Health inspection·September 4, 2025

F 0565 Honor the resident's right to organize and participate in resident/family groups in the facility. Level of Harm - Minimal harm or potential for actual harm Based on a review of facility policy, the minutes from facility Resident Council meetings, and grievances lodged with the facility, and resident and staff interviews, it was determined the facility failed to put forth sufficient efforts to promptly resolve continued resident complaints and grievances expressed during Resident Council meetings and verbal grievances, including those voiced by four of four residents attending a resident group meeting (Residents 22, 29, 43, and 8) and failed to keep the residents apprised of the status of the facility's decisions and efforts toward grievance resolution.Findings include: A review of the facility's Grievance Policy last reviewed on July 29, 2025, indicated the residents', families, and their representatives have the right to voice grievances concerning care and treatment, behavior of staff or other residents or any concerns regarding their stay. Further stating the grievance official follow up on all concerns and grievances registered by any resident or resident representative. A review of the Minutes from a Resident Council meeting, which included a food committee review, dated June 4, 2025, revealed concerns from residents that snacks were not being provided in the evening. Review of grievances revealed no documented evidence of a grievance regarding this concern and no evidence of any corrective actions taken to address this issue. A review of the Minutes from Resident Council meetings dated July 2, 2025, revealed concerns from residents that call bells were not answered timely. A grievance was filed on July 2, 2025, regarding this concern. Review of this grievance revealed no follow up was completed with the residents who raised this concern during resident council. Review of the food committee minutes reviewed during this resident council meeting revealed continued concerns with snacks not being provided in the evening. A review of the Minutes from a Resident Council meeting, which included a food committee review, dated August 7, 2025, revealed continued concerns from residents that snacks were not being provided in the evening. Review of grievances revealed no documented evidence of a grievance regarding this concern and no evidence of any corrective actions taken to address this issue. A group meeting conducted on September 3, 2025, at 10:30 a.m. with four residents (Residents 22, 29, 43, and 8) revealed unanimous reports that the facility failed to address their complaints regarding the timeliness of call bell response. Snacks continue to be a concern as well. Resident 43 stated that snacks are not brought to residents in the evening, that snacks are left at the nurse's station and stated that residents can come get them. However, the other Residents in attendance (Residents 22, 29, and 8) were unaware that snacks were left at the nurses' station and further stated that if they were in bed already, they would not be able to go to the nurses' station without assistance and were unaware they could ask staff for a snack in the evening. The facility was unable to provide documented evidence that efforts had been made to resolve resident complaints concerning call bell timeliness as of the survey ending September 4, 2025, that had been brought up during resident council meeting. During an interview on September 4, 2025, at 9:10 a.m., the Nursing Home Administrator (NHA) confirmed the absence of documented actions addressing grievances raised during Resident Council meetings or Residents Affected - Some (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 6 Event ID: 395092 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 395092 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Meadow View Rehabilitation & Healthcare Center 225 Park Street Montrose, PA 18801 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)