Health inspection·February 1, 2024

F 0584 28 Pa. Code 207.2(a) Administrator's Responsibility. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395241 If continuation sheet Page 2 of 20 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 395241 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/01/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hilltop Healthcare and Rehabilitation Center 700 S. Cayuga Avenue Altoona, PA 16602 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 0607 Develop and implement policies and procedures to prevent abuse, neglect, and theft. Level of Harm - Minimal harm or potential for actual harm Based on review of policies, clinical records, and investigation documents, as well as staff interviews, it was determined that the facility failed to ensure that staff followed the facility's policy regarding reporting an allegation of physical abuse in a timely manner for one of 48 residents reviewed (Resident 65). Residents Affected - Few Findings include: The facility's policy regarding abuse, dated November 30, 2023, indicated that employees, facility consultants and/or attending physicians must immediately report any suspected abuse or incidents of abuse to the Director of Nursing. In the absence of the Director of Nursing such reports may be made to the nurse supervisor on duty. Any individual observing an incident of resident abuse or suspecting resident abuse must immediately report such incident to the Nursing Home Administrator, Director of Nursing, or charge nurse. A quarterly Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs) for Resident 65, dated December 5, 2023, revealed that the resident was was cognitively impaired and had a diagnosis which included Parkinson's disease, and Post Traumatic Stress Disorder (PTSD a disorder that develops when a person has experienced or witnessed a scary, shocking, terrifying, or dangerous event). Facility investigation documents, dated January 22, 2024, revealed that Nurse Aide 3 reported to staff that yesterday January 21, 2024, at approximately 5:30 p.m. to 6:00 p.m. she witnessed Nurse Aide 4 punch Resident 65 in the stomach. The resident is unable to give a description. A witness statement completed by Nurse Aide 3, dated January 22, 2024, revealed that on January 21, 2024, at approximately 5:00 p.m. Nurse Aide 4 asked her to assist with toileting Resident 65. Nurse Aide 3 pushed the resident into the bathroom in his wheelchair and while Nurse Aide 4 was getting his clothes the resident reached for grab bar and attempted to stand up to get on the toilet, but the resident sat back down in the wheelchair. She said to Nurse Aide 4 to just give the resident a minute, and Nurse Aide 4 stated just let me do it, it will be faster. Nurse Aide 4 stood in front of the resident, lifted him around the waist, and pulled his pants down. She then directed the resident to the toilet. Nurse Aide 4 wiped his face off and the resident swatted at Nurse Aide 4. Nurse Aide 4 pushed the resident back on the toilet with an open hand to his left shoulder. Nurse Aide 3 then grabbed Nurse Aide 4 and told her to stop. Nurse Aide 4 placed a gown on the resident and the resident attempted to punch Nurse Aide 4. Nurse Aide 4 then punched the resident in the stomach with a closed fist and stated, Don't even think you can hit me. The resident appeared startled and did not appear in pain. Nurse Aide 3 then separated Nurse Aide 4 from the resident and Nurse Aide 4 stated whatever, and she left the resident's bathroom. Nurse Aide 3 then assisted the resident with care, assisted him back into his wheelchair, and took him out into the hall where he always sits. Nurse Aide 3 did not report this immediately because she did not want to tell the wrong person that would spread gossip. She indicated that she thought about it all night and knows she should have reported it immediately. An interdisciplinary team (IDT) note, dated, January 23, 2024, revealed that the incident was reviewed by IDT. Nurse Aide 3 reported that she witnessed Nurse Aide 4 punch Resident 65 in the stomach. The resident is confused and unable to confirm or deny that this occurred. Interviews were completed with both nurse aides, other nursing staff assigned on that unit when the alleged incident (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395241 If continuation sheet Page 3 of 20 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 395241 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/01/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hilltop Healthcare and Rehabilitation Center 700 S. Cayuga Avenue Altoona, PA 16602 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 0607 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few occurred, and the resident's roommate who is alert and oriented. The alleged incident was not substantiated by any witness or other residents. Corrective action was completed with Nurse Aide 3 for not reporting the allegation of abuse timely, and education was completed with Nurse Aide 4 regarding dealing with resident behaviors and dementia. Interview with the Director of Nursing on January 30, 2024, at 2:30 p.m. confirmed that Nurse Aide 3 did not report the alleged allegation of abuse immediately as per the facility's policy. She indicated that they provided education to Nurse Aide 3 and Nurse Aide 4, as well as to the whole facility. 28 Pa. Code 201.18(e)(1) Management. 