Inspection·December 14, 2023

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. Based on observations, facility policy review, and staff interviews, it was determined that the facility failed to maintain a safe, clean, and home-like environment for one of 35 residents reviewed (Residents 36) and in two of two dining rooms observed (Heritage Hall dining area and Second Floor dining area). Findings include: Review of facility policy, titled Homelike Environment, with a last review date of March 28, 2023, indicated, in part, 2.The facility staff and management shall maximize, to the extent possible, the characteristics of the facility that reflect a personalized, homelike setting. These characteristics include: a. Clean, sanitary and orderly environment. Observation of Resident 36's room on December 11, 2023, at 10:06 AM, revealed that their overbed table had missing laminate and the plywood surface was visible, there was a brown substance/stain on privacy curtain between their bed and their roommate's bed, and that there was a dark red stain on privacy curtain at door. During an interview with the Nursing Home Administrator (NHA) and Director of Nursing (DON) on December 13, 2023, at 11:30 AM, the aforementioned observations were shared. During a follow-up interview with the NHA and DON on December 14, 2023, at 10:30 AM, the NHA indicated that Resident 36's privacy curtains were cleaned yesterday and that the overbed table was replaced. He indicated that the privacy curtains are cleaned/changed on an as needed basis. He further indicated that he would have expected staff to report concerns such as soiled curtains and overbed tables in disrepair so they could be addressed in a timely manner. Observation of the Heritage Hall dining area on December 11, 2023, at 12:50 PM, revealed 47 residents were eating meals served on trays. Observation of the second floor dining area on December 13, 2023, at 1:29 PM, revealed 16 residents were eating meals served on trays. During an interview with the NHA on 10:35 AM, the surveyor revealed a concern with resident's being served meals on trays in the dining rooms. No further information was provided. 28 Pa. Code 207.2(a) Administration responsibility 28 Pa. Code 201.18(e)(2.1) Management FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395660 If continuation sheet Page 2 of 17 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 395660 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/14/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Claremont Nursing & Rehabilitation Center 1000 Claremont Road Carlisle, PA 17013 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)

F 0585 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. Based on policy review, review of facility documentation, clinical record review, and staff and resident interviews, it was determined that the facility failed to ensure that prompt efforts were made to resolve grievances/concerns for one of 35 residents reviewed (Resident 199). Findings: Review of the facilities policy, titled Resident and Family Grievances, last reviewed and approved on March 28, 2023, revealed the facility will make prompt efforts to resolve grievances.' Review of the facilities policy, titled Resident Lost Items Policy, last reviewed and approved on March 28, 2023, revealed in the event of the loss of basic off-the-shelf clothing, the facility will replace the lost clothing with similar items. Review of Resident 199's clinical record revealed diagnoses that included essential hypertension (high blood pressure) and gastro-esophageal reflux disease (when stomach acid repeatedly flows back into the tube connecting your mouth and stomach). Review of the facility's Resident Council Meeting Minutes held on October 18, 2023, revealed under the Other questions/comments section, Resident 199 reported a missing sweater, with a response underneath that revealed the Nursing Home Administrator (NHA) would look to replace it if it was not found. During an interview with Resident 199 during Group with Resident Council held on December 12, 2023, at 1:00 PM, Resident 199 reported that their missing sweater has not been found or replaced. Resident 199 revealed that they have heard no follow-up from facility staff regarding their missing sweater. During an interview with the NHA on December 13, 2023, at 11:18 AM, NHA revealed they will check with the laundry team regarding Resident 199's missing sweater. Review of electronic correspondence received from the NHA on December 14, 2023, at 11:04 AM, revealed an attachment of a Grievance Form completed on December 12, 2023, in regards to Resident 199's missing sweater. The resolution was documented as follows: Resident 199's sweater was replaced with two grey sweaters on December 14, 2023. They were donated to facility like new clothes. Resident 199 accepted them as replacement for her missing sweaters. During and interview with the NHA on December 14, 2023, at 1:15 PM, NHA revealed they did not feel an unreasonable amount of time has passed since Resident 199's grievance was resolved. 28 Pa Code 201.18(b)(2)(3)Management 28 Pa code 201.29(a) Resident rights FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395660 If continuation sheet Page 3 of 17 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 395660 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/14/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Claremont Nursing & Rehabilitation Center 1000 Claremont Road Carlisle, PA 17013 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)

