Health inspection·September 12, 2023

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 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review and interviews with staff, it was determined that the facility did not ensure that the resident was provided needed care and services related to follow up medical appointments for surgery clearance as recommended for one of four clinical records reviewed (Resident R3). Residents Affected - Few Findings include: Review of Resident R3's admission MDS (Minimum Data Set - a mandatory periodic resident assessment tool), dated, revealed that the resident was admitted to the facility on [DATE], with a diagnosis of pyelonephritis (inflammation of the kidney, typically due to a bacterial infection). Review of Resident R3's August 10, 2023, Urology Consult revealed a diagnosis of nephrolithiasis (the presence of stones in the kidney due to a decrease in urine volume or excess of stone-forming substances in the urine, causing back pain, abdominal pain, burning sensation during urination, blood in urine and fever. Urgent medical attention is usually recommended in severe cases by healthcare providers and can be dangerous or life threatening if untreated.) Urologist recommendation was to obtain surgical clearance from cardiology and nephrology and to follow up with urologist in 4 weeks. A review of Resident R3's medical appointments revealed that Resident R3 had a Nephrology appointment on August 31, 2023, at 9:00 a.m. which was cancelled because the transportation company could only transfer one resident on a stretcher and another resident was determined to be more urgent. Interview with the Director of Nursing (DON), Employee E1, on September 11, 2023, at 3:30 p.m. confirmed that Resident R3 missed his nephrology appointment at 9:00 a.m. due to another resident having to go out, and that the alternate transportation company was not able to arrange transportation on short notice in time for the 9:00 a.m. appointment. Interview with Resident R3 at 11:30 a.m. on September 11, 2023, revealed that he had another appointment with Nephrology for 9:45 a.m. that morning that was cancelled again due to transportation and that he was disappointed and distraught, and that he needed this appointment before he could have his kidney stones removed. He said it was very difficult for him to get physical therapy due to the pain from the kidney stones. Interview with DON on September 11, 2023, at 3:15 p.m. confirmed that Resident R3 missed his nephrology appointment at 9 a.m. that morning on September 11, 2023 due to a problem at the transportation company. She stated that when the transport company's drivers showed up in the morning they discovered that someone had broken into the office and stolen the keys and gas cards for all the transport vans. She provided an email from the company explaining the ongoing police investigation which was Page 1 of 4 395296 395296 09/12/2023 Meadowview Rehabilitation and Nursing Center 9209 Ridge Pike White Marsh, PA 19128

F 0684 Level of Harm - Minimal harm or potential for actual harm centered on prior employees who were recently let go. She further stated that the transportation was a no show and when the facility called the nephrology office to arrange for another transport later, the nephrology office said it was too late and that the appointment would have to be rescheduled and that the earliest appointment would be September 29, 2023. This is another two-and half-week delay in the services which were recommended on August 10, 2023. Residents Affected - Few 28 Pa. Code:201.18(a)(b)(1)(3) Management. 28 Pa. Code:211.12(d)(1)(5) Nursing services. 395296 Page 2 of 4 395296 09/12/2023 Meadowview Rehabilitation and Nursing Center 9209 Ridge Pike White Marsh, PA 19128

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. Based on observation and interviews with staff, it was determined that the facility failed to maintain a clean, safe and functional environment for residents and staff in four of five central bathing rooms (A wing, B wing, C wing, D wing) and in the boiler room. Findings include: A tour of the central bathing rooms on the five nursing units at 10:00 a.m. on September 11, 2023, with Employee E12, the Infection Preventionist, revealed the following: Observations in the central bathroom on A Wing revealed a wall mounted heating and air conditioning unit with rust colored corrosion on the lowered vents at the top of the unit and adjacent sheet metal cover. Observations in the central bathroom on B Wing revealed a bariatric shower chair with rust colored corrosion on the white metal pipes on the underside of the chair. Observations in the central bathroom on C Wing revealed a shower chair with build-up of medium brown colored material on the white pipes on the underside of the chair. Observations in the central bathroom on D Wing revealed a wall mounted heating and air conditioning unit with rust colored corrosion on the louvered vents at the top of the unit and adjacent sheet metal cover. Interview at 10:20 a.m. on September 11, 2023, with Employee E12, the Infection Preventionist confirmed the above findings. A tour of the main boiler room on the ground floor at 2:30 p.m. on September 11, 2023, with Employee E10, the Maintenance Director, revealed the following: Observation of the floor near the wall in the corner of the boiler room revealed a wooden pallet with a stack of old bed rails and a broken wooden end table and the floor all around was wet with water dripping from pipes above. Observation near the center of the boiler room revealed a blue garbage can overflowing with trash, an old table saw, an old meat slicer and various lengths of different sizes of pipe laying all over the wet floor. The damp air had a foul odor from the puddles of standing water and trash. Observation of the vertical pipes for the cooling tour revealed the insulation was peeling off the pipes exposing the pink fiberglass insulation and the floor had large puddles of standing water all around this area. Observation of the steel, double exit doors revealed that the bottom of both doors where they meet are corroded to the point of creating an opening to the exterior of the building and water is freely dripping into a puddle in front of these doors. Interview at 2:45 p.m. on September 11, 2023, with Employee E10, Maintenance Director confirmed the 395296 Page 3 of 4 395296 09/12/2023 Meadowview Rehabilitation and Nursing Center 9209 Ridge Pike White Marsh, PA 19128

F 0921 above findings. Level of Harm - Minimal harm or potential for actual harm 28 Pa. Code 201.14(a) Responsibility of licensee 28 Pa. Code 201.18(b)(1)(3) Management Residents Affected - Some 395296 Page 4 of 4