Health inspection·July 1, 2025

F 0584 Level of Harm - Minimal harm or potential for actual harm Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. Based on review of facility policy, observation, and staff interview, it was determined that the facility failed to maintain a clean, safe, and homelike environment for one of one coffee area (first-floor lobby). Residents Affected - Few Findings Include: Review of the facility policy Resident Rights last reviewed 3/14/25, indicated it is the policy of this facility to provide resident care that meets the psychosocial, physician and emotional needs and concerns of the resident. Safety of residents, visitors and employees is a top priority of care During an observation completed on 7/1/25, at 9:08 a.m. the first-floor lobby coffee area revealed the following: · The ice machine with white substance on catch tray, the counter area under the ice machine had white substance and debris. · The microwave revealed brown splatter debris on inside. · The sinks plastic shield located over faucet with yellow and brown substances. · The area under sink contained a basket, a washcloth and debris to the left corner as well as scattered on the base of cabinet. · The area under the coffee machine revealed white fuzzy substance underneath as well as a grape. · Page 1 of 4 395300 395300 07/01/2025 Perry Health & Rehab Center 9850 Old Perry Highway Wexford, PA 15090

F 0584 A step stool splattered with brownish tan substance Level of Harm - Minimal harm or potential for actual harm · The floor with tan debris, paper wrappers and coffee stirrers. Residents Affected - Few · The windowsill had leaf debris under a plant. During an interview completed on 7/1/25, at 9:17 a.m. the receptionist Employee E2 confirmed the above observations and stated, I don ' t think housekeeping has been here they start at 8:00 a.m. During an interview completed on 7/1/25, at 9:22 a.m. the Nursing Home Administrator confirmed the above observations and that the facility failed to maintain a clean, safe, and homelike environment for one of one coffee areas (first-floor lobby). 28 Pa. code: 201.14 (b) Responsibility of licensee. 28 Pa Code: 201.18 (e)(1)(2) Management. 28 Pa Code: 201.29 (a)(c) Resident Rights. 395300 Page 2 of 4 395300 07/01/2025 Perry Health & Rehab Center 9850 Old Perry Highway Wexford, PA 15090

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 review of facility policy, clinical records, resident interviews and staff interview it was determined that the facility failed to provide assistance with Activity of Daily Living (ADL) involving consistent shower or baths for two out of seven residents (Closed Record (CR) Resident R1 and Resident R3). Residents Affected - Few Findings include: The facility Routine Resident Care last reviewed 3/14/25, indicated it is the policy of this facility to promote resident centered care by attending to the total medical, nursing, physical, emotional, mental, social and spiritual needs and honor resident lifestyle preferences while in the care of this facility. Providing routine daily care by a nursing assistant with specialized training including but not limited to maintaining a program for skin care. Routine care includes bathing, dressing, eating and toileting. Review of the clinical record indicated CR Resident R1 was admitted to the facility on [DATE]. Review of CR Resident R1's Minimum Data Set (MDS - a periodic assessment of care needs) dated 6/11/25, indicated the diagnosis of anemia (low iron in the blood), gastroesophageal reflux disease (stomach contents flow back up the esophagus) and anxiety. Review of the facility shower schedule indicated that CR Resident R1 would receive showers on Tuesdays and Fridays on the daylight shift. Review of CR Resident R1's documentation survey report for June of 2025, indicated that resident's shower days are scheduled on Tuesday and Fridays on the daylight shift. Further review failed to include documentation to indicate CR Resident R1 received or refused a shower or bed bath on 6/6/25. During an interview completed on 7/1/25, at 1:40 p.m. the Director of nursing confirmed that CR Resident R1 did not receive a shower or bed bath on 6/6/25. Review of the clinical record indicated Resident R3 was admitted to the facility on [DATE]. Review of Resident R3's MDS assessment dated [DATE], indicated he had diagnoses that included quadriplegia (paralysis of all four limbs), neuromuscular dysfunction of the bladder (muscle and nerve concerns impacting bladder control), and anxiety disorder (a medical condition creating a sense of acute fear, restlessness, and worry). Review of Resident R3's care plan dated 9/27/24, indicated that he is dependent for bathing and helper does all of the effort. Review of Resident R3's physician orders dated 2/21/25, indicated that it was ok for Resident R3 to shower. Review of Resident R3's shower documentation report and the Treatment Administration Record (TAR) for June 2025, failed to include documentation to indicate that Resident R3 received or refused a shower/bed bath on the following dates: 395300 Page 3 of 4 395300 07/01/2025 Perry Health & Rehab Center 9850 Old Perry Highway Wexford, PA 15090

F 0677 6/5/25 Level of Harm - Minimal harm or potential for actual harm 6/9/25 6/23/25 Residents Affected - Few During an interview on 7/1/25, at 9:15 a.m. Resident R3 stated the following: They have only one nurse aide to help shower me or to get me out on Sunday. Longest have gone without a shower was six weeks. One nurse aide is supposed to have 10-12 residents and there are a lot more residents than that on this hallway. They have a real problem with being understaffed. During an interview completed on 7/1/25, at 12:20 p.m. the Director of Nursing (DON) confirmed that the facility failed to provide assistance with Activity of Daily Living (ADL) involving consistent shower or baths for Resident R3 as required. 28 Pa. Code: 211.12(1) Nursing services. 28 Pa. Code: 211.10(d) Resident care policies. 28 Pa. Code: 211.12 (2)(5) Nursing services. 395300 Page 4 of 4