hypertension, ataxic gait (impaired ability to walk), and partial weakness of the dominant right side. Review of the quarterly Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed the resident had moderately impaired cognition. He received scheduled and as needed pain medication. Review of the physician's orders for November 2022 revealed an order for Nucynta, a medication used to treat pain, 50 milligrams (mg) four times per day (QID) as needed. Review of the Medication Administration Record (MAR) for October 2022 revealed Resident #34 received Nucynta three times on 10/01/22, four times on 10/02/22, three times on 10/03/22 and 10/04/22, four times on 10/05/22, 10/06/22 and 10/07/22, one time on 10/08/22, three times on 10/09/22, four times on 10/10/22 and 10/11/22, two times on 10/12/22, four times on 10/13/22, three times on 10/14/22 and 10/15/22, four times on 10/16/22, one time on 10/17/22, four times on 10/19/22 and 10/20/22, three times on 10/21/22, two times on 10/23/22 and 10/24/22, four times on 10/25/22, one time on 1026/22, three times on 10/27/22, 10/28/22, 10/29/22 and 10/30/22 and four times on 10/31/22. Of the 91 times Nucynta was administered, non-pharmacological interventions were attempted 48 times. Review of the MAR for November 2022 revealed Resident #34 received Nucynta four times on 11/01/22, three times on 11/02/22, two times on 11/03/22, three times on 11/04/22, one time on 11/05/22, two times on 11/06/22 and 11/07/22, four times on to 11/08/22, three times on 11/09/22, two times on 11/10/22, three times on 11/11/22 and 11/13/22, one time on 11/14/22, four times on 11/15/22 and three times on 11/16/22. Of the 45 times Nucynta was administered, non-pharmacological interventions were attempted 27 times. Interview on 11/17/22 at 9:09 A.M. with the Director of Nursing (DON) confirmed non-pharmacological interventions were not attempted each time prior to Nucynta being administered. 2. Review of the medical record for Resident #58 revealed an admission date of 10/03/22. Diagnoses included COPD, diabetes, spinal stenosis, and rheumatoid arthritis. Review of the quarterly MDS 3.0 assessment dated [DATE] revealed the resident had moderately impaired cognition. He received scheduled and as needed pain medication. Review of the physician's orders for November 2022 revealed an order for Oxycodone, a medication used to treat pain, 20 mg every six hours as needed. Review of the MAR for October 2022 revealed the Resident #58 received Oxycodone one time on 10/04/22, two times on 10/05/22, 10/06/22, 10/07/22 and 10/08/22, one time on 10/09/22 and 10/10/22, two (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366363 If continuation sheet Page 20 of 22 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 366363 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/17/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Laurels of Steubenville The 500 Stanton Boulevard Steubenville, OH 43952 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 0757 Level of Harm - Minimal harm or potential for actual harm times on 10/122/22, one time on 10/12/22, two times on 10/13/22 and 10/14/22, three times on 10/15/22, two times on 10/16/22, three times on 10/17/22/ 10/18/22 and 10/19/22, two times on 10/19/22, one time on 10/21/22, 10/22/22 and 10/23/22, three times on 10/24/22, two times on 10/25/22, 10/26/22, 10/27/22, 10/28/22 and 10/29/22, one time on 10/30/22 and two times on 10/31/22. Of the 47 times Oxycodone was administered, non-pharmacological interventions were attempted 26 times. Residents Affected - Few Review of the MAR for November 2022 revealed the Resident #58 received Oxycodone one time on 10/01/22 and two times on 11/02/22, 11/03/22, 11/04/22, 11/05/22 and 11/06/22. Of the 11 times Oxycodone was administered, non-pharmacological interventions were attempted five times. Interview on 11/16/22 at 11:40 A.M. with the DON confirmed non-pharmacological interventions were not attempted each time prior to Oxycodone being administered. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366363 If continuation sheet Page 21 of 22 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 366363 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/17/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Laurels of Steubenville The 500 Stanton Boulevard Steubenville, OH 43952 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 and interview, the facility failed to ensure Resident #42's recommendation for a gradual dose reduction (GDR) was addressed by the physician. This affected one (Resident #42) of six residents reviewed for unnecessary medications. The facility census was 79. Findings include: Review of the medical record for Resident #42 revealed an admission date of 01/26/22. Diagnoses included dementia, visual hallucinations, and depression. Review of the comprehensive Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed the resident had severely impaired cognition. Review of the physician's orders for November 2022 revealed an order for Risperdal, an antipsychotic medication, 0.5 milligrams (mg) two times per day. Review of the consultation report 01/28/22 by Pharmacist #302 revealed a recommendation to reduce the dosage of Risperdal with a plan to discontinue the medication. There was no evidence the physician reviewed the recommendation or addressed it. Interview on 11/16/22 at 1:05 P.M. with the Director or Nursing (DON) confirmed the physician did not address the above referenced GDR for Resident #42. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366363 If continuation sheet Page 22 of 22