Inspection·December 4, 2025

F 0554 Allow residents to self-administer drugs if determined clinically appropriate. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, review of select facility policy and clinical records, and staff and resident interviews, it was determined that the facility failed to assess and determine a resident's capability to self-administer medications for one of 13 residents reviewed (Resident 1).Findings include: A review of the facility policy titled Self-Administration of Medications, last reviewed September 2025, revealed that residents have the right to self-administer medications if the interdisciplinary team determines it is clinically appropriate and safe. The policy required:Residents who express the desire to self-administer medications will be assessed to determine ability to self-administer medications.In addition to the general evaluation of a resident's decision-making capacity, the nursing staff will perform a more specific skill assessment, including (but not limited to) the resident'sability to read and understand medication labels.The comprehension of the purpose and proper dosage and administration time for his or her medications.Comprehension of the purpose and proper dosage and administration time for his or her medications.The ability for safe storage of medications.If the team determines that a resident cannot safely self-administer medications, the nursing staff will administer the resident's medicationsFor self-administering residents, the nursing staff will determine who will document medication administration.If the resident is able and willing to take responsibility for documenting their self-administration of medications, the resident will be instructed on how to complete a record indicating the administration of the medication.Self-administered medications must be stored in a safe and secure place, which is not accessible to other residents. A review of Resident 1's clinical record revealed admission on [DATE], with diagnoses including aftercare following abdominal surgery, asthma (a chronic respiratory condition), anxiety, and depression. A review of an admission Minimum Data Set assessment (MDS, a federally mandated standardized assessment conducted at specific intervals to plan resident care) dated October 20, 2025 revealed a BIMS score of 15 (brief interview for mental status, a tool to assess the residents attention, orientation and ability to register and recall new information, a score of 13-15 equates to being cognitively intact). A physician's order dated October 14, 2025, included the following medications:Bupropion HCL extended release 150 mg and 300 mg (antidepressant medications)Acidophilus 1 capsule twice daily (digestive aide)Docusate Sodium 100 mg twice daily (stool softener)Gabapentin 600 mg twice daily (antiseizure medication also used for nerve pain)Topiramate 100 mg twice daily (antiseizure medication also used for migraine prevention)Budesonide inhalation suspension 0.5 mg/2 ml once daily (inhaled corticosteroid for asthma) A physician's order dated October 15, 2025, included:Alfuzosin extended release 10 mg daily (treatment for enlarged prostate)Vitamin B2 100 mg tablets, four daily (nutritional supplement)Folic Acid 400 mcg, two tablets daily (nutritional supplement)Loratadine 10 mg daily (antihistamine used for allergies)Multivitamin one daily (nutritional supplement)Potassium Chloride extended release 20 mEq daily (electrolyte replacement)Senna 8.6 mg, two tablets daily (laxative medication)Sertraline HCL 100 mg, three tablets daily Residents Affected - Few (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 5 Event ID: 395623 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 395623 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Grandview Nursing and Rehabilitation 78 Woodbine Lane Danville, PA 17821 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)