28 Pa. Code 211.12(d)(5) Nursing Services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395241 If continuation sheet Page 4 of 20 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 395241 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/01/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hilltop Healthcare and Rehabilitation Center 700 S. Cayuga Avenue Altoona, PA 16602 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 0641 Ensure each resident receives an accurate assessment. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 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 comprehensive Minimum Data Set assessments for nine of 48 residents reviewed (Residents 23, 31, 56, 63, 65, 80, 83, 84, 86). Residents Affected - Some Findings include: The Long-Term Care Facility 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 2023, revealed that Section O0110K (b) (Hospice Care) was to be coded if hospice services were provided while a resident of the facility and within the last 14 days. Physician's orders for Resident 23, dated August 20, 2021, included an order for the resident to receive hospice Care Services. A current care plan for Resident 23 included a plan of care to provide hospice care to the resident. A quarterly MDS assessment for Resident 23, dated November 30, 2023, revealed that Section O0110K (b) was coded (0), indicating that the resident did not receive any hospice care within the last 14 days of the assessment period. Interview with the Registered Nurse Assessment Coordinator (RNAC) on January 31, 2024, at 3:28 p.m. confirmed that Section O0110K(b) was coded incorrectly on Resident 23's quarterly MDS assessment dated [DATE]. The RAI User's Manual, dated October 2023, revealed that section H0300 should be coded (0), always continent when the resident has been continent of urine, without any episodes of incontinence during the seven-day look-back period. A quarterly MDS assessment for Resident 31, dated December 23, 2023, revealed that the resident was cognitively intact, required moderate assist with toileting and transfers, and was always continent of bladder. A care plan for Resident 31, dated August 7, 2023, revealed that she was incontinent of urine due to impaired mobility. A nurse aide documentation report for December 2023 revealed that Resident 31 was incontinent of bladder six times during the seven-day look back period. Interview with the RNAC on February 1, 2024, at 10:05 a.m. confirmed that Resident 31's MDS Section H0300 for bladder continence was coded inaccurately. The RAI User's Manual, dated October 2023, revealed that Section N0415E Anticoagulant (a blood thinning medication) was to be coded if the resident took the medication during the seven-day look-back period. Physician's orders for Resident 56, dated October 26, 2023, included an order for the resident to receive 5 milligrams of Apixaban (anticoagulant medication) twice a day for a pulmonary embolus (blood clot in the lung). (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395241 If continuation sheet Page 5 of 20 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 395241 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/01/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hilltop Healthcare and Rehabilitation Center 700 S. Cayuga Avenue Altoona, PA 16602 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 0641 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Resident 56's Medication Administration Record for October 2023 revealed that the resident was administered Apixaban during the seven-day look-back assessment period. An admission MDS assessment for Resident 56, dated November 1, 2023, revealed that N0415E was not coded, indicating he did not receive an anticoagulant medication during the seven-day look-back assessment period. Interview with the RNAC on February 1, 2024, at 4:04 p.m. confirmed that Resident 56's MDS section N0415E for anticoagulant medication was coded inaccurately. The RAI Manual, dated October 2023, revealed that Section H0100A was to be checked if the resident had an indwelling urinary catheter (a tube held in the bladder for the continuous drainage of urine) any time during the seven-day assessment period. If the resident had an indwelling catheter in use during the entire seven-day assessment period, then Section H0300 (Urinary Continence) was to be coded nine (9), indicating that the resident's urinary continence was not rated due to the presence of the catheter. Physician's orders for Resident 63, dated January 16, 2024, included an order for staff to connect the urostomy (a surgically-created opening in the abdominal wall through which urine passes) to the foley drainage bag every shift and to change the urostomy bag every day shift and as needed. A quarterly MDS assessment, dated December 6, 2023, revealed that Section H0100A was checked, indicating that the resident had an indwelling urinary catheter, and Section H0100C was checked, indicating that the resident had an ostomy (is surgery to create an opening from an area inside the body to the outside); however, Section H0300 (Urinary Continence) was coded with a zero (0), indicating that the resident was always continent of urine. Interview with the RNAC on January 31, 2024, at 2:05 p.m. confirmed that Section H0300 was coded incorrectly on Resident 63's quarterly MDS assessment dated [DATE]. The RAI User's Manual, dated October 2023, revealed that if the influenza (flu) vaccine was not received, Section O0250C (influenza vaccine) was to be coded with the reason the flu vaccine was not received. The section was to be coded with a one (1) if the resident was not in the facility during this year's influenza vaccination season; two (2) if the