Health inspection·March 5, 2025

F 0584 28 Pa Code 201.18(b)(1) Management Level of Harm - Minimal harm or potential for actual harm 28 Pa Code 201.18(b)(3) Management 28 Pa Code 205.63(b) Plumbing and piping systems required for existing and new construction Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395374 If continuation sheet Page 2 of 10 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 395374 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/05/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Edenbrook of Yeadon Lansdowne and Lincoln Ave Yeadon, PA 19050 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 - Immediate jeopardy to resident health or safety Residents Affected - Some Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, review of facility policies, facility documentation and interviews with staff, it was determined the facility failed to ensure water temperatures in the central shower room and resident bathroom sinks were maintained at a safe temperature for one of four nursing units observed (TCU Nursing Unit). This failure placed residents on the TCU Nursing Unit at risk for serious injury from a burn and resulted in an Immediate Jeopardy situation. Findings include: Review of facility policy titled, Water Temps - Bathing dated February 1, 2025, revealed, It is the policy of this facility to provide a safe and comfortable temperature for residents during bathing and procedures to protect them from avoidable injury whenever possible. The facility will monitor domestic hot water temperatures prior to bathing/showering residents and testing will be conducted on a routine basis by the Maintenance Department. Domestic hot water ideally will be maintained at 105 degrees to 110 degrees Fahrenheit. Acceptable range is 100-110 degrees. Continued review of the facility policy, under subsection titled, Procedure revealed, Water temperature will be checked using the digital bath temperature reading prior to immersing a resident in water, using water from a shower, or using hot water for the purpose of bathing or soaking. Hot water temperatures exceeding 110 degrees Fahrenheit or less than 100 degrees Fahrenheit will be reported immediately to the Charge Nurse or designee. The Charge Nurse or designee will notify the Maintenance Department and communicate the situation to all unit staff. Signs should be posted in the affected areas, such as 'Caution-Hot Water' or 'Do Not Use-Hot Water', until the situation has been corrected. Observation of the TCU Nursing Unit, on March 5, 2025, at 10:45 a.m. with Employee E6, Maintenance Assistant, revealed hot water from the hand sink in the Central Shower Room was 121.2 degrees Fahrenheit and hot water from the shower stall was 121.1 degrees Fahrenheit. Employee E6, Maintenance Assistant, immediately left the TCU Nursing Unit to check the hot water tank in the boiler room. Observation conducted on March 5, 2025 at 10:50 a.m. revealed in room [ROOM NUMBER] on the TCU Nursing Unit, the hot water from the resident hand sink in the bathroom was 123.8 degrees Fahrenheit. Observation of the boiler room on March 5, 2025, at 10:53 a.m. with Employee E6, Maintenance Assistant, revealed the thermostat on the hot water tank that supplies water to the TCU Nursing Unit was set to 135 degrees Fahrenheit and the temperature of the water inside the hot water tank was 160 degrees Fahrenheit. Interview conducted at the time of the observation, with Employee E6, Maintenance Assistant, revealed when Employee E6 first came down to check the hot water tank, that the thermostat was set at 150 degrees Fahrenheit and he turned it down to 135 degrees Fahrenheit. Employee E6, Maintenance Assistant, stated that this hot water tank supplies hot water to all of the resident rooms, shower room, and care areas on the TCU Nursing Unit. Interview on March 5, 2025, at 11:14 a.m. Employee E8, agency nurse aide, revealed that she gave Resident R4 a shower in the TCU Central Shower Room that morning. Continued interview revealed that she did not use a thermometer to check the water temperature prior to giving the resident a shower. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395374 If continuation sheet Page 3 of 10 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 395374 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/05/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Edenbrook of Yeadon Lansdowne and Lincoln Ave Yeadon, PA 19050 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 - Immediate jeopardy to resident health or safety Residents Affected - Some Further interview revealed that Employee E8, agency nurse aide, was unable to state what the safe water temperature range should be when bathing a resident. Interview on March 5, 2025, at 11:16 a.m. Employee E9, nurse aide, revealed that she gave Resident R5 a shower in