Health inspection·August 3, 2023

F 0641 Ensure each resident receives an accurate assessment. Level of Harm - Minimal harm or potential for actual harm Based on review of the Resident Assessment Instrument User's Manual and clinical records, as well as staff interviews, it was determined that the facility failed to complete accurate Minimum Data Set assessments for three of 33 residents reviewed (Residents 21, 62, 112). Residents Affected - Some Findings include: The Resident Assessment Instrument (RAI) User's Manual, which gives instructions for completing Minimum Data Set (MDS) assessments (mandated assessments of a resident's abilities and care needs), dated October 2019, revealed that Sections P0100A through P0100D (physical restraints) were to be coded if the resident had various types of restraints in use when in bed. These sections were to be coded zero (0) if a restraint was not used, one (1) if a restraint was used less than daily, and two (2) if a restraint was used daily. A quarterly MDS assessment for Resident 21, dated July 3, 2023, revealed that the resident was understood and could usually understand, was independent with daily care needs including bed mobility and transfers, and had diagnoses that included multiple sclerosis (a disease that affects the nerves of the brain and spinal cord), high blood pressure, and depression. Section P0100A was coded coded two (2), indicating that the resident used bed rails (a type of restraint) daily when in bed. A bed rail assessment for Resident 21, dated June 28, 2023, revealed that the resident was capable and used bed rails for independence with mobility. Interview with the Director of Nursing on August 3, 2023, at 11:26 a.m. confirmed that section P0100A was coded incorrectly for Resident 21. A quarterly MDS assessment for Resident 62, dated June 26, 2023, revealed that the resident was understood and could usually understand, was cognitively intact, required extensive assistance of two for bed mobility, extensive assistance of one for transfers, and had diagnoses that included Parkinson's disease (a disease that affects the muscles causing stiffness and tremors), high blood pressure, and depression. Section P0100A was coded two (2), indicating that the resident used bed rails daily when in bed. A bed rail assessment for Resident 62, dated June 28, 2023, revealed that the resident was self-capable and wanted side rails. The side rails would assist him with turning side to side in bed, moving up and down in bed, pulling from lying to sitting position, improved balance with transfers, and support during transfers. A quarterly MDS assessment for Resident 112, dated July 6, 2023, revealed that the resident was understood and usually understands, was cognitively intact, and required extensive assistance from staff with her daily care needs including bed mobility and transfers. Section P0100A was coded two (2), indicating that the resident used bed rails daily when in bed. Interview with the Director of Nursing on August 3, 2023, at 12:15 p.m. confirmed that section P0100A was coded incorrectly for Residents 62 and 112. 28 Pa. Code 211.5(f) Clinical records. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395050 If continuation sheet Page 2 of 14 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 395050 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/03/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Garvey Manor 1037 South Logan Boulevard Hollidaysburg, PA 16648 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 0656 Level of Harm - Minimal harm or potential for actual harm Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Based on review of policies and clinical records, as well as staff interviews, it was determined that the facility failed to develop individualized plans of care for one of 33 residents reviewed (Resident 51). Residents Affected - Few Findings include: The facility's policy regarding care plans, dated September 22, 2022, indicated that the facility would develop a written, individualized care plan for each resident by an interdisciplinary team of professionals to address and treat the resident's physical, mental, spiritual, and psychosocial needs in order to deliver consistent, quality care that allows the resident to attain and maintain their highest possible level of functioning and well-being. A admission Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs), dated July 13, 2023, revealed that the resident was sometimes understood and could sometimes understand, was cognitively impaired, required extensive assistance for daily care needs, and had diagnoses that included atrial fibrillation (an abnormal heartbeat), high blood pressure, and Alzheimer's. Physician's orders for Resident 51, dated July 12, 2023, included orders for the resident to receive 125 micrograms (mcg) of Digoxin (a medicine that controls the rate and rhythm of the heart) one time a day for atrial fibrillation, to check the apical pulse prior to administering, and to hold for a heart rate of less than 60 beats per minute. There was no documented evidence that a care plan was developed to address Resident 51's specific care needs related to being on Digoxin. Interview