Health inspection·June 6, 2024

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 review of facility policies, clinical record reviews and staff interviews it was determined that the facility failed to provide written notice, including reason for the change, prior to moving a resident to another room, for two of four residents reviewed (Residents R1, and R2). Findings include: Review of facility policy, Transfer, Room to Room , last reviewed 5/28/24, indicated that the following information should be recorded in the resident's medical record: · The date and time the room transfer was made. · The name and title of the individual(s) who assisted with the move. · All assessment data obtained during the move. · How the resident tolerated the move. · If the resident refused the move, the reason(s) why and the intervention taken. · The signature and title of the person recording the data. Review of the clinical record revealed that Resident R1 was admitted to the facility on [DATE]. Review of Resident 1's MDS (Minimum Data Set, periodic assessment of resident care needs) dated 3/12/24, indicated diagnoses of high blood pressure, muscle weakness, and pain. Review of Resident R1's census information revealed that on 3/2/24, the Resident R1 was moved from room [ROOM NUMBER]-1 to room [ROOM NUMBER]-2. Review of Resident R1's clinical record revealed no documented evidence of the reason for the room changes, if the resident was notified prior to the room changes or if the resident was agreeable or given the opportunity to refuse the room changes. Review of the clinical record revealed that Resident R2 was admitted to the facility on [DATE]. Review of Resident 2's medical record indicated diagnoses of diabetes, dementia (a group of Page 1 of 3 395109 395109 06/06/2024 Beaver Healthcare and Rehabilitation Center 616 Golf Course Road Aliquippa, PA 15001

F 0559 symptoms that affects memory, thinking and interferes with daily life), and high blood pressure. Level of Harm - Minimal harm or potential for actual harm Review of Resident R2's census information revealed that on 6/4/24, the Resident R2 was moved from room [ROOM NUMBER]-2 to room [ROOM NUMBER]-2. Residents Affected - Few Review of Resident R2's clinical record revealed no documented evidence of the reason for the room changes, if the resident was notified prior to the room changes or if the resident was agreeable or given the opportunity to refuse the room changes. During an interview on 6/6/24, at 11:56 a.m. Nursing Home Administrator confirmed that the facility failed to provide documentation regarding written notice, including reason for the change prior to moving residents to another room. 28 Pa. Code 201.14(a) Responsibility of licensee 29 Pa. Code 201.29(d)(j) Resident rights 395109 Page 2 of 3 395109 06/06/2024 Beaver Healthcare and Rehabilitation Center 616 Golf Course Road Aliquippa, PA 15001

F 0620 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Not require residents to give up Medicare or Medicaid benefits, or pay privately as a condition of admission; and must tell residents what care they do not provide. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of facility policy, resident records, admissions documentation and staff interview it was determined that the facility failed to provide a comprehensive review of resident admission rights and maintain admission documentation for one of four sampled records (Resident R3). Finding include: The facility policy Admissions Orientation last reviewed 5/28/24, indicated that the facility shall provide each resident with a facility tour and an orientation of the facility's policies, programs, and services which includes but is not limited to residents rights and responsibilities. Review of Resident R3 admission record indicated she was admitted on [DATE]. Review of Resident R3's MDS assessment (Minimum Data Set assessment: MDS -a periodic assessment of resident care needs) dated 5/12/24, indicated diagnoses of anorexia nervosa (an eating disorder causing patients to obsess about weight and what they eat), low potassium, and muscle weakness. Review of Resident R3's admission packet (no date) did not indicate a signature from Resident R3 or a rights were reviewed. Review of Resident R3s clinical nurse notes and admission documents did not indicate that Resident R4 or her representative reviewed resident rights and the admission packet. During an interview on 6/6/24, at 11:45 a.m. Nursing Home Administrator confirmed that the facility failed to provide a comprehensive review of resident admission rights and maintain admission documentation for Resident R3 as required. 28 Pa Code: 201.18 (b)(2) Management. 28 Pa Code: 201.24 (a) admission policy. 28 Pa Code: 201.19 (i) Resident rights. 395109 Page 3 of 3