Inspection·October 4, 2023

F 0553 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Allow resident to participate in the development and implementation of his or her person-centered plan of care. Based on clinical record review, resident interview, and staff interview, it was determined that the facility failed to ensure that the resident and/or the resident representative were offered the opportunity to participate in the development, review and/or revision of their care plan for four of 21 residents sampled (Resident 24, 31, 53, 86) Findings include: Clinical record review revealed that Resident 24 had diagnoses that included stroke and paralysis on one side of the body. The resident was identified as being alert and oriented and very capable of making needs known. The resident reported during a resident council meeting held on October 3, 2023, at 1:09 p.m., that he and his resident representative had not been offered the opportunity to be involved in the development and revision of his care plan. Review of the resident's clinical record revealed that the resident had a Minimum Data Set (MDS) assessment completed on April 5, 2023, and July 5, 2023. A care plan meeting should have been scheduled within seven days of these assessments. There was no documented evidence that the care plan meeting was held or that the resident was offered the opportunity to attend the care plan meetings. Clinical record review revealed that Resident 31 had diagnoses that included a mood disorder and depression. The resident was identified as being alert and oriented and capable of making needs known. The resident reported during a resident council meeting held on October 3, 2023, at 1:09 p.m., that she had not been offered the opportunity to be involved in the development and revision of her care plan. Review of the resident's clinical record revealed that the resident had a MDS assessment completed on May 4, 2023, and August 3, 2023. A care plan meeting should have been scheduled within seven days of these assessments. There was no documented evidence that the care plan meeting was held or that the resident was offered the opportunity to attend the care plan meetings. Clinical record review revealed that Resident 53 had diagnoses that included a stroke. The resident was identified as being alert and oriented and very capable of making needs known. The resident reported during a resident council meeting held on October 3, 2023, at 1:09 p.m., that he had not been offered the opportunity to be involved in the development and revision of his care plan. Review of the resident's clinical record revealed that the resident had a MDS assessment completed on April 4, 2023, and July 4, 2023. A care plan meeting should have been scheduled within seven days of these assessments. There was no documented evidence that the care plan meeting was held or that the resident was offered the opportunity to attend the care plan meetings. Clinical record review revealed that Resident 86 had diagnoses that included end stage renal disease and heart failure and was dependent on dialysis. Resident 86 had an admission MDS assessment completed on August 5, 2023. The resident was identified as being alert and oriented and very capable of making needs known. During an interview on October 1, 2023, at 2:07 p.m., the resident stated that he was not offered the opportunity to be involved in the development of his care plan. Review of the resident's clinical record revealed that the interdisciplinary team had a care plan meeting on August 16, 2023. There was no documented evidence that the resident and/or the resident's representative was offered the opportunity to attend the care plan meeting with the interdisciplinary team. In an inteview on October 4, 2023, at 12:51 p.m., the Administrator confirmed there was no documented evidence that there was a care plan meeting held with the residents and/or their responsible (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395277 If continuation sheet Page 2 of 19 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 395277 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harborview Rehabilitation Care Center at Doylestow 432 Maple Avenue Doylestown, PA 18901 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 0553 party and the interdisciplinary team. Level of Harm - Minimal harm or potential for actual harm 28 Pa. Code 211.11(e) Resident care plan. Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395277 If continuation sheet Page 3 of 19 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 395277 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harborview Rehabilitation Care Center at Doylestow 432 Maple Avenue Doylestown, PA 18901 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 0677 Provide care and assistance to perform activities of daily living for any resident who is unable. