Inspection visit
Inspection
1 citation recorded
Inspector’s narrative
What the inspector wrote
This survey cited 1 deficiency. The full statement and the facility’s plan of correction follow, verbatim from the federal record.
F 0760
Ensure that residents are free from significant medication errors.
Level of Harm - Minimal harm
or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
review of facility policy, documents, clinical records, and staff interviews, it was determined that the facility
failed to ensure that residents were free from significant medication errors for one of three residents
(Resident R1).
Residents Affected - Few
Findings include:
Review of facility policy Administering Medications 1/18/24, indicated medications are administered in a
safe and timely manner, and as prescribed. The policy further stated that the individual administering the
medication records in the resident's medical record:
-the date and time the medication was administered;
-the dosage;
-the route of administration;
-the injection site (if applicable);
-any complaints or symptoms for which the drug was administered;
-any results achieved and when those results were observed; and
-the signature and title of the person administering the drug.
Review of Resident R1's admission record indicated he was originally admitted to the facility on [DATE],
and readmitted on [DATE].
Review of Resident R1's Minimum Data Set (MDS - mandated assessment of a resident's abilities and care
needs) dated 8/2/24, included diagnoses of epilepsy (disorder of the brain characterized by repeated
seizures) and non-traumatic brain dysfunction.
Review of Resident R1's plan of care initiated 10/11/23, indicated Resident R1 is at risk for seizure activity.
Included in the care plan interventions was, Medications as ordered.
Review of a physician's order dated 4/26/24, then discontinued on 9/7/24, indicated for Resident R1 to
receive 500 mg (milligrams) of levetiracetam (Keppra, an anti-seizure medication).
(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 3
Event ID:
395289
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
395289
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
09/07/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Wecare at South Hills Rehabilitation and Nrsg Ctr
201 Village Drive
Canonsburg, PA 15317
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 0760
Review of facility census information indicated Resident R1 was hospitalized from [DATE], until 8/21/24.
Level of Harm - Minimal harm
or potential for actual harm
Review of hospital discharge paperwork dated 8/20/24, indicated in the Final Medication List levetiracetam
(Keppra 500 mg oral tablet) 2 tab(s) by mouth 2 times per day.
Residents Affected - Few
Review of a progress note dated 8/23/24, at 1:58 a.m. indicated, CNA (nurse aide) alerted this Nurse to Pt
(patient) having grand Mal seizure (a type of seizure that involves a loss of consciousness and violent
muscle contractions). Nurse rushed in to find Pt convulsing without dilated pupils. Pt immediately rolled to
L(left) side to conclude seizure activity while Nurse Supervisor was alerted. Seizure endured for 12
seconds before occurrence ended. VS (vital signs) 128/81, 104, 97% on RA, 97.0. Resps (respirations)
shallow, even and labored. Neuro checks back to baseline post seizure. Pt gradually calmed down after
Nurse supervisor entered room. Pt lethargic post seizure. MD alerted. Will continue to monitor.
Review of a progress note dated 8/23/24, at 4:10 a.m. indicated Resident R1 was sent to the local hospital
via ambulance.
Review of hospital laboratory blood test results dated 8/23/24, collected at 4:46 a.m. indicated that Resident
R1's level of levetiracetam level was less than 2.0 ug/mL (micrograms per milliliter). The normal level
expected is referenced on this document as 10.0 - 40.0 ug/mL.
Review of Resident R1's medication administration record (MAR) for August 2024 indicated Resident R1
received 500 mg of levetiracetam twice daily.
During an interview on 9/7/24, at approximately 1:00 p.m. the Director of Nursing (DON) confirmed that
when Resident R1 returned from the hospital on 8/21/24, the facility was experiencing an electronic medical
record down time and produced a paper MAR (printed on 8/18/24) that indicated an order for levetiracetam
500 mg, twice daily. Handwritten next to the order was information that the order was changed to two
tablets, twice daily. Administrations on this paper MAR were for 8/20/24, and 8/21/24.
Review of the electronic MAR from 8/21/24, through 8/26/24, revealed the order was not updated in the
medical record to reflect the change from one tablet (500 mg) twice daily, to two tablets (1000 mg) twice
daily.
Review of the electronic MAR indicated the administrations were ordered for 8:00 a.m. and 8:00 p.m. The
following levetiracetam administrations were documented as provided:
8/21/24: 500 mg at approximately 8:00 p.m.
8/22/24: 500 mg at approximately 8:00 a.m.
8/22/24: 500 mg at approximately 8:00 p.m.
8/23/24: Not provided due to Resident R1 being hospitalized .
8/23/24: 500 mg at approximately 8:00 p.m.
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395289
If continuation sheet
Page 2 of 3
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
395289
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
09/07/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Wecare at South Hills Rehabilitation and Nrsg Ctr
201 Village Drive
Canonsburg, PA 15317
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 0760
8/24/24: 500 mg at approximately 8:00 a.m.
Level of Harm - Minimal harm
or potential for actual harm
8/24/24: 500 mg at approximately 8:00 p.m.
8/25/24: 500 mg at approximately 8:00 a.m.
Residents Affected - Few
8/25/24: 500 mg at approximately 8:00 p.m.
8/26/24: 500 mg at approximately 8:00 a.m.
8/26/24: Not provided due to Resident R1 being hospitalized .
During an interview on 9/7/24, at approximately 2:00 p.m. the Director of Nursing confirmed that the
physician's order in the medical record was not updated, and confirmed the MAR from 8/21/24, through
8/26/24, documented that 500 mg of levetiracetam was provided twice daily, rather than the updated
dosage of 1000 mg twice daily.
During an interview on 9/7/24, at approximately 2:00 p.m. the Director of Nursing confirmed that the facility
failed to ensure that residents were free from significant medication errors for one of three residents.
28 Pa Code 201.14(a) Responsibility of licensee.
28 Pa. Code 201.18(b)(1)(e)(1) Management.
28 Pa. Code 211.10(c) Resident care policies.
28 Pa Code 211.12(d)(1)(3)(5) Nursing Services.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395289
If continuation sheet
Page 3 of 3
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Back to topCitations
1 citation recorded*CMS
What do CMS severity letters mean?
Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.
General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.
Each letter combines severity with scope: how many residents the deficiency affected.
F760 - Residents are free of any significant medication errors
Ensure that residents are free from significant medication errors.
FAQ · About this visit
Common questions about this visit
What happened during the September 7, 2024 survey of WECARE AT SOUTH HILLS REHABILITATION AND NRSG CTR?
This was a inspection survey of WECARE AT SOUTH HILLS REHABILITATION AND NRSG CTR on September 7, 2024. The surveyor cited 1 deficiency, recorded on the federal Form 2567 statement of deficiencies.
Were any deficiencies cited at WECARE AT SOUTH HILLS REHABILITATION AND NRSG CTR on September 7, 2024?
Yes, 1 deficiency was cited, each with a CMS Scope and Severity grade. The first was: "Ensure that residents are free from significant medication errors."
What type of survey was this?
This was a inspection survey conducted by state surveyors under federal Centers for Medicare & Medicaid Services (CMS) oversight. Findings are published on CMS Care Compare.
SourceView on CMS Care Compare
Next steps
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Data from CMS Care Compare public records. Dataset last refreshed . If you believe any information is inaccurate, report it here.