with the Director of Nursing on August 1, at 3:30 p.m. confirmed that a care plan to address Resident 51's care needs related to the use of Digoxin was not developed and should have been. 28 Pa. Code 211.11(d) Resident care plan. 28 Pa. Code 211.12(d)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395050 If continuation sheet Page 3 of 14 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 395050 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/03/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Garvey Manor 1037 South Logan Boulevard Hollidaysburg, PA 16648 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 - Few Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. Based on review of facility policies and clinical records, as well as staff interviews, it was determined that the facility failed to ensure that care plans were updated to reflect changes in residents' care needs for two of 33 residents reviewed (Residents 26, 57). Findings include: The facility's policy regarding care plans, dated September 22, 2022, indicated that resident care plans were to be reviewed or modified at least quarterly or upon a significant change in the resident's condition. A quarterly Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs) for Resident 26, dated May 11, 2023, revealed that the resident was cognitively intact, was understood, could understand, was dependent on staff for her daily care needs, had an indwelling urinary catheter (a tube inserted into the bladder to drain urine), and had an active diagnosis of neurogenic bladder (a disorder of bladder control). Physician's orders for Resident 26, dated June 19, 2023, indicated that staff were to change a 24 French (size of catheter), 10 cubic centimeter (cc) balloon catheter monthly. A care plan for Resident 26's indwelling catheter, dated January 20, 2023, indicated that she had an indwelling suprapubic catheter due to urinary retention and a neurogenic bladder, with interventions to change the catheter as ordered by the physician with a 26 French, 30 cc balloon suprapubic catheter. Interview with Director of Nursing on August 3, 2023, at 10:18 a.m. confirmed that the current physician's order did not match the correct catheter size as care planned. The care plan was not accurate and should have been revised. A quarterly MDS assessment for Resident 57, dated June 13, 2023, revealed that the resident was cognitively impaired, was sometimes understood, could sometimes understand, required extensive assistance from staff for her daily care needs, received insulin during the assessment period, and had an active diagnosis of diabetes mellitus (impaired control of blood sugar in the body). Physician's orders for Resident 57, dated June 10, 2023, included orders to administer Novolin Regular Insulin (fast acting medication to control blood sugar) per the sliding scale before meals and at bedtime. Staff were to administer 2 units for a blood glucose reading of 201-250 milligram per deciliter (mg/dL), 4 units for a blood glucose reading of 251-300 (mg/dL), 6 units for a blood glucose reading of 301-350 mg/dL, 10 units for a blood glucose reading of 351-400 mg/dL, and 12 units for a blood glucose reading of 401 mg/dL or greater. The current care plan for Resident 57's Type II diabetes mellitius, dated June 29, 2021, indicated that she was to have glucometer checks twice a day on Monday, Wednesday, and Friday. Interview with Director of Nursing on August 2, 2023, at 3:06 p.m. confirmed that the current physician's order did not match the current glucometer check order as care planned and the care plan was not accurate and should have been revised. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395050 If continuation sheet Page 4 of 14 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 395050 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/03/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Garvey Manor 1037 South Logan Boulevard Hollidaysburg, PA 16648 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 28 Pa. Code 211.11(d) Resident care plan. Level of Harm - Minimal harm or potential for actual harm 28 Pa. Code 211.12(d)(5) Nursing services. Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395050 If continuation sheet Page 5 of 14 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 395050 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/03/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Garvey Manor 1037 South Logan Boulevard Hollidaysburg, PA 16648 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 0658 Ensure services provided by the nursing facility meet professional standards of quality. Level of Harm - Minimal harm or potential for actual harm Based on review of Pennsylvania's Nursing Practice Act, policies, job descriptions, and clinical records, as well as staff interviews, it was determined that the facility failed to ensure that a licensed practical nurse administered medications as ordered by the physician for one of 33 residents reviewed (Resident 81). Residents Affected - Few Findings include: The Pennsylvania Code, Title 49, Professional and Vocational Standards, State Board of Nursing, 21.45(a) indicated that the Licensed