the TCU Central Shower Room that morning. Continued interview revealed Employee E9 did not use a thermometer to check the water temperature prior to giving the resident a shower. Further interview revealed Employee E9, nurse aide, was unable to state what the safe water temperature range should be when bathing a resident. Interview on March 5, 2025, at 11:20 a.m. Employee E10, nurse aide, revealed that she gave Resident R6 a shower in the TCU Central Shower Room that morning. Employee E10, nurse aide, proceeded to enter the TCU Central Shower Room and provide a demonstration of how to use the thermometer in the shower stall. Employee E10, nurse aide, stated that she adjusted the water temperature for comfort and that she did not put the hot water on all the way, so she was unaware the hot water was excessively hot. Observation conducted at the time of the interview, revealed the hot water temperature reading from the shower stall in the TCU Central Shower Room was 122.3 degrees Fahrenheit. Further interview with Employee E10, nurse aide, revealed that she was assigned to work on the TCU Nursing Unit that shift. Employee E10, nurse aide, stated that four residents in her assignment, Residents R7, R8, R6 and R9, were able to independently use the hand sinks in their rooms. Interview on March 5, 2025, at 11:30 a.m. with Employee E11, nurse aide, revealed that she was assigned to work on the TCU Nursing Unit that shift. Continued interview revealed Employee E11 was unable to state what the safe water temperature range should be when bathing a resident. Further interview, Employee E11, nurse aide, stated that three residents in her assignment, Residents R10, R11 and R12, were able to independently use the hand sinks in their rooms. Based on the above findings, Immediate Jeopardy to the safety of the residents on the TCU Nursing Unit, was identified to the Nursing Home Administrator on March 5, 2025, at 1:18 p.m. for failure to ensure that safe hot water temperatures were maintained not to exceed 110 degrees Fahrenheit. The Nursing Home Administrator was provided with the Immediate Jeopardy Template (document which included information necessary to establish each of the key components of immediate jeopardy) and an immediate action plan was requested. On March 5, 2025, at 4:55 p.m. the facility provided the following corrective action plan: - At 11:52 a.m. the facility turned off the hot water valve to TCU unit when they were alerted about the high temperatures on TCU. - Adjustments were made after the system was flushed. Hot water maintained and did not exceed 110 degrees. The plumber who was onsite assisting with a different work order and was called to assess and make recommendations. - The facility checked the sink temperature in every room on the TCU after the hot water valve was turned back on. - There were no additional high temps identified. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395374 If continuation sheet Page 4 of 10 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 395374 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/05/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Edenbrook of Yeadon Lansdowne and Lincoln Ave Yeadon, PA 19050 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 - Immediate jeopardy to resident health or safety -The facility water temperature policy will be reviewed to ensure that safe processes for monitoring water temperatures have been fully developed. - 80% of employee list that were working on the day and evening shift were educated on the water temperature policy including acceptable water temperature ranges (100-110 degrees) and appropriate methods to check water temps. Residents Affected - Some Methods include: - Water temperature will be checked using a thermometer reading prior to immersing a resident in water, using water from a shower, or using hot water for the purpose of bathing or soaking. - Hot water temperatures exceeding 110 degrees Fahrenheit or less than 100 degrees Fahrenheit will be reported immediately to the Charge Nurse or designee. - If the water feels excessively warm or out of range. - Regular maintenance checks to ensure the plumbing system is functioning properly and temperature limits are being adhered to. - Staff for future shift (11-7) will be educated at the beginning of shift. Additional 10% staff will be virtually educated to total of 100% staff education compliance by March 6, 2025. - The plumber is scheduled for a follow-up visit on March 6, 2025, proactively to ensure the adjustments that were made were effective. - The Maintenance staff or designee will complete temp audits hourly for the next 24 hours. The team will continue to monitor water temps daily until further direction of QAPI Committee. - A random sampling of employee interviews to ensure that they are knowledgeable on how to