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review, observation, and staff interview, it was determined that the facility failed to provide services to maintain adequate grooming and personal hygiene and assistance with transfer out of bed for four of six sampled residents who required assistance with activities of daily living. (Residents 3, 19, 86, 238) Residents Affected - Few Findings include: Clinical record review revealed that Resident 3 had diagnoses that included paraplegia (paralysis of the lower body), anxiety, and depression. Review of the Minimum Data Set (MDS) assessment dated [DATE], indicated that the resident required extensive assistance from staff for personal hygiene. Review of the care plan revealed a problem for self-care deficit. The intervention was for staff to provide nail care as needed. Review of the Resident's bathing record revealed that the resident was bathed on September 30, 2023. On October 1, 2023, at 12:37 p.m., Resident 3 was observed in bed and her nails were long and discolored. In an interview at that time the resident stated that she preferred her nails to be kept short and that staff could not locate nail clippers when she requested nail care. Resident 3 could not recall the last time staff provided or offered nail care, and stated that she had not refused nail care. On October 3, 2023, at 11:11 a.m., Resident 3's nails remained long and discolored, the resident stated staff had not offered nail care. Clinical record review revealed that Resident 19 had diagnoses that included schizophrenia and dysphagia (difficulty swallowing). The MDS assessment dated [DATE], indicated that the resident was cognitively impaired and required extensive staff assistance for personal hygiene. The care plan identified that the resident had a physical functioning deficit related to mobility and self-care impairment and interventions included for staff to provide the resident with assistance with daily hygiene and grooming. Observations on October 1, 2023, at 12:38 p.m., and October 2, 2023, at 11:49 a.m., revealed that Resident 19's fingernails on both hands were long and jagged with dirt underneath. Clinical record review revealed that Resident 86 had diagnoses that included anemia, end stage renal disease and heart failure. Review of the MDS assessment dated [DATE], indicated that the resident had no memory impairment and required extensive staff assistance for transferring from one position to another. During an interview on October 1, 2023, at 1:33 p.m., Resident 86 stated that he has not been out of bed since he was admitted to the facility except to go to dialysis. The resident stated that he wanted to be out of bed every day. A physician's order dated September 6, 2023, directed staff to offer the resident time out of the bed daily as tolerated. In an interview on October 4, 2023, at 9:50 a.m., the Administrator stated that the resident should have been provided a suitable chair for staff to get him out of bed for his comfort and repositioning needs. Clinical record review revealed that Resident 238 had diagnoses that included Parkinson's disease, schizophrenia, and dyskinesia (uncontrolled, involuntary muscle movement). The MDS assessment dated [DATE], indicated that the resident was cognitively impaired and required extensive staff assistance for personal hygiene. Observations on October 1, 2023, at 11:58 a.m., and October 2, 2023, at 10:36 a.m., revealed that Resident 238's fingernails on both hands were long and jagged with dirt underneath. In an interview on October 3, 2023, at 1:35 p.m., the Director of Nursing stated nails are expected to be done on resident shower days and as needed. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395277 If continuation sheet Page 4 of 19 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 395277 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harborview Rehabilitation Care Center at Doylestow 432 Maple Avenue Doylestown, PA 18901 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 0677 28 Pa. Code 211.12(d)(1)(5) Nursing services. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395277 If continuation sheet Page 5 of 19 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 395277 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harborview Rehabilitation Care Center at Doylestow 432 Maple Avenue Doylestown, PA 18901 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 clinical record review and staff interview, it was determined that the facility failed to ensure that physicians' orders were implemented for five of 21 sampled residents. (Residents 3, 11, 29, 86, 288) Residents Affected - Some Findings include: Clinical record review revealed that Resident 3 had diagnoses that included hypertension. A physician's order dated July 13, 2019, directed staff to administer a medication (lisinopril) once daily for hypertension. Staff were not to administer the medication if the resident's systolic blood pressure (SBP, the first measurement of blood pressure when the heart beats and the pressure is at it's highest) was less than 110 millimeters of