Practical Nurse (LPN) was prepared to function as a member of the health-care team by exercising sound nursing judgment based on preparation, knowledge, experience in nursing and competency. The LPN participates in the planning, implementation and evaluation of nursing care using focused assessment in settings where nursing takes place, (b) the LPN administers medication and carries out the therapeutic treatment ordered for the patient in accordance with the following: The LPN may accept a written order for medication and therapeutic treatment from a practitioner authorized by law and by facility policy to issue orders for medical and therapeutic measures. The facility's policy regarding the administration of oral medications, dated September 22, 2022, indicated that the nurse will document on the Medication Administration Record (MAR) with their initials, at the appropriate date and time for the medication administered, after witnessing the ingestion of the medication. The current LPN job description indicated that the LPN was expected to deliver quality care to assigned residents under the direction of a professional registered nurse in accordance with policies, procedures, and state and federal regulations. The functions of the LPN included administering medications and treatments accurately, and observing resident responses, as evidenced by documentation in the medical record and lack of negative outcomes. A quarterly MDS assessment for Resident 81, dated July 11, 2023, revealed that the resident was sometimes understood, could sometimes understand, was cognitively impaired, required extensive assistance with daily care needs, and had diagnoses that included dementia and high blood pressure. An employee counseling form for LPN 2 revealed that on June 4, 2023, he documented that medications were administered Resident 81. A progress note for Resident 81, dated June 4, 2023, at 5:20 p.m. revealed that the registered nurse found medications in a medicine cup labeled with Resident 81's room number. The medications were not administered but were signed as being administered on the resident's medication administration record when giving report to the second shift licensed practical nurse. Physician's orders for Resident 81, dated January 10, 2023, included orders for the resident to receive 81 milligrams (mg) of aspirin daily for transient ischemic attack (a condition that causes the brain to not receive blood flow), 1200 mg of fish oil daily for supplement, 2.5 mg of lisinopril for hypertension (high blood pressure) daily, 5 mg of amlodipine two times a day for hypertension, 25-5mg of ocuvite lutein for supplement (multivitamin for eye health), and one capsule of preservision areds (multivitamin for eye health). Interview with the Director of Nursing on August 2, 2023, at 12:23 p.m. confirmed that Licensed (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395050 If continuation sheet Page 6 of 14 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 395050 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/03/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Garvey Manor 1037 South Logan Boulevard Hollidaysburg, PA 16648 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 0658 Level of Harm - Minimal harm or potential for actual harm Practical Nurse 2 signed that the medications were administered to Resident 81 but did not administer them to the resident. She confirmed that he should have administered the medications per physician orders. 28 Pa. Code 211.12(d)(1)(5) Nursing services. Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395050 If continuation sheet Page 7 of 14 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 395050 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/03/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Garvey Manor 1037 South Logan Boulevard Hollidaysburg, PA 16648 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 Based on review of policies and clinical records, as well as staff interviews, it was determined that the facility failed to follow physician's orders for three of 33 residents reviewed (Residents 51, 70, 81). Residents Affected - Some Findings include: The facility's policy regarding administration of medications and following physician orders, dated September 22, 2022, revealed that if any medications require a blood pressure or apical pulse before administering, these vitals signs should be obtained prior to preparing any medications. The policy regarding physician orders indicated that resident medications, treatments, and consults must be ordered by the attending physician and implemented by the appropriate staff. A admission Minimum Data Set (MDS) assessments (mandated assessments of a resident's abilities and care needs), dated July 13, 2023, revealed that the resident was sometimes understood, could sometimes understand, was cognitively impaired, required extensive assistance for daily care needs, and had diagnosis that included atrial fibrillation (an abnormal heartbeat), high blood pressure, and Alzheimer's. Physician's orders for Resident 51, dated July 12, 2023, included orders for the resident to receive 125 micrograms (mcg) of Digoxin (a medicine that controls