Health inspection·December 26, 2024

F 0567 Honor the resident's right to manage his or her financial affairs. Level of Harm - Minimal harm or potential for actual harm Based on review of facility policy, grievances and staff and resident interviews, it was determined that the facility failed to provide residents with access to their personal funds/petty cash for three of four residents (Residents R1, R2, R4). Residents Affected - Few Findings include: Review of the facility policy Management of Residents' Personal Funds last reviewed on 11/1/24, indicated that the facility manages the personal funds of residents who request the facility to do so. Should the facility be appointed the resident's representative payee, and directly receive monthly benefits to which the resident is entitled, such funds are managed in accordance with established polices and federal/state requirements. Review of the Business Office Manager job description reviewed 11/1/24, indicated the BOM is responsible for the overall supervision and management of the business office staff and assists with managing resident trust fund. Review of the facility Resident Council minutes dated 12/5/24, indicated residents would like to know how to set up a trust fund account and how to get money taken out. Review of Resident R2's grievance report dated 12/6/24, it was indicated he was upset that he did not receive his money that was owed to him by social security. The response from facility to the grievance revealed the resident was given cash on 12/19/24, 13 days after he expressed a concern. During an interview on 12/26/24, at 10:02 a.m. Resident R2 indicated he had a concern with accessing his funds from the facility. He indicated it took about two weeks to get his money. Review of Resident R4's grievance dated 12/19/24, indicated family expressed a concern that Resident R4 was not provided his $45 personal allowance for December. Review of Resident R4's Resident Fund Management Service (RFMS) statement revealed his account was opened on 11/7/24. It was indicated on 12/3/24, he had a balance of $1,167.00. Review of Resident R4's progress note dated 12/19/24, at 9:47 a.m. entered by Business Office Manager, Employee E1 indicated the administrator spoke to family again regarding personal allowance, multiple family member have called and made threats about resident allowance, administrator explained the check just came yesterday and the bank is just now opening, and resident will have money by today. Family and resident upset showing erratic behaviors. (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 2 Event ID: 395251 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 395251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/26/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Ivy Park Post Acute 5609 Fifth Avenue Pittsburgh, PA 15232 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)