identify and respond to elevated water temperatures. Audits will occur daily until further direction of the QAPI Committee. - The Medical Director was updated on this Correction and Removal-Abatement Plan as well as occurrences of which this plan pertains. Monitoring will be initiated and completed by the Administrator and/or designee as indicated above. Any discrepancies identified during completion of these audits will be immediately addressed. All audits, reviews and interviews will be forwarded to the Center's QAPI (Quality Assurance Performance Improvement) Committee to identify patterns and trends of noncompliance and to determine if further action is necessary. Frequency of continued audits will be determined at that time. If issues are identified, re-education will be completed. If any trends are identified, systems will be assessed to determine effectiveness. A plan will be developed, and revision will be made as deemed necessary. Interviews conducted on March 5, 2025, between 2:06 p.m. and 2:46 p.m. with day shift nursing staff, and between 4:21 p.m. and 4:44 p.m. with evening shift nursing staff, verifying the implementation of the immediate action plan. Nursing staff were able to verbalize the facility's water policy, including that water temperatures should not exceed 110 degrees Fahrenheit, what to do if water temperatures were found to be too hot, and how to check water temperatures. The hot water on the TCU Nursing Unit at residents' hand sinks and in the Central Shower Room were tested and verified that they (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395374 If continuation sheet Page 5 of 10 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 395374 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/05/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Edenbrook of Yeadon Lansdowne and Lincoln Ave Yeadon, PA 19050 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 - Immediate jeopardy to resident health or safety Residents Affected - Some did not exceed 110 degrees Fahrenheit. Maintenance and Supervisory staff were observed checking water temperatures and completing audit logs. Water temperature logs were reviewed and revealed appropriate water temperatures. Following verification of the implementation of the immediate action plan, review of water temperature logs and review of staff education documentation, the Immediate Jeopardy was lifted on March 5, 2025, at 5:20 p.m. 28 Pa Code 201.14(a) Responsibility of licensee 28 Pa Code 201.18(b)(1) Management 28 Pa Code 201.18(b)(3) Management 28 Pa Code 205.63(c) Plumbing and piping systems required for existing and new construction 28 Pa Code 211.12(d)(5) Nursing services FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395374 If continuation sheet Page 6 of 10 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 395374 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/05/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Edenbrook of Yeadon Lansdowne and Lincoln Ave Yeadon, PA 19050 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 0835 Administer the facility in a manner that enables it to use its resources effectively and efficiently. 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 records, job description, and staff interviews, it was determined that the Nursing Home Administrator (NHA) did not effectively manage the facility to ensure that water temperatures in the central shower room and resident bathroom sinks were maintained at a safe temperature for one of four nursing units observed (TCU Nursing Unit). This failure placed residents on the TCU Nursing Unit at risk for serious injury from a burn and resulted in an Immediate Jeopardy situation. Residents Affected - Few Findings include: Review of the job description of the nursing home administrator indicated that the Nursing Home Administrator manages all business-related activity to achieve the faciltiy's vision and supporting strategies and assures that the company image as an ethical and high quality provider of health services is maintained. Safety and Sanitation included to follow established safety policies and procedures. Ensures potential safety/health hazards are eliminated. Under Administrator Provision of Services Responsiblities it included to complete rounds to assess resident climate and to address complaints or other issues; refers these issues to appropriate department head or other personnel. Under Administrator Human Resources Management Responsibility it included to manage safety according to [corporation] procedures/guidelines; ensures that potential safety/health hazards are eliminated or controlled through regular reviews of work activities materials and facilities. Observation of the TCU Nursing Unit, on March 5, 2025, at 10:45 a.m. with Employee E6, Maintenance Assistant, revealed hot water