the rate and rhythm of the heart) one time a day for atrial fibrillation and to check the apical pulse prior to administering and hold for a heart rate less than 60 beats per minute. There was no documented evidence that Resident's 51 apical pulse was being obtained prior to the medication being administered to the resident. Interview with the Director of Nursing on August 1, at 3:30 p.m. confirmed that Resident 51's apical heart rate should have been obtained prior to the medication being administered. A quarterly MDS assessment for Resident 70, dated May 30, 2023, indicated that the resident was cognitively intact, required extensive assistance with bed mobility and personal hygiene, and had diagnoses that included dementia, depression, and severe obesity. Physician's orders for the resident, dated May 20, 2020, included orders for the resident's weight to be obtained weekly. A review of Resident 70's clinical record revealed that weights were obtained on May 21, June 2, and July 10, 2023. A nutrition assessment for Resident 70, dated May 29, 2023, indicated that the current diet order was regular with thin liquids, small portions are provided to help limit weight gain related to her sedentary lifestyle. Interview with the Director of Nursing on August 3, 2023, at 12:18 p.m. confirmed that Resident 70 had a physician's order to obtain weekly weights and that the order was not implemented. A quarterly MDS assessment for Resident 81, dated July 11, 2023, revealed that the resident was sometimes understood and could understand, was cognitively impaired, required extensive assistance with daily care needs, and had diagnoses that included dementia and high blood pressure. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395050 If continuation sheet Page 8 of 14 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 395050 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/03/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Garvey Manor 1037 South Logan Boulevard Hollidaysburg, PA 16648 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 - Some An employee counseling form revealed that on June 4, 2023, Licensed Practical Nurse 2 documented that medications were administered to Resident 81 when they were not given. A progress note for Resident 81, dated June 4, 2023, at 5:20 p.m. revealed that the registered nurse found medications in a medicine cup labeled with the resident's room number and not administered but were signed off on the resident's medication administration record when giving report to the second shift licensed practical nurse. Physician's orders for Resident 81, dated January 10, 2023, included orders for the resident to receive 81 milligrams (mg) of aspirin daily for transient ischemic attack (a condition that causes the brain to not receive blood flow), 1200 mg of fish oil daily for supplement, 2.5 mg of lisinopril for hypertension (high blood pressure) daily, 5 mg of amlodipine two times a day for hypertension, 25-5mg of ocuvite lutein for supplement (multivitamin for eye health), and one capsule of preservision areds (multivitamin for eye health). Interview with the Director of Nursing on August 2, 2023, at 12:23 p.m. confirmed that Licensed Practical Nurse 2 signed that the medications were administered to Resident 81 but did not administer them to the resident. She confirmed that he should have administered the medications per physician orders. 28 Pa. Code 211.12(d)(1)(3)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395050 If continuation sheet Page 9 of 14 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 395050 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/03/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Garvey Manor 1037 South Logan Boulevard Hollidaysburg, PA 16648 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 0760 Ensure that residents are free from significant medication errors. Level of Harm - Minimal harm or potential for actual harm Based on review of facility policies and clinical records, as well as staff interviews, it was determined that the facility failed to ensure that residents were free from significant medication errors for one of 33 residents reviewed (Resident 70). Residents Affected - Some Findings include: The facility's policy regarding medication administration, dated September 22, 2023, revealed that the purpose was to provide a method for the safe, accurate administration of medications to the resident. An annual Minimum Data Set (MDS) assessment (a federally-mandated assessment of a resident's abilities and care needs) for Resident 70, dated May 30, 2023, revealed that the resident was cognitively intact and had diagnoses that included, high blood pressure, Alzheimers disease, schizoaffective disorder (a mood disorder), and diabetes (high blood sugar). A nursing note for Resident 70, dated May 14, 2023, at 8:30 pm. revealed that the medication nurse inadvertently gave Resident 70 another resident's medication. The nursing supervisor and on-call physician were notified. The physician stated concern with the resident being administered extended release morphine and ordered Resident 70 to be sent to the emergency room for evaluation and monitoring. A medication incident report for Resident 70, dated May 14, 2023, revealed that the resident received another resident's medication that included Tylenol (a pain and fever reducer), aspirin (anti-inflammatory and blood thinner), Coreg (a heart medication), Colace (a stool softener), donepezil (treats memory loss), neurontin (seizure and nerve pain medication), Requip (treats nerve diseases), and extended release morphine (an opioid pain medication that lasts for an extended time). Education and observation of medication administration was provided to the registered nurse involved. Interview with the Director of Nursing on August 3, 2023, at 11:03 a.m. confirmed that Registered Nurse 3 administered another resident's medications to Resident 70. 