resident received the vaccination outside of the facility; three (3) if the resident was not eligible for the vaccine due to a medical contraindication; (4) if the vaccine was offered and declined; or (5) if the vaccine was not offered. Review of Resident 65's Immunization record revealed that the resident received the influenza vaccination on September 29, 2023. A quarterly MDS assessment for Resident 65, dated December 5, 2023, revealed that Section O0250A was coded with no, indicating that the resident did not receive the influenza vaccination in the facility for this year's influenza vaccination season, and Section O0250C was coded with a five (5), indicating that the influenza vaccine was not offered to the resident. Interview with the RNAC on January 31, 2024, at 2:05 p.m. confirmed that Section O0250A and Section O0250C were coded incorrectly on Resident 65's quarterly MDS assessment dated [DATE]. The RAI User's Manual, dated October 2023, revealed that Section N0415J hypoglycemic medication (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395241 If continuation sheet Page 6 of 20 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 395241 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/01/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hilltop Healthcare and Rehabilitation Center 700 S. Cayuga Avenue Altoona, PA 16602 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 0641 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some (lowers blood sugar - including insulin) was to be coded if the resident took the medication during the seven-day look-back period. Physician's orders for Resident 80, dated November 1, 2023, included an order for the resident to receive 6.25 mg (milligrams) of alogliptin benzoate (a hypoglycemic medication) daily for diabetes. The resident's Medication Administration Record (MAR) for November 2023 revealed that the resident received alogliptin benzoate daily during the seven-day look-back assessment period. An admission MDS assessment for Resident 80, dated November 7, 2023, revealed that Sections N0415J was not coded, indicating that the resident did not receive a hypoglycemic medication during the seven-day look-back assessment period. Interview with the RNAC on January 31, 2024, at 3:28 p.m. confirmed that Section N0415J was coded incorrectly on Resident 80's admission MDS assessment dated [DATE]. The RAI User's Manual, dated October, 2023, revealed that if a wander/elopement alarm was used, then Section P0200E was to be coded as (0) not used, (1) used less than daily, or (2) used daily. Physician's orders for Resident 83, dated December 4, 2023, included orders for the resident to use a Wanderguard (device that alarms when close to exit doors) and to check the placement/function every shift. The resident's Treatment Administration Record (TAR) for December 2023 revealed that the resident used a Wanderguard from December 4 through December 8, 2023. An admission MDS assessment for Resident 83, dated December 8, 2023, revealed that Section P0200E was coded with a (0), indicating that the resident did not use a wander/elopement alarm. Interview with the RNAC on February 1, 2024, at 4:05 p.m. confirmed that Section P0200E of Resident 83's December 8, 2023, MDS assessment should have been coded (2) for daily use of a wander/elopement alarm. The RAI Manual, dated October 2023, revealed that Section H0100A was to be checked if the resident had an indwelling urinary catheter (a tube held in the bladder for the continuous drainage of urine) any time during the seven-day assessment period. If the resident had an indwelling catheter in use during the entire seven-day assessment period, then Section H0300 (Urinary Continence) was to be coded nine (9), indicating that the resident's urinary continence was not rated due to the presence of the catheter. Section N0415F Antibiotic (medication used for infection) and Section N0415I Antiplatelet (a medication used to prevent clots) was to be coded if the resident took the medication during the seven-day look-back period. Physician's orders for Resident 84, dated January 5, 2024, included an order for the resident to have an indwelling foley catheter (a tube inserted into the bladder for urine), to receive 125 mg (milligrams) of Vancomycin (an antibiotic medication) four times a day, and to receive 81 mg of aspirin (an antiplatelet medication) every day. The resident's Medication Administration Record (MAR) for January 2024 revealed that the resident received Vancomycin and aspirin daily during the seven-day look-back assessment period. An admission MDS assessment for Resident 84, dated January 10, 2024, revealed that Section H0300 was coded with a zero (0), indicating that the resident was always continent of urine. Sections N0401F (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395241 If continuation sheet Page 7 of 20 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 395241 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/01/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hilltop Healthcare and Rehabilitation Center 700 S. Cayuga Avenue Altoona, PA 16602 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 0641 Level of Harm - Minimal harm or potential for actual harm and N0401I was not coded, indicating that the resident did not receive an antibiotic and antiplatelet medication during the seven-day look-back assessment period. Interview with the RNAC on January 31, 2024, at 12:58 p.m. confirmed that Sections H0300, N0401F and N0401I on Resident 84's admission MDS were coded inaccurately. Residents Affected - Some The RAI User's Manual, dated October 2023, indicated that the intent of Section A was to record the discharge status of the resident. Section A2105 was to be coded with the location of the resident's discharge. A nursing note for Resident 86, dated November 6, 2023, indicated that the resident was discharged to home on that date. However, a discharge tracking MDS for Resident 86, dated November 6, 2023, indicated that Resident 86 was discharged to the hospital. An interview with the Registered Nurse Assessment Coordinator on February 1, 2024, at 10:05 a.m. confirmed that Resident 86's discharge tracking MDS was coded incorrectly. 