F 0658 Ensure services provided by the nursing facility meet professional standards of quality. Level of Harm - Minimal harm or potential for actual harm Based on clinical record review, observations, and staff interviews, it was determined that the facility failed to ensure care and services were provided in accordance with professional standards for one of 35 residents reviewed (Resident 87). Residents Affected - Few Findings include: Review of Resident 87's clinical record revealed diagnoses that included Pressure ulcer of left ankle, stage 4 (injury to skin and underlying tissue caused by prolonged pressure on the skin), and morbid obesity (a complex disease that involves having too much body fat and increases the risk of many other diseases and health problems). Review of Resident 87's physician orders revealed an order for, Air Mattress every shift for pressure injury Check function and setting, with a start date of December 1, 2023. Observation in Resident 87's room on December 11, 2023, at 1:26 PM, revealed he was not laying on an air mattress. Observation in Resident 87's room on December 12, 2023, at 10:19 AM, revealed he was not laying on an air mattress. Review of Resident 87's MAR (Medication Administration Record - documentation for medication/treatment administered or monitored), revealed it was signed off that the mattress was in place and functioning from December 1, 2023, evening shift, through December 11, 2023, night shift. During an email correspondence with the Nursing Home Administrator on December 12, 2023, at 1:52 PM, the surveyor inquired about Resident 87's air mattress order. Review of Resident 87's clinical record on December 13, 2023, revealed a nursing note on December 13, 2023, at 9:26 AM, that stated, This nurse approached resident last night to ascertain if resident was willing to get out of bed to have an air mattress placed, resident declined. Further review of Resident 87's clinical record revealed a note that he refused an air mattress on November 27, 2023, and his care plan was updated to indicate he declined an air mattress. During an interview with the Director of Nursing on December 13, 2023, at 11:08 AM, she revealed Resident 87 refuses to have an air mattress placed, and she would expect nursing staff to not sign off that an air mattress was in place and functioning since it was not in place. 28 Pa. Code 211.12(d)(1)(3)(5) Nursing services FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395660 If continuation sheet Page 4 of 17 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 395660 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/14/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Claremont Nursing & Rehabilitation Center 1000 Claremont Road Carlisle, PA 17013 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)

F 0677 Provide care and assistance to perform activities of daily living for any resident who is unable. Level of Harm - Minimal harm or potential for actual harm Based on clinical record review, observation, and resident and staff interviews, it was determined that the facility failed to provide assistance with activities of daily living for dependent residents for one of 35 residents reviewed (Resident 34). Residents Affected - Few Findings include: Review of Resident 34's clinical record revealed diagnoses that included rheumatoid arthritis (when the body's immune system mistakenly attacks its own body's tissues, causing pain, swelling, and deformity) and osteoporosis (a condition when bone strength weakens and is susceptible to fracture). Observation of Resident 34 in her room on December 11, 2023, at 10:34 AM, revealed her hair looked greasy. Interview with Resident 34 on December 11, 2023, at 10:36 AM, revealed staff is not always giving showers on her preferred shower day. Review of Resident 34's Nurse Aide Tasks documentation revealed Resident 34 was scheduled to have a shower every Monday and Thursday during the evening shift. Review of the documentation revealed that Resident 34 received a bed bath instead of a shower on November 16, 23, 27, and 30, 2023; and December 4, 7, and 11, 2023. Review of Resident 34's care plan revealed a focus area of: The resident has an ADL (activities of daily living) self-care performance deficit related to decreased mobility, last revised June 1, 2022, with an intervention for The resident requires assist by 1 staff with showers twice weekly, last revised June 1, 2022. During an interview with the Director of Nursing (DON) on December 14, 2023, at 10:31 AM, the surveyor inquired why Resident 34 received bed baths instead of showers on her scheduled shower days. During a follow-up interview with the DON on December 14, 2023, at 2:19 PM, revealed she had no information to provide as to why Resident 34 did not receive a shower per her preferred shower schedule on the aforementioned dates. 28 Pa code 211.12(d)(1)(5) Nursing services FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395660 If continuation sheet Page 5 of 17 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 395660 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/14/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Claremont Nursing & Rehabilitation Center 1000 Claremont Road Carlisle, PA 17013 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)