28 Pa. Code 211.12(d)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395050 If continuation sheet Page 10 of 14 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 395050 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/03/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Garvey Manor 1037 South Logan Boulevard Hollidaysburg, PA 16648 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 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Based on review of policies, as well as observations and staff interviews, it was determined that the facility failed to ensure that medications were properly secured in the medication cart. Findings include: The facility's policy regarding medication administration, dated September 22, 2022, indicated that the purpose was to provide a method for the safe, accurate administration of oral medications to residents. Observations of the top drawer of the D1 medication cart on August 3, 2023, at 4:01 p.m. revealed an undated/unmarked medication cup that contained two white round tablets, two white capsules, and one-half white tablet that was broken into two pieces. Interview with Registered Nurse 4 at that time confirmed that an undated/unmarked medication cup that contained medications was in the top drawer of the D1 medication cart, and it should not have been. Interview with the Director of Nursing on August 3, 2023, at 11:08 a.m. confirmed that an undated/unmarked medication cup that contained medications should not have been in the top drawer of the medication cart. 28 Pa. Code 211.9(a)(1) Pharmacy services. 28 Pa. Code 211.12(d)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395050 If continuation sheet Page 11 of 14 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 395050 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/03/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Garvey Manor 1037 South Logan Boulevard Hollidaysburg, PA 16648 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 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on review of facility policies, as well as observations and staff interviews, it was determined that the facility failed to ensure that opened food items were properly labeled, and failed to ensure that dietary staff wore appropriate hair coverings while preparing residents' food. Findings include: The facility's policy regarding labeling and dating food, dated September 22, 2022, revealed that in order to ensure proper storage and safety of food, all shelf-safe items are to be dated when opened. Observations in the dry storage area in the main kitchen on July 31, 2023, at 9:32 a.m. revealed that there was a ten-pound bag of pasta and a five-pound container of breadcrumbs that were opened and undated. Interview with the Dietary Director on July 31, 2023, at 9:37 a.m. confirmed that the above food items should have been labeled and dated with the date they were opened. The facility's policy regarding hair restraints, dated September 22, 2022, revealed that all kitchen employees prepping or preparing food must wear hair restraints that are designed to effectively keep hair properly restrained. Observations in the D1 Dining room on July 31, 2023, at 12:26 p.m. revealed that Dietary Aide 5 was plating food for residents who were seated in the dining room. It was noted that Dietary Aide 5 had two to three inches of hair at the back of her head at her hairline that was not covered. Interview with the Dietary Director on August 1, 2023, at 10:49 p.m. confirmed that Dietary Aide 5 should have had her hair completely covered when plating food for the residents. 28 Pa. Code 211.6(f) Dietary services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395050 If continuation sheet Page 12 of 14 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 395050 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/03/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Garvey Manor 1037 South Logan Boulevard Hollidaysburg, PA 16648 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 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Based on review of policies and clinical records, as well as staff interviews, it was determined that the facility failed to ensure that clinical records were complete and accurately documented for one of 33 residents reviewed (Resident 81). Findings include: The facility's policy regarding the administration of oral medications, dated September 22, 2022, indicated that