28 Pa. Code 211.5(f) Clinical Records. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395241 If continuation sheet Page 8 of 20 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 395241 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/01/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hilltop Healthcare and Rehabilitation Center 700 S. Cayuga Avenue Altoona, PA 16602 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 0655 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted Based on clinical record reviews, observations, and staff interviews, it was determined that the facility failed to ensure that a baseline care plan was developed for one of 48 residents reviewed (Resident 94) who was a recent admission. Findings include: A nursing note for Resident 94, dated January 23, 2024, revealed that the resident was admitted from a hospital setting and was alert and oriented to person, place and time. Physician's orders for Resident 94, dated January 23, 2024, included an order for the resident to receive four liters of oxygen via nasal cannula (a tube that is inserted into the nares to delivery oxygen). Observations and an interview with Resident 94 on January 29, 2024, at 12:02 p.m. revealed that the resident was sitting in his wheelchair watching television and was receiving oxygen by nasal canula. The resident was admitted for a short-term stay to receive therapy services. He said he was admitted from the hospital after being in another facility for respite care. The baseline care plan for Resident 94, initiated on January 23, 2024, was incomplete and not signed off in the electronic record. An interview with Director of Nursing on February 1, 2024, at 12:10 p.m. confirmed that the baseline care plan was incomplete, and there was no documented evidence that a copy of the baseline care plan was given to the resident. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395241 If continuation sheet Page 9 of 20 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 395241 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/01/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hilltop Healthcare and Rehabilitation Center 700 S. Cayuga Avenue Altoona, PA 16602 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 Residents Affected - Some 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 comprehensive care plans that included specific and individualized interventions to address resident care needs for four of 48 residents reviewed (Residents 61, 65, 80, 84). Findings include: The facility's policy regarding care plans, dated November 30, 2023, revealed that a comprehensive care plan for each resident will be developed within seven days of completion of the MDS and be individualized to the resident's care needs. A nursing note, dated September 14, 2023, at 1:50 p.m. revealed that Resident 61 was admitted from the hospital and had a pacemaker (a small medical device implanted under the skin that delivers electrical impulses to the heart to help control abnormal heart rhythms) inserted. A quarterly Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs) for Resident 61, dated January 6, 2024, revealed that the resident was cognitively impaired and had a pacemaker. As of February 1, 2024, there was no documented evidence that Resident 61's care plan included any information or interventions related to the pacemaker. Interview with Director of Nursing 1 on February 1, 2024, at 3:46 p.m. confirmed that there was no care plan developed to address Resident 61's pacemaker. The facility policy regarding informed trauma care, dated November 30, 2023, revealed that the facility would develop individualized care plans that address past trauma in collaboration with the resident and family as appropriate. The facility would identify and decrease exposure to triggers that may re-traumatize the resident. A quarterly Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs) for Resident 65, dated December 5, 2023, revealed that the resident was cognitively impaired and had a diagnosis which included Parkinson's disease and Post Traumatic Stress Disorder (PTSD a disorder that develops when a person has experienced or witnessed a scary, shocking, terrifying, or dangerous event). A care plan for the resident, dated September 19, 2023, revealed that the resident has a mood problem related to depression/anxiety and PTSD. However, there was no documented evidence the facility developed individualized interventions to identify and/or prevent specific triggers that could re-traumatize the resident. An admission MDS assessment for Resident 80, dated November 7, 2023, revealed that the resident was cognitively impaired and had a diagnosis of dementia. A care plan, dated November 3, 2023, revealed that the resident had a past traumatic event or exposure to combat or warzone. A psychiatry note for Resident 80, dated December 16, 2023, revealed that Resident 80 had a history of dementia and severe PTSD in which he was followed by psychiatry for management. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395241 If continuation sheet Page 10 of 20 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 395241 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/01/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hilltop Healthcare and Rehabilitation Center 700 S. Cayuga Avenue Altoona, PA 16602 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 Residents Affected - Some There was no documented evidence that the facility developed individualized interventions to identify and/or prevent specific triggers that could re-traumatize the resident. An admission MDS assessment for Resident 84, dated January 10, 2024, indicated that the resident was cognitively intact, required assistance from staff for daily care needs, and had diagnoses that included heart failure, diabetes and PTSD. A review of Resident 84's plan of care revealed that there was no documented evidence that a care plan was developed to address Resident 84's triggers related to PTSD. Interview with the Director of Social Services on January 30, 2024, at 11:53 a.m. confirmed that she is responsible for behavior care plans and also confirmed that Residents 65, 80, and 84 do not have individualized care plans for PTSD triggers. Interview with the Director of Nursing on January 30, 2024, at 11:46 a.m. confirmed that Resident 65's, 80's, and 84's care plans should have included triggers related to their diagnosis of PTSD. 28 Pa. Code 211.12(d)(5) Nursing Services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395241 If continuation sheet Page 11 of 20 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 395241 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/01/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hilltop Healthcare and Rehabilitation Center 700 S. Cayuga Avenue Altoona, PA 16602 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 clinical records, as well as staff interviews, it was determined that the facility failed to ensure that a resident's care plan was updated/revised to reflect the resident's specific care needs for two of 48 residents reviewed (Residents 3, 26). Findings include: A significant change Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs) for Resident 3, dated November 16, 2023, indicated that the resident was cognitively impaired, required assistance from staff for daily care needs, and had diagnoses that included high blood pressure and dementia. A care plan, dated January 26, 2023, revealed that the resident and her family preferred that she receive showers twice a week. A review of the December 2023 and January 2024 shower record revealed that the resident was receiving bed baths. A nursing note, dated January 30, 2024, revealed that the nurse spoke with the resident's daughter, and she stated she told staff to bed bath the resident whenever they needed to. An interview with Director of Nursing on January 30, 2024, at 9:05 a.m. confirmed that the care plan developed for Resident 3 was incorrect and should have included a plan of care for a preference on bathing. A quarterly MDS for Resident 26, dated November 22, 2023, indicated that the resident was cognitively impaired, required assistance from staff for daily care needs, and had diagnoses that included stroke. A care plan, dated September 26, 2022, revealed that the resident had a nutritional concern with dysphagia (difficulty swallowing food and liquids) management, and the facility was to provide a controlled-carbohydrate pureed diet with thin liquids. Physician's orders for Resident 26, dated January 8, 2024, included an order for the resident to receive a controlled- carbohydrate mechanical soft, ground texture diet with thin liquids. Observations of Resident 26's lunch meal on February 1, 2024, at 12:30 p.m. revealed that she received ground turkey with pureed vegetables, mashed potatoes, gravy, and pureed cake. Interview with the Director of Nursing on February 1, 2024, at 1:04 p.m. revealed that Resident 26's care plan was not updated to reflect her current ordered diet. 28 Pa. Code 211.12(d)(5) Nursing Services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395241 If continuation sheet Page 12 of 20 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 395241 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/01/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hilltop Healthcare and Rehabilitation Center 700 S. Cayuga Avenue Altoona, PA 16602 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 clinical records, as well as staff interviews, it was determined that the facility failed to ensure that residents received care and treatment in accordance with professional standards of practice by failing to ensure that physician's orders were followed for two of 48 residents reviewed (Residents 23, 83). Residents Affected - Few Findings include: A quarterly Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs) for Resident 23, dated November 30, 2023, revealed that the resident was cognitively impaired, was dependent on staff for toileting hygiene, was always incontinent of bowel, and had diagnoses that included dementia. A care plan for Resident 23, dated July 29, 2022, revealed that the resident was to receive incontinent care every two to three hours and as needed. Physician's orders for Resident 23, dated April 2, 2021, included orders for the resident to receive 30 milliliters (ml) of Milk of Magnesia (MOM - an oral laxative) as needed for constipation if no bowel movement