Health inspection·February 26, 2026

F 0559 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review and staff interview, it was determined that the facility failed to provide written notice, including the reason for the change, prior to moving a resident to another room, for 2 of 3 residents reviewed for room moves (Residents CR2 and 3).Findings include: Review of Resident CR2's closed clinical record revealed that the facility admitted him on September 28, 2025, to the B-wing unit. A social service progress note dated January 12, 2026, at 4:29 PM revealed that social service received a notice from the interdisciplinary team to discuss a room move with Resident CR2 to one of the facility's long term care units. The note indicated that social service went to see Resident CR2 on this date, after he returned from his dialysis (a treatment for kidney failure that filters the waste and excess fluid from the blood when the kidneys can no longer function) treatment, to discuss the room move and staff on the wing stated that he was already moved to long term care unit F. Interview with the Nursing Home Administrator on February 26, 2026, at 11:00 AM revealed that the resident was provided with a written notice of his room move. She provided the surveyor with a printed notice that had the resident's last name and first initial in the [NAME] corner. The form indicated that the notice was to inform Resident CR2 that he was being moved to F-wing, as discussed with him, and/or his family/responsible party. The notice was not dated. The notice did not indicate the reason for the room move. Interview with the Nursing Home Administrator on February 26, 2026, at 1:30 PM confirmed that the notice provided to Resident CR2 did not indicate the reason for the room move and that the facility did not provide Resident CR2's family/responsible party with a written notification of the room move and the reason for the room move. Clinical record review revealed the facility admitted Resident 3 on May 10, 2025, to room F15-2. A social service progress note dated February 17, 2026, at 12:01 PM revealed a message was left for Resident 3's daughter about the facility moving Resident 3 to room F25-1. The social worker told Resident 3's daughter to call with any questions or concerns. Interview with the Nursing Home Administrator on February 26, 2026, at 11:00 AM revealed that Resident 3 was provided with a written notice of her room move. The Nursing Home Administrator provided the surveyor with a printed notice that had the resident's last name and first initial in the [NAME] corner. The form indicated that the notice was to inform Resident 3 that she was being moved to room F25-1, as discussed with her, and/or her family/responsible party. The notice was not dated or indicate the reason for the room move. Further interview with the Nursing Home Administrator on February 26, 2026, at 1:30 PM confirmed that the notice provided to Resident 3 did not indicate the reason for the room move, nor did the facility did not provide Resident 3's family/responsible party with a written notification of the room move and the reason for the room move. The facility failed to provide a written notice of a room move that included the reason for the room move to Residents CR2 and 3, and their family/responsible parties. The Nursing Home Administrator and Director of Nursing were made aware of the concerns related to room moves for Residents CR2 (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 4 Event ID: 395045 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 395045 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/26/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mountain View Rehabilitation and Senior Living Ctr 2050 Trevorton Road Coal Township, PA 17866 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)