from the hand sink in the Central Shower Room was 121.2 degrees Fahrenheit and hot water from the shower stall was 121.1 degrees Fahrenheit. Employee E6, Maintenance Assistant, immediately left the TCU Nursing Unit to check the hot water tank in the boiler room. Observation conducted on March 5, 2025 at 10:50 a.m. revealed in room [ROOM NUMBER] on the TCU Nursing Unit, the hot water from the resident hand sink in the bathroom was 123.8 degrees Fahrenheit. Observation of the boiler room on March 5, 2025, at 10:53 a.m. with Employee E6, Maintenance Assistant, revealed the thermostat on the hot water tank that supplies water to the TCU Nursing Unit was set to 135 degrees Fahrenheit and the temperature of the water inside the hot water tank was 160 degrees Fahrenheit. Interview conducted at the time of the observation, with Employee E6, Maintenance Assistant, revealed when Employee E6 first came down to check the hot water tank, that the thermostat was set at 150 degrees Fahrenheit and he turned it down to 135 degrees Fahrenheit. Employee E6, Maintenance Assistant, stated that this hot water tank supplies hot water to all of the resident rooms, shower room, and care areas on the TCU Nursing Unit. Interview on March 5, 2025, at 11:14 a.m. Employee E8, agency nurse aide, revealed that she gave Resident R4 a shower in the TCU Central Shower Room that morning. Continued interview revealed that she did not use a thermometer to check the water temperature prior to giving the resident a shower. Further interview revealed that Employee E8, agency nurse aide, was unable to state what the safe water temperature range should be when bathing a resident. Interview on March 5, 2025, at 11:16 a.m. Employee E9, nurse aide, revealed that she gave Resident (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395374 If continuation sheet Page 7 of 10 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 395374 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/05/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Edenbrook of Yeadon Lansdowne and Lincoln Ave Yeadon, PA 19050 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 0835 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few R5 a shower in the TCU Central Shower Room that morning. Continued interview revealed Employee E9 did not use a thermometer to check the water temperature prior to giving the resident a shower. Further interview revealed Employee E9, nurse aide, was unable to state what the safe water temperature range should be when bathing a resident. Interview on March 5, 2025, at 11:20 a.m. Employee E10, nurse aide, revealed that she gave Resident R6 a shower in the TCU Central Shower Room that morning. Employee E10, nurse aide, proceeded to enter the TCU Central Shower Room and provide a demonstration of how to use the thermometer in the shower stall. Employee E10, nurse aide, stated that she adjusted the water temperature for comfort and that she did not put the hot water on all the way, so she was unaware the hot water was excessively hot. Observation conducted at the time of the interview, revealed the hot water temperature reading from the shower stall in the TCU Central Shower Room was 122.3 degrees Fahrenheit. Further interview with Employee E10, nurse aide, revealed that she was assigned to work on the TCU Nursing Unit that shift. Employee E10, nurse aide, stated that four residents in her assignment, Residents R7, R8, R6 and R9, were able to independently use the hand sinks in their rooms. Interview on March 5, 2025, at 11:30 a.m. with Employee E11, nurse aide, revealed that she was assigned to work on the TCU Nursing Unit that shift. Continued interview revealed Employee E11 was unable to state what the safe water temperature range should be when bathing a resident. Further interview, Employee E11, nurse aide, stated that three residents in her assignment, Residents R10, R11 and R12, were able to independently use the hand sinks in their rooms. Based on the deficiencies identified in this report, the NHA failed to fulfill essential duties and responsibilities of their position, contributing to the Immediate Jeopardy situation. Refer to F689. 