by the third day (9 shifts); one Dulcolax suppository (a laxative inserted rectally) as needed if no bowel movement within 24 hours after administration of Milk of Magnesia; and one Fleets enema (a liquid inserted rectally to stimulate a bowel movement) as needed for constipation if no bowel movement by the end of the following shift after administration of the suppository, and the physician was to be notified if it was ineffective. Resident 23's bowel records for December 2023 revealed that the resident had a bowel movement on December 24, 2023, and did not have a bowel movement from December 25 through December 28, 2023. The Medication Administration Records (MAR's) for December 2023 revealed that staff did not administer Milk of Magnesia on December 27, 2023, as ordered, which was the third day without a bowel movement. The resident's MAR revealed that there was no laxative administered on December 28, 2023, which would have been the fourth day without a bowel movement. Resident 23's bowel records for January 2024 revealed that the resident had a bowel movement on January 7, 2024, and did not have a bowel movement from January 8 through January 11, 2024. The Medication Administration Records (MAR's) for January 2024 revealed that staff did not administer Milk of Magnesia on January 10, 2024, as ordered, which was the third day without a bowel movement. The resident's MAR revealed that there was no laxative administered on January 11, 2024, which would have been the fourth day without a bowel movement. Interview with Registered Nurse 5 on February 1, 2024, at 3:09 p.m. confirmed that Resident 23's physician's orders for constipation were not followed on the above days. An admission MDS assessment for Resident 83, dated December 8, 2023, revealed that the resident was cognitively impaired, had diagnoses that included diabetes, and received insulin (medication that lowers blood sugar levels). Physician's orders for Resident 83, dated December 11, 2023, included an order for the resident's blood sugar to be checked before meals and at bedtime. If the resident's blood sugar was less than 70 milligrams/deciliter (mg/dL) or greater than 400 mg/dL the physician or registered nurse supervisor was to be notified. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395241 If continuation sheet Page 13 of 20 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 395241 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/01/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hilltop Healthcare and Rehabilitation Center 700 S. Cayuga Avenue Altoona, PA 16602 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 - Few Resident 83's Medication Administration Record (MAR's) for December 2023 revealed that the resident's blood sugar result on December 24, 2023, was 499 mg/dL at 8:00 p.m. There was no documented evidence that the physician or registered nurse supervisor was notified that the resident's blood sugar was greater than 400 mg/dL. Interview with the Director of Nursing on February 1, 2024, at 12:28 p.m. confirmed that there was no documented evidence that Resident 83's physician or the registered nurse supervisor was notified of the high blood sugar on December 24, 2023, at 8:00 p.m. as ordered. 28 Pa. Code 211.12(d)(1)(5) Nursing Services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395241 If continuation sheet Page 14 of 20 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 395241 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/01/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hilltop Healthcare and Rehabilitation Center 700 S. Cayuga Avenue Altoona, PA 16602 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 0699 Provide care or services that was trauma informed and/or culturally competent. Level of Harm - Minimal harm or potential for actual harm Based on review of facility policies and clinical records, as well as staff interview, it was determined that the facility failed to ensure that residents were assessed and received trauma-informed care to eliminate or mitigate triggers for residents with the diagnosis of Post Traumatic Stress Disorder (PTSD - a mental and behavioral disorder that develops related to a terrifying event) for three of 48 residents reviewed (Residents 65, 80, 84) Residents Affected - Some Findings include: The facility's policy regarding Trauma Informed Care, dated November 30, 2023, revealed the facility will complete an assessment that involves an in-depth process of evaluating the presence of symptoms, their relationship to trauma, as well as the identification of triggers. A quarterly Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs) for Resident 65, dated December 5, 2023, revealed that the resident was was cognitively impaired and had a diagnosis which included Parkinson's disease and Post Traumatic Stress Disorder (PTSD a real disorder that develops when a person has experienced or witnessed a scary, shocking, terrifying, or dangerous event). A care plan for the resident, dated September 19, 2023, revealed that the resident has a mood problem related to depression/anxiety and PTSD. However, there was no documented evidence the facility completed an assessment for a history of trauma for Resident 65 to identify specific triggers that could re-traumatize the resident. An admission MDS assessment for Resident 80, dated November 7, 2023, revealed that the resident was cognitively impaired and had a diagnosis which included dementia. A care plan, dated November 3, 2023, revealed that the resident had a past traumatic event of exposure to combat