Health inspection·April 9, 2025

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 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, observations and staff interviews it was determined the facility failed to ensure comfortable air temperature levels were provided for 22 of 25 residents (Resident R1, R2, R3, R4, R5, R6, R7, R8, R9, R10, R11, R12, R13, R14, R15, R16, R17, R18, R19, R20, R21, and R22). Findings include: Review of the facility policy Homelike Environment dated 2/3/25, indicated the facility will provide residents with a safe, clean, comfortable, and homelike environment. The policy further stated the facility staff and management maximizes, to the extent possible comfortable and safe temperatures (71°F 81°Fahrenheit). Review of Title 42 Code of Federal Regulations §483.10(i)(2) Housekeeping and maintenance services necessary to maintain a sanitary, orderly, and comfortable interior. During an interview on 4/8/25, at approximately 3:15 p.m. Maintenance Employee E1 stated the boiler (a closed tank where water is heated under pressure, and then used for hot water or heating a building) stopped functioning on 4/5/25. At this time, temperature logs since the boiler malfunction were requested. During an interview on 4/8/25, at 3:40 p.m. Maintenance Employee E1 confirmed the boiler went down Saturday (4/5/25), and was repaired late this morning (4/8/25). During observations of resident area temperatures on 4/8/25, Maintenance Employee E1 received a phone call from Maintenance Employee E2, which he answered on Speakerphone in the presence of the surveyor and the Nursing Home Administrator (NHA). During this phone call, Maintenance Employee E2 stated the temperatures on the log were really low, and that's why they are here. Maintenance Employee E2 asked if he should make new temperature records. During an interview of 4/8/25, at 3:56 p.m. Maintenance Employee E2 was asked when the boiler stopped functioning, and he stated, I believe it was Sunday afternoon (4/6/25). When asked when he started monitoring facility temperatures, Maintenance Employee E2 stated, 6 am Monday morning. During this interview, Maintenance Employee E2 stated that he felt the low temperatures were inaccurate. When asked why if he felt they were inaccurate, he did not act upon them, he was unable to provide an answer. During a confidential interview on 4/8/25, at 4:10 p.m. the resident stated, The boiler is broken. Page 1 of 3 395423 395423 04/09/2025 Champion City Nursing and Rehabilitation Center 6655 Frankstown Avenue Pittsburgh, PA 15206

F 0584 It's cold, but you didn't hear that from me. Level of Harm - Minimal harm or potential for actual harm During an interview on 4/8/25, at 4:11 p.m. Resident R1 stated, It was cold this weekend. Residents Affected - Some During an interview on 4/8/25, at 4:15 p.m. when asked if it was cold in the facility over the weekend, Resident R2 stated, A little bit. During an interview on 4/8/25, at 4:17 p.m. when asked if it was cold in the facility over the weekend, Resident R3 stated, Yes. During an interview on 4/8/25, at 4:24 p.m. when asked if it was cold in the facility over the weekend, Resident R4 stated, Yes, I had to put this on. At this time, Resident R4 displayed a gray hooded sweatshirt. During an interview on 4/8/25, at 4:25 p.m. when asked if it was cold in the facility over the weekend, Resident R5 stated, It was cold. During an interview on 4/8/25, at 4:32 p.m. when asked if it was cold in the facility over the weekend, Resident R6 stated, It's always cold here. Review of facility provided temperature logs on 4/8/25, at 4:45 p.m. revealed no temperatures collected on 4/5/25, and 4/6/25. Once daily temperatures were collected on 4/4/25 (Friday), and 4/8/25 (Monday). During an interview on 4/8/25, at 4:46 p.m. the NHA confirmed he was not made aware of the boiler malfunction until 4/6/25, at 4:36 p.m. Review of facility submitted information dated 4/9/25, indicated that on 4/6/25, at approximately 1:00 p.m. Maintenance Employee E1 identified the boiler was not functional. Maintenance Employee E1 to repair the boiler without success. Maintenance Employee E1 reported to the Maintenance Employee E2 that boiler was down. Maintenance Employee E2 notified the Nursing Home Administrator. The Nursing Home Administrator reported to the regional team and gave direction to have a vendor come in to repair the boiler. Maintenance Employee E2 reported that the Center was at a home like environment with the temperature at the 71-to-81-degree threshold. Review of the facility provided temperature log for 4/7/25, of the 18 resident areas monitored, 16 were below 71°F: Resident R2's room: 67°F Resident R7 and R8's room: 69°F Resident R9's room: 62°F Resident R10's room: 65°F Resident R11 and R12's room: 67°F Resident R13 and R14's room: 60°F 395423 Page 2 of 3 395423 04/09/2025 Champion City Nursing and Rehabilitation Center 6655 Frankstown Avenue Pittsburgh, PA 15206

F 0584 Resident R15 and R16's room: 70°F Level of Harm - Minimal harm or potential for actual harm Resident R17 and R18's room: 57°F Resident R19 and R20's room: 68°F Residents Affected - Some Resident R21 and R22's room: 63°F Vacant resident room: 63°F 3 East Central Bath: 67°F 4 East Central Bath: 69°F 5 East Central Bath: 65°F 5 [NAME] Central Bath: 66°F 6 East Central Bath: 67°F During an interview on 4/8/25, at approximately 5:00 p.m. the Nursing Home Administrator confirmed the facility failed to ensure comfortable air temperature levels were provided for 22 of 25 residents. 28 Pa. Code 201.14(a) Responsibility of licensee 28 Pa. Code 201.18(b)(3) Management 28 Pa. Code 205.61(a) Heating and Electrical Requirements 395423 Page 3 of 3