mercury (mm/Hg). Review of Resident 3's medication administration records (MAR) revealed that staff administered the medication when the resident's SBP was less than 110 mm/Hg two times in August and two times in September of 2023. Clinical record review revealed that Resident 11 had diagnoses that included remission for psychoactive substance dependence, anxiety, depression, borderline personality disorder, and psychoactive and mood disturbance. A physician's order dated December 28, 2022, directed staff to perform a mouth check after the resident took her pills. A physician's order dated May 3, 2023, directed staff to crush all Resident 11's medications to prevent diversion. The resident was not to handle the medications directly. Observation on October 3, 2023, at 12:10 p.m., revealed Registered Nurse (RN) 3, prepared Resident 11's medications and poured the following medications into a medication cup: 50 milligrams (mg) tramadol, 4 mg tolterodine, and 600 mg ibuprofen. RN 3 did not crush the medication and proceeded to hand the medication cup of whole medications to Resident 11. The resident inspected the medications and proceeded to take the whole medications. RN 3 did not perform a mouth check. Clinical record review revealed that Resident 29 had diagnoses that included hypertension. A physician's order dated December 21, 2022, directed staff to administer a medication (carvedilol) twice per day for hypertension. Staff were not to administer the medication if the resident's SBP was less than 110 mm/Hg. Review of Resident 29's MARs revealed that staff administered the medication when the resident's SBP was less than 110 mm/Hg four times in August and six times in September of 2023. Clinical record review revealed that Resident 86 had diagnoses that included end stage renal disease and heart failure. A physician's order dated August 6, 2023, directed staff to administer a medication (midodrine hydrochloride) three times a day for hypotension (low blood pressure). Staff was not to administer the medication if the resident's SBP was 130 mm/Hg or higher. A review of Resident 86's MARs revealed that staff administered the medication when the resident's SBP was higher than 130 mm/Hg five times in August, 13 times in September, and twice in October of 2023. Clinical record review revealed that Resident 288 had diagnoses that included convulsions and epilepsy (seizures). On September 15, 2023, the physician ordered for staff to administer the anti-seizure medication lacosamide (250 milligrams every 12 hours) at 9:00 a.m. and 9:00 p.m. Review of the resident's MAR for September 2023, revealed that the resident did not receive the lacosamide on September 15, 22, 28, 29, and 30, 2023, at 9:00 p.m., and September 30, 2023, at 9:00 a.m. During an interview on October 4, 2023, at 12:52 p.m., the Director of Nursing confirmed that the identified medications were administered outside the established parameters. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395277 If continuation sheet Page 6 of 19 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 395277 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harborview Rehabilitation Care Center at Doylestow 432 Maple Avenue Doylestown, PA 18901 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 28 Pa. Code 211.12(d)(1)(5) Nursing services. 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: 395277 If continuation sheet Page 7 of 19 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 395277 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harborview Rehabilitation Care Center at Doylestow 432 Maple Avenue Doylestown, PA 18901 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 0686 Provide appropriate pressure ulcer care and prevent new ulcers from developing. Level of Harm - Minimal harm or potential for actual harm Based on clinical record review, observation, and interview, it was determined that the facility failed to provide interventions to prevent pressure ulcers for one of 21 sampled residents. (Resident 29) Residents Affected - Few Findings include: Clinical record review revealed that Resident 29 had diagnoses that included chronic kidney disease, diabetes mellitus, chronic pain, and depression. A physician's order dated September 28, 2023, directed staff to provide a Roho cushion (a pressure reduction device) to the resident's chair when out of bed and during dialysis. On October 1, 2023, at 11:23 a.m., Resident 29 was observed in bed. There was a cushion on the resident's dresser. Resident 29 stated that the cushion was to be used while out of bed, at dialysis. Observation on October 2, 2023, at 11:26 a.m., revealed the cushion remained on Resident 29's dresser and the resident was not in the room. At 11:32 a.m., on the same date, Resident 29 was observed sitting in the chair at dialysis treatment. There was no cushion observed under the resident. During the same observation period, Registered Nurse 2 stated that no cushion was provided or applied to the resident's chair for treatment. Observation on October 2, 2023, at 1:32 p.m., revealed that Resident 29 remained sitting in the chair at dialysis treatment with no cushion in place. In an interview on October 3, 2023, at 11:05 a.m., Resident 29 confirmed that the cushion was not in place at any time during dialysis treatment. There was no evidence that the resident refused use of the cushion during dialysis treatment on October 2, 2023. 