or warzone. A psychiatry note, dated December 16, 2023, revealed that Resident 80 had a history of dementia and severe PTSD in which he was followed by psychiatry for management. However, there was no documented evidence the facility completed an assessment for a history of trauma for Resident 80 to identify specific triggers that could re-traumatize the resident. An admission MDS assessment for Resident 84, dated January 10, 2024, indicated that the resident was cognitively intact, required assistance from staff for daily care needs, and had diagnosis that included heart failure, diabetes, and PTSD. There was no documented evidence the facility completed an assessment for a history of trauma for Resident 84 to identify specific triggers that could re-traumatize the resident. Interview with the Director of Nursing on January 30, 2024, at 11:46 a.m. confirmed that there was no documented evidence of an assessment for a history of trauma being completed for Residents 65, 80, and 84. 28 Pa. Code 211.12(a)(d)(3)(5) Nursing Services. 28 Pa. Code 211.16(a) Social Services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395241 If continuation sheet Page 15 of 20 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 395241 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/01/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hilltop Healthcare and Rehabilitation Center 700 S. Cayuga Avenue Altoona, PA 16602 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 0804 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Level of Harm - Minimal harm or potential for actual harm Based on review of facility policies and observations, as well as resident and staff interviews, it was determined that the facility failed to serve food items at palatable temperatures. Residents Affected - Some Findings include: The facility's policy regarding hot foods, dated November 30, 2023, revealed that dietary staff will serve all hot foods at 135 degrees Fahrenheit (F) or above and ensure that the food is palatable. An interview with a group of residents on January 30, 2024, at 3:30 p.m. revealed that the food served by the facility was sometimes bland and was sometimes served cold. Observations of the lunch meal service in the main kitchen on February 1, 2024, revealed that the C-Wing cart containing a test tray left the main kitchen at 12:36 p.m. and arrived on C-Wing at 12:38 p.m. Trays were passed to the residents that were in their rooms and in the common area at the end of the hall. The last resident was served at 12:56 a.m. The test tray was removed from the cart at 12:56 a.m. and the temperature of the milk was 45.1 degrees F, the coffee was 140 degrees F, the zucchini was 129.3 degrees F, the stuffing was 134 degrees F, the turkey was 128.6 degrees F. The Zucchini and milk were lukewarm and not at a palatable or appetizing temperature. Interview with the Dietary Director on February 1, 2024, at 12:56 p.m. confirmed that the food on the test tray was not at an appetizing temperature. 28 Pa. Code 201.18(b)(1)(2)(e) Management. 28 Pa. Code 211.6(c) Dietary services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395241 If continuation sheet Page 16 of 20 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 395241 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/01/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hilltop Healthcare and Rehabilitation Center 700 S. Cayuga Avenue Altoona, PA 16602 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 - Many Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on review of policies, as well as observations and staff interviews, it was determined that the facility failed to serve and store food in accordance with professional standards for food service safety by failing to ensure that outdated or expired food was removed from the refrigerator and failing to ensure that dietary staff wore hair coverings that completely covered their hair during food handling. Findings include: Observations in the main cooler on January 29, 2024, at 9:09 a.m. revealed a container of strawberries with a white substance (mold) all over them. Interview with the Dietary Director on January 29, 2024, at 9:09 a.m. confirmed that the strawberries had white mold all over them and then removed them from the cooler. The facility's dietary policy regarding personal hygiene, dated November 30, 2023, revealed that staff members will have their hair off the shoulders, confined in a hair net or cap, and facial hair properly restrained. Observations in the kitchen on February 1, 2024, at 12:21 p.m. revealed dietary staff preparing meal trays for delivery to the units for the resident's lunch. Cook/Server 6 had hair exposed on both sides of her face as well as the back of her head. Interview with the Dietary Director on February 1, 2024, at 1:45 p.m. confirmed that Cook/Server 6 did not have all her hair covered with a restraint and that she should have. 28 Pa. Code 211.6(f) Dietary services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395241 If continuation sheet Page 17 of 20 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 395241 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/01/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hilltop Healthcare and Rehabilitation Center 700 S. Cayuga Avenue Altoona, PA 16602 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 - Some Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Based on clinical record reviews and staff interviews, it was determined that the facility failed to ensure that residents' clinical records were