Health inspection·October 12, 2023

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 Based on clinical record review, observation, and resident interview, it was determined that the facility failed to provide assistance with bathing and dressing for one of 24 sampled residents. (Resident 38) Residents Affected - Few Findings include: Clinical record review revealed that Resident 38 had diagnoses that included abnormalities of gait and mobility (an inability to walk or move around without support), muscle weakness, and diabetes. According to the Minimum Data Set assessment, dated July 19, 2023, the resident was alert and oriented and was dependent on staff for bathing and lower body dressing. Review of the care plan revealed that Resident 38 had difficulty caring for himself due to his weakness and interventions included that staff provide assistance with activities of daily living such as washing and dressing. On October 10, 2023, at 11:05 a.m. and 2:21 p.m., and on October 11, 2023, at 10:20 a.m., the resident was observed sitting in his wheelchair with bare feet. His feet had a thick layer of dead skin covering them and blackened toenails. In an interview on October 10, 2023, at 11:05 a.m., the resident stated that he preferred to have his feet cleaned, but that his feet had not been washed in a very long time. 28 Pa. Code 211.12(d)(5) Nursing services. Page 1 of 4 395408 395408 10/12/2023 Laurel Center 125 Holly Road Hamburg, PA 19526

F 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few 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 observation and staff interview, it was determined that the facility failed to ensure that the environment remained free of accident hazards on one of two nursing units. (North Hall) Findings include: Review of the facility policy entitled Storage and Expiration Dating of Medications, last reviewed September 14, 2023, revealed that all medication carts were to be secured when not supervised by authorized personnel. Observation on October 11, 2023 between 8:37 a.m. and 8:42 a.m. revealed an unlocked medication cart in the North Hall. Several cognitively impaired and independently mobile residents resided on that unit. Observation on October 11, 2023 between 1:10 p.m. and 1:30 p.m., revealed two unlocked medication carts in the North Hall between rooms [ROOM NUMBERS]. In an interview on October 11, 2023 at 03:10 p.m the Director of Nursing confirmed that medication carts were to be locked when unattended by staff. 28 Pa. Code 211.12(d)(5) Nursing services. 395408 Page 2 of 4 395408 10/12/2023 Laurel Center 125 Holly Road Hamburg, PA 19526

F 0804 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Level of Harm - Potential for minimal harm Based on review of resident council minutes, observation, and resident and staff interview, it was determined that the facility failed to ensure that the food served was palatable on one of two nursing units (South Hall) and for three of 24 sampled residents. (Residents 14, 63, 81) Residents Affected - Some Findings include: During the resident group interview conducted on October 11, 2023, at 10:30 a.m., six of seven residents complained that food, including pizza, was overcooked and difficult to cut and chew. A review of resident council meeting minutes dated April 11, 2023, and September 13, 2023, revealed that the residents previously complainted that food was overcooked. Observation in the kitchen on October 11, 2023, at 1:00 p.m. revealed staff was having difficulty cutting pizza into portions with a metal spatula. A test tray conducted on October 11, 2023, at 1:14 p.m., revealed the pizza was burnt and difficult to chew. In interviews on October 11, 2023, between 1:14 p.m., and 1:30 p.m., Resident 14, 63, 81 stated that the pizza was burned and unpalatable. 28 Pa. Code 201.29(j) Resident rights. 395408 Page 3 of 4 395408 10/12/2023 Laurel Center 125 Holly Road Hamburg, PA 19526

F 0814 Dispose of garbage and refuse properly. Level of Harm - Potential for minimal harm Based on observation, it was determined that the facility failed to dispose of garbage and refuse properly. Findings include: Residents Affected - Many Observation of the trash compactor area on October 10, 2023, at 11:53 a.m., revealed garbage was not completely contained sanitarily within the trash compactor. Trash had accumulated along the perimeter of the building near the compactor and recycling dumptser. 28 Pa. Code 201.18(b)(3) Management. 395408 Page 4 of 4