28 Pa. Code 211.12(d)(3)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395277 If continuation sheet Page 8 of 19 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 395277 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harborview Rehabilitation Care Center at Doylestow 432 Maple Avenue Doylestown, PA 18901 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 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Based on observation and staff interview, it was determined that the facility failed to ensure that the environment remained free of accident hazards in two of three shower rooms. (1st floor shower room and 2nd floor shower room) Findings include: On all days of the survey, observations of the first floor shower room revealed that there was a bagged disposable razor on top of a box of gloves. Observations of the second floor shower room revealed that there was an unlocked cabinet that contained antiperspirant, skin/hair cleanser, a container of petroleum jelly, a resident's prescription blended topical cream, skin cream, vitamin A & D cream, shaving cream and a dirty electric razor with hair and debris on the razor head. In an interview on October 3, 2023, at 12:10 p.m., the Director of Nursing confirmed that there were four ambulatory residents that were cognitively impaired and had access to the potentially hazardous materials. CFR 483.25(d)(1)(2) Accidents. Previously cited 11/3/2022 28 Pa. Code 211.12(d)(1)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395277 If continuation sheet Page 9 of 19 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 395277 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harborview Rehabilitation Care Center at Doylestow 432 Maple Avenue Doylestown, PA 18901 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 0692 Provide enough food/fluids to maintain a resident's health. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review and staff interview, it was determined that the facility failed to timely assess the nutritional status of two of three sampled residents at nutrition risk. (Residents 4, 29) Residents Affected - Few Findings include: Review of the facility policy entitled, Weight Management, last reviewed August 31, 2023, revealed that a reweigh would be obtained for any weight change of plus or minus five pounds from the previous weight, unless other parameters were ordered by the physician. All reweighs would be obtained within 24 hours and were to be documented in the resident's record. Clinical record review revealed that Resident 4 had diagnoses that included depression, anemia, anxiety, dementia, and dysphagia. Review of the care plan revealed that the resident was at nutrition risk related to weight loss. On December 28, 2022, the resident weighed 261.6 pounds (lbs.), on January 2, 2023, the resident weighed 236.2 lbs., which reflected a 25.4 pound (lb.) (9.7%) weight loss. There was no evidence that a reweigh was obtained, per the policy. There was no evidence that the Registered Dietitian (RD) assessed the resident's nutritional status or weight loss until March 2, 2023. On February 13, 2023, the resident weighed 232.8 lbs., on April 27, 2023, the resident weighed 215.0 lbs., which reflected a 17.8 lb. (7.6%) weight loss. There was no evidence that a reweigh was obtained, per the policy. There was no evidence that the RD addressed the resident's nutritional status or continued weight loss until July 4, 2023. In an interview on October 3, 2023, at 1:30 p.m., the Administrator stated that residents with a history of significant weight loss should be followed at high risk and assessed on a monthly basis. In an interview on October 4, 2023, at 10:57 a.m., the RD confirmed that the resident should have been reweighed on those dates and that the reweighs were not obtained per the policy. Additionally, the RD stated that the resident should have been followed and assessed monthly due to a high nutrition risk related to a history of significant weight loss and that the resident was not monitored monthly. Clinical record review revealed that Resident 29 had diagnoses that included chronic kidney disease, diabetes mellitus, chronic pain, and anxiety. Review of the care plan revealed that the resident was at nutrition risk related to weight loss. Further review of the resident's record revealed that she was readmitted to the facility on [DATE], and weighed 138.4 lbs. This reflected a 27.6 lb. (16.6%) weight loss from April 5, 2023. There was no evidence that a nutrition assessment was completed upon