Health inspection·February 16, 2024

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Based on observation, review of drug manufacturer instructions, and staff interviews, it was determined that the facility failed to appropriately date and store medications on one of two nursing units (North medication room) and one of five medication carts (South medication cart). Findings include: Observation on 2/14/2024, at 9:45 a.m. in the North medication room, revealed an opened vial of Tubersol Purified Protein Derivative (PPD-a skin testing agent for tuberculosis) without an open date marked on the vial. A review of the drug manufacturer leaflet indicated a vial of Tubersol which has been entered and in use for 30 days should be discarded. At the time of the observation, the Registered Nurse Supervisor Employee E1 confirmed the PPD vial was opened, undated and not dated to indicate when the medication should be discarded. The Director of Nursing (DON) confirmed on 2/15/2024, at 9:45 a.m. the PPD vial should have been identified with an open date to indicate after 30 days of use, the vial would be discarded. Observation on 2/14/2024, at 3:10 p.m. of the South medication cart, revealed an opened Humalog insulin pen without an open date marked on the pen. A review of the drug manufacturer leaflet indicated a Humalog insulin pen which has been entered and in use for 28 days should be discarded. At the time of the observation, the Licensed Practical Nurse Employee E2 confirmed the insulin pen was opened, undated and not dated to indicate when the medication should be discarded. The DON confirmed on 2/15/2024, at 9:45 a.m. the insulin pen should have been identified with an open date to indicate after 28 days of use, the insulin pen would be discarded. 28 Pa. Code 211.9(a)(1) Pharmacy services 28 Pa. Code 211.12(d)(1)(5) Nursing services Page 1 of 2 395404 395404 02/16/2024 Lecom at Presque Isle, Inc 4114 Schaper Avenue Erie, PA 16508

F 0809 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. Based on review of facility policy and facility documents, and staff and resident interviews, it was determined that the facility failed to ensure that the residents were offered snacks at bedtime daily for four of four nursing units. Findings include: Review of facility policy entitled Resident Nourishments, with a policy review date of 10/30/2023, revealed Nourishments will be provided in addition to regular meals in order to promote high levels of nutritional intake. These items are located in the pantries. At any time, residents can request food from the kitchen or direct care staff. When kitchen staff are not available, the direct care staff can access food if it is not in the pantry. Review of meal times revealed that breakfast is delivered to the first hallway at 7:35 a.m. and dinner delivered to the first hallway at 4:35 p.m., which is fifteen hours between meals. The facility must provide meals within 14 hours unless a nourishing snack is served. During a resident council meeting held on 2/14/2024, at 1:00 p.m. there were seven cognitively intact residents that regularly attend resident council meetings. The residents were asked if the facility offers them snacks in the evening. The residents responded that the kitchen area is stocked with snacks after dinner, you have to get what you want right away or else they are out of snacks. If you try to request a snack, staff are either too busy or you have to wait long periods of time to get what you want. Sometimes they forget and you don't get anything. Residents who can't request a snack do not get one. Observation of the snack cabinets on 2/15/24, at 9:30 a.m. in the dining area revealed snacks were available for resident consumption. It was observed that the pantry doors were unlocked, and snacks were available for residents to take when they wanted. During an interview with the Director of Nursing (DON) and the Nursing Home Administrator (NHA), on 2/15/2024, at 8:45 a.m. they confirmed that the facility does supply and stock snacks to residents in the kitchen area. Residents have to obtain them themselves if they are able to go to the kitchen area, or wait for staff assistance to request a snack from staff members. It was confirmed that snacks are not offered or delivered to all residents by staff members routinely. Residents unable to request or obtain a snack themselves do not get snacks. 28 Pa. Code 201.14(a) Responsibility of licensee 395404 Page 2 of 2