Health inspection·January 25, 2024

F 0622 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged. Based on review of clinical records and staff interview, it was determined that the facility failed to ensure the presence of necessary documentation to support the specific reasons for discharge versus returning to the facility after an emergency transfer to an acute care facility for one of three residents reviewed (Resident R1). Findings include: Review of Resident R1's clinical record revealed an initial admission date of 12/07/23, with diagnoses that included edema (swelling), dysphagia (difficulty swallowing) and short bowel syndrome (malabsorption disorder caused by lack of functional small intestine). Review of a progress note, dated 12/09/23, and as a late entry, revealed that Resident R1 was displaying behaviors including verbal, throwing things, putting other residents at risk, interfering with resident care and participation in activities. Another nursing note at 1:00 p.m., revealed that Crisis was called and Resident R1 was transferred to an acute care facility on a 302 petition and evaluation. Review of Resident R1's clinical record revealed that there was no physician documentation concerning the basis for the transfer/discharge; the specific resident's needs the facility could not meet; the facility efforts to meet the needs of the resident; and the specific services the receiving facility will provide to meet the needs of the resident which cannot be met at the current facility. During an interview on 1/24/24, at 2:25 p.m. the Nursing Home Administrator confirmed the clinical record did not contain the required physician documentation as to the rationale that Resident R1's clinical symptoms could not be treated at the facility. 28 Pa. Code 201.29(a)(c) Resident rights Page 1 of 2 395593 395593 01/25/2024 Quality Life Services - Grove City 400 Hillcrest Avenue Grove City, PA 16127

F 0623 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. Based on review of clinical records and facility policy and staff interview, it was determined that the facility failed to provide the resident and resident representative of a Notice before Transfer/Discharge in writing for one of three residents reviewed (Resident R1). Findings include: Review of the facility policy entitled 30 Day Discharge Notice AR-29 revealed to ensure proper notice is given and to secure a safe discharge location per state regulations. Review of Resident R1's clinical record revealed an initial admission date of 12/07/23, with diagnoses that included edema (swelling), dysphagia (difficulty swallowing) and short bowel syndrome (malabsorption disorder caused by lack of functional small intestine). Review of Resident R1's clinical record revealed a progress note dated 12/09/23, at 1:00 p.m., which identified that Resident R1 was transferred to the hospital. The clinical record lacked documentation that Resident R1 and their representative was provided with a copy of a Notice of Transfer/Discharge as required. During an interview on 1/24/24, at 2:25 p.m. the Nursing Home Administrator confirmed that there was no evidence that Resident R1 and his/her representative was provided with a copy of the Notice of Transfer/Discharge. 28 Pa. Code 201.14(a) Responsibility of licensee 28 Pa. Code 201.29(a) Resident rights 395593 Page 2 of 2