readmission to the facility. The resident's nutritional status and weight loss was not assessed until July 3, 2023. In an interview on October 3, 2023, at 1:30 p.m., the Administrator stated that a full nutrition assessment should be conducted upon a resident's readmission to the facility. In an interview on October 4, 2023, at 10:57 a.m., the RD confirmed that a nutrition assessment should have been completed upon Resident 29's readmission to the facility on May 5, 2023, and that the assessment was not done. 28 Pa. Code 211.12(3)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395277 If continuation sheet Page 10 of 19 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 395277 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harborview Rehabilitation Care Center at Doylestow 432 Maple Avenue Doylestown, PA 18901 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 0698 Provide safe, appropriate dialysis care/services for a resident who requires such services. Level of Harm - Minimal harm or potential for actual harm Based on policy review, clinical record review, and interview, it was determined that the facility failed to ensure that staff provided services consistent with professional standards of practice for one of three dialysis residents sampled. (Resident 86) Residents Affected - Few Findings include: Review of the facility policy entitled, Obtaining Blood Pressures in Dialysis Residents, dated August 31, 2023, revealed that staff was not to take a blood pressure on a resident's arm where a chest wall catheter was present for access to provide dialysis. Clinical record review revealed that Resident 86 had diagnoses that included heart failure, kidney failure, and dependence on dialysis. The resident had a catheter inserted into the right chest wall for dialysis access and a physician order dated August 5, 2023, directing that staff was not to take blood pressure measurements in the resident's right arm. The care plan revealed that the resident was not to have blood pressures taken in the right arm. Review of Resident 86's blood pressure summary revealed that from August 5, 2023 through October 4, 2023, nursing staff had taken the resident's blood pressure in the right arm 30 of 191 times. In an interview conducted on October 4, 2023, at 10:08 a.m., the Director of Nursing confirmed that staff should have taken Resident 86's blood pressure using the left arm. CFR 483.25(l) Dialysis Previously cited 11/3/2022 28 Pa. 211.12(d)(1)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395277 If continuation sheet Page 11 of 19 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 395277 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harborview Rehabilitation Care Center at Doylestow 432 Maple Avenue Doylestown, PA 18901 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 0732 Post nurse staffing information every day. Level of Harm - Potential for minimal harm Based on observation and interview, it was determined that the facility failed to post accurate and current nurse staffing information. Residents Affected - Many Findings include: During a tour of the facility conducted on October 1, 2023, at 9:19 a.m., the staffing information that was posted in the lobby was dated for September 25, 2023. On October 4, 2023, at 10:30 a.m., the Nursing Home Administrator confirmed that incorrect staffing data was posted. 28 Pa. Code 201.18(b)(3) Management. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395277 If continuation sheet Page 12 of 19 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 395277 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harborview Rehabilitation Care Center at Doylestow 432 Maple Avenue Doylestown, PA 18901 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 0757 Ensure each resident’s drug regimen must be free from unnecessary drugs. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review, policy review, and staff interview, it was determined that the facility failed to adequately monitor residents on psychoactive medications for one of 21 sampled residents. (Resident 19) Residents Affected - Few Findings include: Review of the facility policy entitled, Behavior Management, last reviewed August 31, 2023, revealed that staff was to assess and monitor a resident for abnormal involuntary movements and adverse side effects upon a new order for antipsychotic medication and every six months when on an antipsychotic medication. Clinical record review revealed that Resident 19 was admitted to the facility on [DATE], with diagnoses of schizophrenia and dysphagia (difficulty swallowing). On March 15, 2023, the physician ordered that the resident receive an antipsychotic medication (lorazepam). On July 5, 2023, the physician ordered that the resident receive an antipsychotic medication (haloperidol). The care plan revealed that the resident was to be monitored for adverse side effects related to the use of this medication. There was no documentation in the clinical record to support that nursing staff monitored the resident for abnormal involuntary movements per facility policy. In an interview on October 4, 2023, at 3:00 p.m., the Director of Nursing stated that there was no documentation to support that Resident 19 was monitored for abnormal involuntary movements per facility policy. 