28 Pa. Code 201.14(a) Responsibility of licensee 28 Pa Code 201.18(b)(1) Management FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395374 If continuation sheet Page 8 of 10 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 395374 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/05/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Edenbrook of Yeadon Lansdowne and Lincoln Ave Yeadon, PA 19050 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 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm Based on observations, review of facility policies, clinical record reviews and interviews with staff, it was determined that the facility failed to maintain an effective infection control program related to Enhanced Barrier Precautions for three of three residents with sacral wounds observed (Residents R1, R2 and R3). Residents Affected - Some Findings include: Review of facility policy, Enhanced Barrier Precautions dated March 6, 2024, revealed, It is the policy of this facility that Enhanced Barrier Precautions, in addition to Standard and Contact Precautions will be implemented during high-contact resident care activities when caring for residents that have an increased risk for acquiring a multidrug-resistant organisms (MDRO) such as a resident with chronic wounds requiring a dressing, indwelling medical devices or residents with 'infection or colonization with an MDRO'. Enhanced Barrier Precautions (EBP) refer to an infection control intervention designed to reduce transmission of multidrug-resistant organisms that employs targeted gown and glove use during high contact resident care activities. Continued review revealed, High-Contact Resident Care Activities include: dressing; bathing/showering; transferring; providing hygiene; changing linens; changing briefs or assisting with toileting; device care or use: central line, urinary catheter, feeding tube, tracheostomy/ventilator; wound care: any skin opening requiring a dressing. EBP are used in conjunction with standard precautions and expand the use of PPE [Personal Protective Equipment] to donning of gown and gloves during high-contact resident care activities that provide opportunities for transfer of MDROs to staff hands and clothing. Further review revealed, Post clear signage on the door/wall outside resident room. Review of Resident R1's care plan, dated initiated December 9, 2021, revealed that the resident had a stage IV pressure ulcer (most severe stage of a pressure sore, wound extends deep into muscle, tendon or bone) to her sacrum. Continued review revealed another care plan, dated initiated April 9, 2024, for Enhanced Barrier Precautions related to the open wound on the resident's sacrum. Observation on March 5, 2025, at 9:38 a.m. revealed Employee E4, licensed nurse, provide wound care to Resident R1's sacrum, which included removing the old dressing, cleansing the wound and application of a new dressing. Employee E3, unit manager, provided assistance to Employee E4, licensed nurse, while the wound care was being performed. Both employees were observed wearing only gloves while providing care. Review of Resident R2's care plan, dated initiated February 5, 2025, revealed that the resident had a pressure wound. Continued review revealed another care plan, dated initiated March 5, 2025, for Enhanced Barrier Precautions related to the resident's sacral wound. Observation on March 5, 2025, at 10:07 a.m. revealed Employee E5, licensed nurse, provide wound care to Resident R2's sacrum, which included removing the old dressing, cleansing the wound and application of a new dressing. Employee E3, unit manager, provided assistance to Employee E5, licensed nurse, while the wound care was being performed. Both employees were observed wearing only gloves while providing care. Review of Resident R3's care plan, dated initiated April 4, 2024, revealed that the resident had a stage IV pressure ulcer to her sacrum. Continued review revealed another care plan, dated initiated April 9, 2024, for Enhanced Barrier Precautions. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395374 If continuation sheet Page 9 of 10 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 395374 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/05/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Edenbrook of Yeadon Lansdowne and Lincoln Ave Yeadon, PA 19050 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 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Observation on March 5, 2025, at 10:01 a.m. revealed Employee E5, licensed nurse, turned Resident R3 on her side to assess her sacral wound dressing. Employee E3, unit manager, then provided assistance to Employee E5, licensed nurse, to reposition Resident R3 in bed. Both employees were observed wearing only gloves while providing care. Continued observation of the doors and walls for Residents R1, R2 and R3 revealed that there was no signage posted to indicate that the residents required Enhanced Barrier Precautions. Interview on March 5, 2025, at 10:15 a.m. Employee E3, unit manager, confirmed that Enhanced Barrier Precautions were not maintained while care was being provided by nursing staff to Residents R1, R2 and R3. Employee E3, unit manager, also confirmed that there was no signage posted to indicate that the residents required Enhanced Barrier Precautions. 28 Pa Code 211.10(d) Resident care policies 28 Pa Code 211.12(d)(5) Nursing services FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395374 If continuation sheet Page 10 of 10