Health inspection·September 7, 2023

F 0690 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. Based on observation, facility policy review, clinical record review, and staff interviews, it was determined that the facility failed to ensure residents received appropriate treatment and services to prevent urinary tract infections and to promote dignity related to use of a foley catheter (small, flexible tube that can be inserted through the urethra and into the bladder, allowing urine to drain) for one of one residents reviewed for catheter use (Resident 6). Findings Include: Review of facility policy, titled Foley Catheter Care effective March 1996, revealed, The collection bag should be placed below the resident, but not touching the floor, to allow for proper gravity drainage and prevent backflow of urine up the tubing and into the collection bag. Collection bag covers, also called dignity bags, are available and will be used to promote care for the resident to maintain or enhance their dignity and respect and to prevent the collection bag from dragging on the ground. Review of Resident 6's clinical record revealed diagnoses that included Alzheimer's disease (gradually progressive brain disorder that causes problems with memory, thinking, and behavior) and retention of urine. Observation on September 6, 2023, at 1:18 PM, revealed Resident 6 laying in bed with their foley catheter collection bag hanging on the side of the bed; the edge of the bag was touching the floor. Additionally, it was observed that the collection bag and the urine inside was visible from the hallway. During the observation, a visitor was present in the hallway. A later observation on that date, at 1:39 PM, revealed that the collection bag had been emptied, but was still touching the floor, and was still exposed and visible from the hallway. During an interview with Employee 2 (Nurse Aide) on September 6, 2023, at 1:43 PM, she revealed that Resident 6 used to have a dignity cover for their collection bag, but she was not sure where it went. During an interview with the Director of Nursing on September 7, 2023, at 11:08 AM, she revealed that Resident 6's catheter collection bag was replaced with one that had a built-in dignity cover. 28 Pa Code 211.12(d)(1)(5) Nursing Services Page 1 of 3 395445 395445 09/07/2023 Messiah Lifeways at Messiah Village 100 Mount Allen Drive Mechanicsburg, PA 17055

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on facility policy review, observations, and staff interviews, it was determined that the facility failed to store food and utilize equipment in accordance with professional standards for food service safety in the main kitchen and two of five nourishment areas. Findings include: Review of facility policy, titled 5.2 Food Storage- Sanitation and Infection Control last revised March 2020, revealed, All products are labeled and dated with a receiving date .discard outdated stock. Review of facility policy, titled Storage of Refrigerated and Frozen Foods last revised March 2020, revealed butter has a maximum refrigeration period of up to three months, and open fruit juice cartons have a maximum refrigeration period of up to seven days. Observation of the dry storage area on September 5, 2023, at 9:50 AM, revealed two bags of red skin potatoes not dated. Observation in walk-in freezer unit on September 5, 2023, at 9:57 AM, revealed a pan of frozen prepared food labeled Denver ham, with a use by date of August 26, 2023; a bag of pureed strawberries with a use by date of August 13, 2023; and a bag of hot dog buns not labeled or dated. Interview with Employee 1 (Food Service Director) on September 5, 2023, at 9:58 AM, revealed he would expect items to be labeled and dated per facility policy, and discarded after use by dates. Observation of the walk-in refrigerator on September 5, 2023, at 9:59 AM, revealed one box of tomatoes that were rotten. Observation of the three-compartment sink in the main kitchen area on September 5, 2023, at 10:03 AM, revealed the sanitizing sink was full of water and pans. The surveyor requested Employee 1 to test the concentration (unit of measure) of the sanitizer water with the strips provided; after Employee 1 tested the sanitizer water, observation of the testing strips revealed they had an expiration date of August 1, 2021. Observation during initial tour of the [NAME]/Hampden pantry area refrigerator on September 5, 2023, at 10:10 AM, revealed: eight grape juices without a date; one bag of individual margarine packets without a date; one container of salad labeled use by 9/4; and one container of prune labeled use by 9/3. Further observation of the [NAME]/Hampden pantry area freezer on September 5, 2023, at 10:13 AM, revealed a container of frozen hot dogs labeled use by 8/8. Observation during initial tour of the of the [NAME] pantry area on September 5, 2023, at 10:19 AM, revealed a container of individual whipped butter packets on the counter with a label 9-1-23 to 3-1-24, and a container of brown sugar in the cabinet without a label or date with a spoon stored inside. 395445 Page 2 of 3 395445 09/07/2023 Messiah Lifeways at Messiah Village 100 Mount Allen Drive Mechanicsburg, PA 17055

F 0812 Level of Harm - Minimal harm or potential for actual harm Further observation during initial tour of the of the [NAME] pantry area refrigerator on September 5, 2023, at 10:23 AM, revealed an open container of thickened apple juice with an open date of August 9, 2023; one container of thickened lemon water without an open date; one pan of cinnamon Danish without a label or date; half of an open pan of jelly Danish without a label or date; and one container of lemon pudding without a date. Residents Affected - Some Interview with the Nursing Home Administrator on September 6, 2023, at 2:06 PM, revealed it was the facility's expectation that expired items are discarded, foods items are labeled and dated per facility policy, and food and kitchen equipment are stored and utilized and in accordance with professional standards. 28 Pa. Code 211.6(f) Dietary services 395445 Page 3 of 3