28 Pa. Code 211.12(d)(1)(3)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395277 If continuation sheet Page 13 of 19 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 395277 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harborview Rehabilitation Care Center at Doylestow 432 Maple Avenue Doylestown, PA 18901 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 0758 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. Based on clinical record review and staff interview, it was determined that the facility failed to ensure that a PRN (as needed) psychoactive medication was limited to 14 days unless the physician documented in the clinical record the rationale to extend the PRN for one of 21 sampled residents. (Resident 19) Additionally, the facility failed to ensure the a resident was free from unnecessary use of a psychotropic medication for one of 21 sampled residents. (Resident 4) Findings include: Clinical record review revealed that Resident 4 had diagnoses that included depression with psychotic symptoms, schizoaffective disorder, anxiety, paranoid personality disorder, restlessness and agitation, dementia, and post-traumatic stress disorder. A physician's order dated September 2, 2023, directed staff to administer Klonopin (also known as clonazepam, an antianxiety medication) 0.5 milligrams (mg) every eight hours as needed for anxiety. Review of a progress note dated September 19, 2023, revealed that the resident slept a lot after administration of the medication. The practitioner ordered the dose of Klonopin be reduced to 0.25 mg as needed. A physician's order dated September 19, 2023, directed staff to administer 0.25 mg of clonazepam every eight hours as needed for anxiety. Review of Resident 4's medication administration record for September 2023 revealed that an order for 0.5 mg of Klonopin remained active and staff administered the antianxiety medication at the incorrect, higher dose on September 26, and 29, 2023. Staff did not discontinue the order for 0.5mg Klonopin upon entering the order for the reduced dose. In an interview on October 4, 2023, at 12:51 p.m., the Director of Nursing confirmed that the order for 0.5 mg Klonopin PRN should have been discontinued upon activating the order for the lower dose. Clinical record review revealed that Resident 19 had diagnoses that included schizophrenia and dysphagia (difficulty swallowing). On July 12, 2023, a physician ordered that staff administer a psychoactive medication (haloperidol) every 12 hours as needed. The order for the haloperidol failed to include a time frame for the continued use of the medication. There was no physician documentation that it was appropriate for the order to be extended beyond 14 days. In an interview on October 04, 2023, at 10:15 a.m. the Director of Nursing confirmed that there was no evidence the physician documented a rationale for continuing the medication beyond 14 days. 28 Pa. code 211.12(d)(1)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395277 If continuation sheet Page 14 of 19 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 395277 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harborview Rehabilitation Care Center at Doylestow 432 Maple Avenue Doylestown, PA 18901 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 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on facility policy review, observation, and interview, it was determined that the facility failed to store food in a sanitary manner in the kitchen and on three of three nursing units. (First, Second, and Third floors) Residents Affected - Many Findings include: Review of the facility policy entitled, Nourishment Rooms and Kichenettes, last reviewed August 31, 2023, revealed that containers of resident food would be labeled with the resident's name, room number, and date the item was placed in the refrigerator. Perishable items would be discarded after 72 hours. Observation of the kitchen on October 1, 2023, at 9:45 a.m., revealed a container of coleslaw in the refrigerator with a use by date of September 26, 2023. There was a black substance on the shelves in the refrigerator. There were three rubber spatulas with chipped rubber. There was an accumulation of dirt and various substances on the ledge over the stove top. There was an accumulation of a black substance on the deflector and inside wall of the ice machine. In an interview during the tour, dietary employee DE1 stated that ice in the machine was used for residents on the nursing units and in the kitchen. Observation of the pantry on the first floor nursing unit on October 2, 2023, at 11:00 a.m., revealed that the inside of the microwave was