Health inspection·March 26, 2024

F 0607 Develop and implement policies and procedures to prevent abuse, neglect, and theft. Level of Harm - Minimal harm or potential for actual harm Based on review of select policies and procedures and staff interview, it was determined that the facility failed to implement their abuse policy regarding reporting to the proper state agencies for misappropriation of resident property for five of 17 residents reviewed (Residents CR1, 4, 5, 6 and 7). Residents Affected - Few Findings include: The policy entitled Abuse, last reviewed on July 6, 2023, indicates that the facility will ensure that all alleged violations involving misappropriation of resident property are reported immediately to the state survey and certification agency. Further reporting to law enforcement agencies will be initiated for misappropriation of resident funds and/or property. Interview with Employee 4, assistant director of nursing, on March 26, 2024, at 8:45 AM confirmed that the facility just recently investigated an incident where a large number of narcotics went missing. Review of the facility's investigation indicated that on February 19, 2024, it was noted that 60 tablets of Resident 7's hydrocodone/acetaminophen (a narcotic pain reliever) and 60 tablets of Resident 4's Oxycodone (a narcotic pain reliever) was missing from the medication carts. On February 20, 2024, it was noted that Resident 5 had 120 tablets of Oxycodone missing from the medication cart. Further investigation revealed that Resident CR1 and Resident 6 were both was missing 60 tablets of Oxycodone. In total, the facility determined that 360 tablets of narcotic pain relievers went missing. There was no documented evidence in the facility's investigation to indicate that the Pennsylvania Department of Health was notified of the misappropriation of narcotics for Resident CR1, 4, 5, 6, and 7. The facility also did not notify local law enforcement until February 22, 2024, three days after the initial discovery of missing narcotics. Interview with the Administrator and Employee 4 on March 26, 2024, at 2:00 PM revealed that since the missing narcotics were replaced, the facility felt that they did not have report the incident to the Pennsylvania Department of Health. 28 Pa. Code 201.18(b)(1) Management 28 Pa. Code 201.29(a)(c) Resident rights Page 1 of 3 395616 395616 03/26/2024 Lock Haven Rehabilitation and Senior Living 22 Cree Drive Lock Haven, PA 17745

F 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Based on review of clinical records and resident and staff interview, it was determined that the facility failed to ensure accurate and complete clinical documentation for three of 17 residents reviewed (Residents 2, 8, and 10). Findings include: Interview with Resident 8, on March 26, 2024, at 9:15 AM revealed that she continues to have issues with staff not washing her up in the mornings. Resident 8 indicated that she is incontinent overnight, and that nursing staff will not wash her properly in the morning but only hand her a washcloth and tell her to wash her face, then dress her. Resident 8 indicated that it happened this morning and keeps happening. Review of a grievance filed February 20, 2024, indicated that Resident 8 was not washed and that the nurse only dressed her. A grievance filed on March 19, 2024, again indicated that Resident 8 laid in piss all night and that she was not washed up this morning and that it has been happening all week. Review of Resident 8's clinical record revealed no documented evidence to indicate that AM care (morning care provided to get them ready for the day) is being provided. Morning care can include bathing, dressing, brushing teeth, etc. There was no documented evidence in Resident 8's clinical record to indicate that the facility made any changes to her plan of care to ensure that AM care was being provided. Review of Resident 2's clinical record revealed a nursing intervention for Resident 2 to receive a weekly shower on Tuesdays. Review of Resident 2's shower completions from February 27, 2024, to March 26, 2024, revealed two showers were documented as not applicable and two showers were marked as no. There was no documented evidence to indicate that Resident 2 received a shower in the last month. Review of Resident 10's clinical record revealed a nursing intervention for nursing staff to complete a shower every Tuesday. Review of Resident 10's shower completions from February 29, 2024, to March 26, 2024, revealed no documented evidence to indicate nursing staff completed a shower for her. Interview with the Administrator and Employee 4, assistant director of nursing, on March 26, 2024, at 2:30 PM confirmed the above findings. 28 Pa. Code 211.12(d)(1)(5) Nursing services 395616 Page 2 of 3 395616 03/26/2024 Lock Haven Rehabilitation and Senior Living 22 Cree Drive Lock Haven, PA 17745

F 0925 Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. Level of Harm - Minimal harm or potential for actual harm Based on observation, review of pest control logs, and interviews with residents and staff, it was determined that the facility failed to maintain an effective pest control program on one of three nursing units (Unit Three, Residents 1 and 3). Residents Affected - Some Findings include: Interview with Resident 1 on March 26, 2024, at 9:30 AM revealed that he sees mice come in his room all the time. Resident 1 indicated that the mice enter his room from the hallway. Interview with Employee 1, licensed practical nurse, on March 26, 2024, at 9:40 AM confirmed that staff are seeing mice on Unit Three all the time and mostly at night. Review of the facility's pest control logs revealed that a contracted company is coming in monthly. The pest control being completed monthly is spraying the baseboards in the kitchen and basement and placing exterior bait stations. There was no evidence to indicate that the pest control company was providing interior pest control to eradicate mice. Interview with Employee 2, director of maintenance, on March 26, 2024, at 10:00 AM confirmed that the facility has not spoken to the pest control company regarding the mice problem inside the building. Review of a handwritten log revealed how many traps the facility placed and how many mice were caught. Since February 13, 2024, the facility placed 28 traps, and have caught seven mice, mainly on Unit Three. Employee 2 confirmed that the mice problem continues to be an issue and has not contacted the pest control company for advice. A grievance filed February 19, 2024, revealed that Resident 3's room contained many fruit flies. The grievance indicated that the room was treated for fruit flies. Prior to the surveyors questioning, there was no documented evidence to indicate when the room was treated, who treated the room, what product was used to treat the room, or follow up to ensure the treatment worked. Interview with Employee 3, environmental services director, on March 26, 2024, at 1:35 PM confirmed this information. 28 Pa. Code 201.14(a) Responsibility of licensee 28 Pa. Code 201.18(b)(1)(3) Management 395616 Page 3 of 3