Health inspection·February 29, 2024

F 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Based on review of facility policy and clinical record, and staff interview, it was determined that the facility failed to notify the resident's responsible party of a change in condition for one of 22 residents reviewed (Resident R61). Findings include: A facility policy entitled Notification of Changes last reviewed in June 2023, indicated that the facility must inform the resident's representative, or family member when there is a Clinical Complication an example of which was the development of Stage 2 (partial-thickness skin loss) skin breakdown. Resident R61's clinical record revealed an admission date of 7/22/2022, with diagnoses that included Dementia, Type II Diabetes (condition of improper blood sugar control), Chronic Kidney Disease and Pain. A progress note dated 12/13/23, documented that Resident R61 had newly developed two Stage 2 open areas around the buttocks area. There was no further documentation to indicate that Resident R61's responsible party was notified of these areas of skin breakdown. During an interview on 2/28/24, at approximately 10:20 a.m. the Director of Nursing confirmed that Resident R61's responsible party was not notified of the areas of skin breakdown as required. 28 Pa. Code 201.14(a) Responsibility of licensee 28 Pa. Code 211.10(c) Resident care policies 28 Pa. Code 211.12(d)(1) Nursing services Page 1 of 2 395042 395042 02/29/2024 Nightingale Nursing and Rehab Center 607 East 26th Street Erie, PA 16504

F 0695 Provide safe and appropriate respiratory care for a resident when needed. Level of Harm - Minimal harm or potential for actual harm Based on review of facility policy and clinical records, observations, and staff interview, it was determined that the facility failed to provide oxygen according to physician's orders for one of one residents reviewed for respiratory services (Resident R7). Residents Affected - Few Findings include: Review of facility policy dated 1/25/24, entitled Oxygen Administration indicated that Oxygen will be administered as per MD order to aid in breathing. Review of Resident R7's clinical record revealed an admission date of 6/27/22, with diagnoses that included chronic obstructive pulmonary disease (COPD - a progressive lung disease that results in shortness of breath and difficulty breathing), diabetes (condition of improper blood sugar control), and high blood pressure. Review of Resident R7's clinical record revealed a physician's order dated 2/14/24, for Oxygen via Nasal Cannula (a thin tube with two prongs that fit into the resident's nostrils to deliver oxygen) 2 lpm (liters per minute) every shift for shortness of breath. Observation on 2/26/24, at 2:50 p.m. revealed Resident R7 sitting in his /her wheelchair with supplemental oxygen in place and the oxygen concentrator liter flow set at 3 lpm. Observation on 2/28/24, at 1:38 p.m. revealed Resident R7 sitting in his/her wheelchair with supplemental oxygen in place via portable oxygen tank and set at 2.5 lpm. Oxygen concentrator was also noted to be on and set at 3 lpm. During an interview on 2/28/24, at 1:48 p.m. Licensed Practical Nurse Employee E1 confirmed that Resident R7's oxygen concentrator was on and set at 3 lpm and his/her portable oxygen was on, in use and set at 2.5 lpm and was not in accordance with the physician's order dated 2/14/24, for oxygen at 2 lpm every shift. 28 Pa. Code 211.10(c) Resident care policies 28 Pa. Code 211.12(d)(1)(5) Nursing services 395042 Page 2 of 2