the nurse will document on the Medication Administration Record (MAR) with their initials, at the appropriate date and time for the medication administered, after witnessing the ingestion of the medication. A quarterly Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs) for Resident 81, dated July 11, 2023, revealed that the resident was sometimes understood, could sometimes understand, was cognitively impaired, required extensive assist with daily care needs, and had diagnoses that included dementia and high blood pressure. An employee counseling form revealed that on June 4, 2023, Licensed Practical Nurse 2 documented that medications were administered Resident 81, but they were not administered. A progress note for Resident 81, dated June 4, 2023, at 5:20 p.m. revealed that the registered nurse found medications in a medicine cup labeled with the resident's room number and not administered but were signed off on the resident's medication administration record when giving report to the second shift licensed practical nurse. Physician's orders for Resident 81, dated January 10, 2023, included orders for the resident to receive 81 milligrams (mg) of aspirin daily for transient ischemic attack (a condition that causes the brain to not receive blood flow), 1200 mg of fish oil daily for supplement, 2.5 mg of lisinopril for hypertension (high blood pressure) daily, 5 mg of amlodipine two times a day for hypertension, 25-5mg of ocuvite lutein for supplement (multivitamin for eye health), and one capsule of Preservision Areds (multivitamin for eye health). Interview with the Director of Nursing on August 2, 2023, at 12:23 p.m. confirmed that Licensed Practical Nurse 2 signed that the medications were administered to Resident 81, but he did not administer them to the resident. She confirmed that he should have not signed the medications as being given. 28 Pa. Code 211.5(f) Clinical records. 28 Pa. Code 211.12(d)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395050 If continuation sheet Page 13 of 14 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 395050 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/03/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Garvey Manor 1037 South Logan Boulevard Hollidaysburg, PA 16648 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 0867 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. Based on review of the facility's plans of correction for previous surveys and the results of the current survey, it was determined that the facility's Quality Assurance Performance Improvement (QAPI) committee failed to correct quality deficiencies and ensure that plans to improve the delivery of care and services effectively addressed recurring deficiencies. Findings include: The facility's deficiencies and plans of corrections for State Survey and Certification (Department of Health) survey ending September 28, 2022, and May 1, 2023, revealed that the facility developed plans of correction that included quality assurance systems to ensure that the facility-maintained compliance with cited nursing home regulations. The results of the current survey, ending August 3, 2023, identified repeated deficiencies related to services provided to meet professional standards, quality of care, labeling and storage of drugs and biologicals, food procurement storage, preparing and serving. The facility's plan of correction for a deficiency regarding services provided to meet professional standards, cited during the survey ending May 1, 2023, revealed that services provided to meet professional standards would be monitored by QAPI. The results of the current survey, cited under F658, revealed that the QAPI committee was ineffective in maintaining compliance with regulation regarding services provided to meet professional standards. The facility's plan of correction for a deficiency regarding quality of care, cited during the survey ending September 28, 2022, revealed quality of care would be monitored by QAPI. The results of the current survey, cited under F684, revealed that the QAPI committee was ineffective in maintaining compliance with regulation quality of care. The facility's plan of correction for a deficiency regarding labeling and storage of drugs and biologicals cited during the survey ending September 28, 2022, revealed that labeling and storage of drugs and biologicals would be monitored by QAPI. The results of the current survey, cited under F761, revealed that the QAPI committee was ineffective in maintaining compliance with regulation labeling and storage of drugs and biologicals. The facility's plan of correction for deficiencies regarding food procurement storage, prepare and serve cited during the survey ending September 28, 2022, revealed that food procurement storage, preparing and serving would be monitored by QAPI. The results of current survey, cited under F812, revealed that the QAPI committee was ineffective in maintaining food procurement storage, preparing and serving. Refer to F658, F684, F761, F812. 28 Pa. Code 201.14(a) Responsibility of licensee. 28 Pa. Code 201.18(e)(1) Management. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395050 If continuation sheet Page 14 of 14