Health inspection·October 31, 2024

F 0583 Keep residents' personal and medical records private and confidential. Level of Harm - Minimal harm or potential for actual harm Based on observation, and staff interview, it was determined that the facility failed to ensure resident's privacy on one of five nursing units (2 [NAME] Nursing Unit). Residents Affected - Few Findings include: Observation of the 2 [NAME] nursing unit on October 31, 2024, revealed the following: At 12:21 PM, Employee 1 returned to the medication cart, poured resident medications, and left again to go down the hallway. Employee 1 left a resident clinical record open and in full view/access to anyone choosing to access said record. At this time, one non-licensed staff member was in the vicinity of the medication cart and several residents were congregated near the medication cart and nurse's station. At 12:22 PM, Employee 1 returned to the medication cart, poured resident medications, and immediately left the vicinity of the medication cart. Employee 1 again left a resident's clinical record open and in full view/access to anyone. At 12:24 PM, Employee 1 returned to the medication cart and poured resident medications. At 12:37 PM, Employee 1 left the medication cart, walked to a resident sitting near the nurse's station, but out of sight of the medication cart. Employee 1 again left a resident's clinical record open and in full view/access to anyone. Employee 1 administered the resident's medication, returned to the medication cart, and poured more medications. At 12:38 PM, Employee 1 left the medication cart. Employee 1 again left a resident's clinical record open and in full view/access to anyone. Non-licensed staff were at the nurse's station at the time of the observation. At 12:44 PM, while Employee 1 was away from the medication cart in a resident's room the Nursing Home Administrator (NHA) approached the nurse's station and medication cart. The NHA observed and acknowledged that at resident's clinical record was open, in full view/access to anyone without any licensed staff in the vicinity. There were several residents and staff were nearby and had access/could potentially access the resident's clinical record. The NHA located Employee 1 in a resident's room and informed them that the resident's clinical was in full view while they were not in the vicinity of the cart. At 12:45 PM, Employee 1 returned to the medication cart. (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 4 Event ID: 395586 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 395586 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/31/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Bradford Hills Nursing & Rehabilitation Center 15900 Route 6 Troy, PA 16947 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)