complete and accurately documented for one of 48 residents reviewed (Resident 71). Findings include: Physician's orders for Resident 71, dated January 4, 2024, included an order for the resident to receive one 10 milligram (mg) tablet of Midodrine (used to treat low blood pressure) three times per day for hypotension (low blood pressure) and staff was to hold the medication if the systolic blood pressure (the top number of the blood pressure) was greater than 120 millimeters of mercury (mmHg). Medication Administration Records (MAR's) for Resident 71, dated January 2024, revealed that Licensed Practical Nurse 7 documented as administering the 10 mg of Midodrine to the resident on January 12, 2024, at 8:00 a.m. for a blood pressure reading of 138/72 mmHg, and at 1:00 p.m. for a blood pressure reading of 138/78 mmHg; on January 15, 2024, at 1:00 p.m. for a blood pressure reading of 126/62 mmHg; on Janaury 24, 2024, at 1:00 p.m. for a blood pressure reading of 122/64 mmHg; and on January 26, 2024, at 1:00 p.m. for a blood pressure reading of 142/78 mmHg. Interview with Licensed Practical Nurse 7 on February 1, 2024, at 3:10 p.m. confirmed that Resident 71's MAR's revealed that she documented as administering the 10 mg of Midodrine to the resident on the above dates and times. She indicated that she did not administer the 10 mg of Midodrine to the resident on the above dates and times because the blood pressures were above the physician-ordered parameter. She indicated that when this was brought to her attention the registered nurse supervisor showed her how to chart that the medication was not administered in a supplemental charting area on the MARs. 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: 395241 If continuation sheet Page 18 of 20 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 395241 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/01/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hilltop Healthcare and Rehabilitation Center 700 S. Cayuga Avenue Altoona, PA 16602 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 - Some 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 maintain compliance with nursing home regulations 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 correction for the State Survey and Certification (Department of Health) survey ending February 24, 2023, revealed that the facility developed plans of corrections that included quality assurance systems to ensure that the facility maintained compliance with cited nursing home regulations. The results of the current survey, ending February 1, 2024, identified repeated deficiencies related to a failure to complete Minimum Data Set (MDS) assessments (mandated assessments of residents' abilities and care needs) accurately, to develop comprehensive care plans, following physician's orders, and to prepare and store food under sanitary conditions. The facility's plan of correction for a deficiency regarding completing accurate MDS assessments, cited during the survey ending February 24, 2023, revealed that the facility would complete audits and report the results of the audits to the QAPI committee for review. The results of the current survey, cited under F641, revealed that the facility's QAPI committee failed to successfully implement their plan to ensure ongoing compliance with regulations regarding completing accurate MDS assessments. The facility's plan of correction for a deficiency regarding developing comprehensive care plans, cited during the survey ending February 24, 2023, revealed that the facility developed a plan of correction that included completing audits and reporting the results of the audits to the QAPI committee for review. The results of the current survey, cited under F656, revealed that the facility's QAPI committee failed to successfully implement their plan to ensure ongoing compliance with regulations regarding the development of comprehensive care plans. The facility's plan of correction for a deficiency regarding a failure to follow physician's orders, cited during the survey ending on February 24, 2023, revealed that audits would be conducted, and the results of the audits would be brought before the QAPI committee for further monitoring. The results of the current survey, cited under F684, revealed that the QAPI committee was ineffective in correcting deficient practices related to following physician's orders. The facility's plan of correction for a deficiency regarding labeling and storing food under sanitary conditions, cited during the survey ending February 24, 2023, revealed that the facility developed a plan of correction that included completing audits and reporting the results of the audits to the QAPI committee for review. The results of the current survey, cited under F812, revealed that the QAPI committee failed to successfully implement their plan to ensure ongoing compliance with regulations regarding preparing and storing food under sanitary conditions. Refer to F641, F656, F684, F812. 28 Pa. Code 201.14(a) Responsibility of Licensee. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395241 If continuation sheet Page 19 of 20 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 395241 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/01/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hilltop Healthcare and Rehabilitation Center 700 S. Cayuga Avenue Altoona, PA 16602 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 28 Pa. Code 201.18(e)(1) Management. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395241 If continuation sheet Page 20 of 20