dirty with food/particle spatter. In an interview on October 2, 2023, at 11:05 a.m., nurse aide NA1 stated that the microwave was used to rewarm resident meals. A toaster had a significant buildup of toast crumbs and pieces of bread. There was an ice chest cart for ice dispensing and on the lower shelf there was a stained and saturated towel. There was a stained ceiling tile and the cabinet drawer front was not secure. Observation of the pantry on the second floor nursing unit on October 2, 2023, at 11:20 a.m., revealed the refrigerator was turned up to the coldest setting and the temperature was 26 degrees. There were wet icy paper towels on the shelves and a meat tray contained water and plasticware. There were containers that were not labeled or dated and there was a styrofoam cup and two plastic cups unmarked and filled with a brown substance. The cabinet drawer was dirty. There was an ice chest cart for ice dispensing and on the lower shelf there was a stained and saturated towel. The ice scoop was placed directly on the lower shelf without a container. On October 2, 2023, at 1:20 p.m., licensed practical nurse LPN1 was observed using the ice scoop to get ice from the ice chest for a resident and placing the scoop, unprotected, back on the shelf. The wall light switch cover was broken and missing pieces. Observation of the pantry on the third floor nursing unit on October 2, 2023, at 1:15 p.m., revealed a brown substance, a clear liquid, and a wet paper plate on the bottom level of the refrigerator. There were loose napkins and two containers of food items. One container was open and neither container was labeled or dated. There was a brown substance on the shelf and there was a cup containing a food item that was not labeled or dated. In the freezer was a bag of portioned, frozen meals. A substance had leaked into the bag. There were two Styrofoam cups. One was filled with an unidentified brown substance. 28 Pa. Code 201.18(b)(3)(e)(2.1) Management. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395277 If continuation sheet Page 15 of 19 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 395277 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harborview Rehabilitation Care Center at Doylestow 432 Maple Avenue Doylestown, PA 18901 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 0814 Dispose of garbage and refuse properly. Level of Harm - Potential for minimal harm Based on observation, it was determined that the facility failed to dispose of trash and refuse properly. Findings include: Residents Affected - Some Observation of the dumpster area on October 1, 2023, at 10:25 a.m., revealed various items on the ground surrounding the dumpster, including the metal base to a rolling table, two plastic rolling carts, a wheeled desk chair, plastic cups, personal condiment containers, bags, plastic wrappers, plastic utensils, and an aluminim can. CFR 483.60(i) Food Safety Requirements. Previously cited 05/15/23 28 Pa. Code 201.18(b)(3) Management. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395277 If continuation sheet Page 16 of 19 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 395277 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harborview Rehabilitation Care Center at Doylestow 432 Maple Avenue Doylestown, PA 18901 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 0908 Keep all essential equipment working safely. Level of Harm - Potential for minimal harm Based on observation, facility documentation review, and staff interview, it was determined that the facility failed to ensure mechanical equipment was in working order in the kitchen. Residents Affected - Some Findings include: Observation during the kitchen tour on October 1, 2023, at 9:45 a.m., revealed a large accumulation of ice on the floor in the back of the freezer, as well as on the ceiling. Ice formations extended down from the under side of the fan. There was an accumulation of ice and condensation on two boxes of vanilla shakes and a box of pepperoni. There was a large accumulation of freezer burn on a bucket of veal stock. In an interview on October 2, 2023, at 12:52 p.m., the Director of Dining Services stated that the large accumulation of ice has been present in the freezer for three weeks. Review of a service report dated October 2, 2023, revealed that the water was not flowing properly from the drain pan to the floor and the drain line needed to be refit and insulated. 28 Pa. Code 201.18(b)(3)(e)(2.1) Management. