Inspection·June 16, 2025

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Based on review of facility policy, clinical records, and facility documents, and staff interviews, it was determined that the facility failed to ensure all alleged violations involving abuse were reported in a timely manner for one of six residents reviewed (Resident R1). Findings include: Review of facility policy entitled Abuse - Reasonable Suspicion of a Crime - Prevention / Reporting dated January 2024, revealed the facility will not tolerate any form of abuse, exploitation, mistreatment or neglect of its residents, nor will it tolerate misappropriation of residents' funds or property by anyone. All covered individuals shall report any incident or suspicion of abuse, neglect, mistreatment, or misappropriation of funds or property immediately to the Abuse Coordinator (Director of Human Resources), Director of Nursing, or the Administrator / Executive Director, or in their absence to the RN Supervisor, or Charge Nurse. The policy further states for Protection, Identification, and Reporting that The Administrator / Executive Director, the Director of Nursing, and the Abuse Coordinator, must be informed as soon as possible of alleged abuse, neglect, mistreatment, or misappropriation of resident funds or property. The policy Process revealed that when an employee has reasonable cause to suspect that a resident is a victim of abuse, neglect, exploitation or abandonment, the employee shall report it to their supervisor, who will immediately report it to the facilities Executive Director, Director of Nursing, or Abuse Coordinator, and that staff will complete a Star Witness Report indicating the time, location, resident, and details of the allegation and submit it to the supervisor prior to the completion of his/her shift. Facility policy defines Physical Abuse as including, but not being limited to hitting, slapping, kicking, biting, spitting, or throwing items, etc. Abuse, is defined at §483.5 as the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish. Abuse also includes the deprivation by an individual, including a caretaker, of goods or services that are necessary to attain or maintain physical, mental, and psychosocial well-being. Instances of abuse of all residents, irrespective of any mental or physical condition, cause physical harm, pain or mental anguish. It includes verbal abuse, sexual abuse, physical abuse, and mental abuse including abuse facilitated or enabled through the use of technology. Resident R1's clinical record revealed an admission date of 4/21/16, with diagnoses that included dementia (loss of cognitive functioning affecting a person's memory and behaviors), tracheostomy(a hole made through the front of the neck and into the windpipe [trachea] where a tube is placed to keep the hole open for breathing), and diabetes (a health condition caused by the body's inability to produce enough insulin). (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: 395361 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 395361 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/16/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Pleasant Ridge Manor East/West 8300 West Ridge Road Girard, PA 16417 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)