Health inspection·December 8, 2025

F 0605 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. Based on a review of facility policies and clinical records as well as staff interviews, it was determined that the facility failed to ensure that residents medication regimen was free from unnecessary psychotropic medication (drugs that affect a person's mental state, emotions, and behavior) for one of 31 residents reviewed (Residents 19).The facility's policy regarding antipsychotic medication use, dated May 15, 2025, indicated that residents will not receive as needed doses of psychotropic medications unless that medication is necessary to treat a specific condition that is documented in the clinical record. The need to continue as needed orders for psychotropic medications beyond 14 days requires that the practitioner document the rationale for the extended order. The duration of the as needed order will be indicated in the order. A quarterly Minimum Data Set (MDS) assessment (a federally mandated assessment of the resident's abilities and care needs) for Resident 19 dated August 5, 2025, indicated that the resident was cognitively impaired, required assistance from staff for daily care needs and had diagnosis that included dementia. Physician's orders for Resident 19 dated June 20, 2025, included an order for the resident to receive 10 milligrams (mg) of hydroxyzine (a psychotropic medication used to treat anxiety) every four hours as needed for anxiety. Review of the Medication Administration Record for Resident 19 dated July 2025 and August 2025 revealed that 10 mg of hydroxyzine was administered to the resident on July 9, at 6:38 p.m.; July 12 at 12:08 p.m.; July 30 at 12:48 p.m.; and on August 13 at 1:48 p.m. There was no evidence that a practitioner documented a rationale for extending this as needed medication beyond 14 days or a duration for its use. There was also no documented evidence that non-pharmalogical interventions were attempted prior to administering the as needed doses of hydroxyzine on July 9 at 6:38 p.m.; July 30 at 12:48 p.m.; and on August 13 at 1:48 p.m.Interview with the Director of Nursing on September 24, 2025, at 1:48 p.m. revealed that there was no documented rationale for extending the use of as needed hydroxyzine for Resident 19 beyond 14 days when it was administered on the above dates and times. Interview with the Director of Nursing on September 25, 2025, at 11:34 a.m., respectively, revealed that there was no documented evidence that non-pharmalogical interventions were attempted before administering hydroxyzine to Resident 19 on the above-mentioned dates and times and there should have been.28 Pa. Code 211.12(d)(5) Nursing Services. 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 8 Event ID: 395618 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 395618 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/08/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mulberry Healthcare and Rehabilitation Cent 411 1/2 W Mahoning Street Punxsutawney, PA 15767 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)