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395277 If continuation sheet Page 17 of 19 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 395277 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harborview Rehabilitation Care Center at Doylestow 432 Maple Avenue Doylestown, PA 18901 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 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, it was determined that the facility failed to provide a safe, sanitary, and comfortable environment on three of three nursing units. (Nursing units 1, 2, and 3) Findings include: Observations throughout the facility at various times during all days of the survey revealed the following: A wall mounted fan at the nurse's station on the first floor had a heavy accumulation of dust and dirt. The first floor hallway was missing a ceiling tile over the oxygen storage room door and there were six stained ceiling tiles. Wall corners at the shower and opposite corner were marred and crumbled with significant dust on the floor. On October 1, 2023, there was no sheet on the mattress in room [ROOM NUMBER], and the resident was observed laying directly on the mattress. During the rest of the survey a sheet that did not fit was observed on the mattress and the resident was observed laying on exposed mattress. In the room [ROOM NUMBER] bathroom, there was a stained ceiling tile. The molding tile was missing at the base of the wall with a long, deep hole at the base. In room [ROOM NUMBER], there were brown-stained privacy curtains between A and B bed. The air conditioner cover was not secure and the bathroom ceiling tile was stained. In room [ROOM NUMBER]A, the privacy curtains were pulled down in places and the bathroom light cover was broken. In the first floor supervised bath, the floor was broken, cracked, and had areas that no longer adhered to the floor. Hair and dirt covered the drain. The shower table pad had dirt and debris on it and had multiple cracks and tattered edges. There was a tube of ointment under the dirty laundry hampers. The tub contained clothing, a discarded glove, a roll of medical tape, a plastic bag containing a pad, a chair pad, and two wheelchair footrests. In the second floor supervised bath, the floor was broken, cracked, and had areas that no longer adhered to the floor. The shower chairs had a buildup of dirt. The shower table pad had tattered edges, a cracked perimeter, and was dirty with stains and debris. The shower table was broken at the base. There were no paper towels in two of two dispensers. A window double fan was tipped on its side, lengthwise, and was not secure. In the second-floor pantry, the overhead storage cabinet was missing a door and the drawer under the counter was dirty with a buildup of dirt and debris. Throughout the third-floor nursing unit, the walls were marred and chipped. There was a dark dried substance spattered on the bottom half of the walls. The blood pressure cart had a dried orange (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395277 If continuation sheet Page 18 of 19 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 395277 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harborview Rehabilitation Care Center at Doylestow 432 Maple Avenue Doylestown, PA 18901 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 0921 substance on the wheelbase. Level of Harm - Minimal harm or potential for actual harm In room [ROOM NUMBER], the privacy curtain between beds 2 and 3 had brown stains and there was a dark brown dried substance splattered on the walls. In room [ROOM NUMBER], the privacy curtain between beds 2 and 3 had orange and brown stains. There was a pervasive odor of urine in rooms [ROOM NUMBERS]. The mattress was peeling in room [ROOM NUMBER], bed 1. In room [ROOM NUMBER], the drywall in the right-hand corner of the room and along the base of the wall was crumbled. In room [ROOM NUMBER], there was a hole in the wall near the bathroom. The privacy curtain between beds 2 and 3 had orange and brown stains. There were yellow, orange, and brown streaks splattered on the walls and bed 3's dresser drawer handle was broken. In room [ROOM NUMBER], the window curtain had brown stains and the rubber baseboard molding behind bed 2 was off the wall. In room [ROOM NUMBER], the drywall was bubbled and peeling to the left of the window. Residents Affected - Some The dining room on the third-floor nursing unit had a brown substance on various areas of the wall. The soiled linen cart in the supervised bathroom on the third-floor nursing unit was uncovered on multiple observations. The contents of the cart were exposed and spilled onto the floor. The privacy curtain was draped over, and falling into, one of the compartments of the cart. The material on the lock cabinet was peeling. There was a black substance on the ledge that separated the bathing areas. There was a box of gloves on the ledge of the wall in front of the toilet. Half of the box had been removed which exposed the gloves. The cover for the light over the toilet was broken. The privacy curtain in room [ROOM NUMBER] was hanging by the solid cloth, not the netting with hook holes. There was a black substance on the bottom of the straps that hold the ice cooler on the water cart of the third floor. There were broken handles on both dressers in room [ROOM NUMBER]. 28 Pa. Code 201.18(b)(3), (e)(2.1) Management. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395277 If continuation sheet Page 19 of 19