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm Based on review of the clinical record and resident and staff interviews, it was determined that the facility failed to ensure care and services are provided in accordance with professional standards of practice that will meet each resident's physical, mental, and psychosocial needs for two of 35 residents reviewed (Residents 86 and 129). Residents Affected - Some Findings include: Review of Resident 86's clinical record revealed diagnoses that included history of pulmonary embolism (a sudden blockage in your pulmonary arteries, the blood vessels that send blood to your lungs) and sequelae of cerebral infarction (neurologic deficits that persist after the initial episode of a stroke). Review of Resident 86's physician orders on December 11, 2023, at 12:30 PM, revealed an order for Pradaxa (anticoagulant) Oral Capsule 150 MG (Dabigatran Etexilate Mesylate) give one capsule by mouth two times a day related to cerebral infarction, unspecified, with an order date of November 8, 2023. Further review of Resident 86's physician orders failed to reveal any orders for monitoring for side effects of anticoagulant medication. Review of Resident 86's care plan failed to reveal Resident 86's use of anticoagulant medication and monitoring for side effects of the anticoagulant medication. During an interview with the Director of Nursing (DON) on December 14, 2023, at 1:11 PM, she indicated she reviewed Resident 86's care plan and updates were made to include use of anticoagulant medication and monitoring for side effects of the anticoagulant medication. She confirmed she would have expected Resident 86's care plan to include use of anticoagulant medication and monitoring for side effects of the anticoagulant medication. Review of Resident 129's clinical record revealed diagnoses that included chronic diastolic congestive heart failure (heart failure that occurs when the heart does not relax properly between beats causing the heart to be unable to pump an adequate amount of blood to the body) and morbid (severe) obesity (disorder involving excessive body fat that increases the risk of health problems). During an interview with Resident 129 on December 11, 2023, at 10:57 AM, Resident 129 indicated that they were waiting to receive an antibiotic for an ear infection and that they have been waiting about 10 days. Resident 129 further indicated that they had asked about 20 people and that they had just told someone again that day around 8:00 AM, but that it was now 11:00 AM and they still had not heard anything. During an interview with Employee 6 (Registered Nurse Unit Manager) on December 11, 2023, at 11:12 AM, Employee 6 indicated that Resident 129 was seen by the doctor on December 5, 2023, and an order was given for antibiotic ear drops, but that there was an insurance issue and it was addressed by the doctor on December 6, 2023. Employee 6 further indicated the medication should have been delivered on December 6, 2023, but that they had been off for a few days so they would need to look into the concern further. Review of Resident 129's clinical record revealed that on December 5, 2023, they were seen by their physician for an acute visit for left ear pain and discharge. The physician's progress noted (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395660 If continuation sheet Page 6 of 17 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 395660 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/14/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Claremont Nursing & Rehabilitation Center 1000 Claremont Road Carlisle, PA 17013 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)

F 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some further indicated that the physician visit was accompanied by a staff member and that Cortisporin ear drops would be ordered. Review of Resident 129's physician orders on December 11, 2023, at 11:15 AM, revealed an order for Cortisporin-TC Otic Suspension 3.3-3-10-0.5 MG/ML (Neomycin-Colistin-HC-Thonzonium) Instill four drops in the left ear three times a day for ear pain for five Days, with an ordered date of December 5, 2023, and discontinuation date of December 6, 2023. Further review of Resident 129's physician orders at that time failed to reveal any other orders for any antibiotic ear drops. Review of Resident 129's medication administration record revealed the following: 1) on December 5, 2023, their 2:00 PM dose was coded 9, indicating Other/See Progress Notes; and their 9:00 PM dose was coded 5, indicating Hold/See Progress Notes; and 2) on December 6, 2023, their 9:00 AM and 2:00 PM doses were both coded as 5, indicating Hold/See Progress Notes. Further review of Resident 129's clinical record progress notes revealed the following documentation: 1) a nurse's note dated December 5, 2023, at 2:56 PM, Orders - Administration Note Note Text: Cortisporin-TC Otic Suspension 3.3-3-10-0.5 MG/ML Instill 4 drop in left ear three times a day for ear pain for 5 Days ordered from pharmacy; 2) a nurse's note dated December 5, 2023, at 9:11 PM, Orders - Administration Note Note Text: Cortisporin-TC Otic Suspension 3.3-3-10-0.5 MG/ML Instill 4 drop in left ear three times a day for ear pain for 5 Days Awaiting delivery from pharmacy; and 3) a nurse's note dated December 6, 2023, at 2:20 PM, insurance issues, order updated by MD A follow-up review of Resident 129's physician orders revealed that an order was obtained on December 11, 2023, at 12:45 PM, for Neomycin-Polymyxin-HC Otic Solution 1 % (Neomycin-Polymyxin-HC (Otic) Instill four drops in left ear three times a day for five days. A follow-up review of Resident 129's medication administration record revealed that Resident 129 received their first dose of antibiotic ear drops on December 11, 2023, at 9:00 PM, a total of six days after the original diagnosis of an acute ear infection and subsequent antibiotic treatment order. During an interview with the Nursing Home Administrator (NHA) and DON on December 13, 2023, at 11:25 AM, the aforementioned concern with delay in getting an antibiotic medication for an acute ear infection for Resident 129 was shared for further follow-up. During a follow-up interview with the NHA and DON on December 14, 2023, at 10:30 AM, the DON indicated that she had no additional information to offer as to the delay in Resident 129 receiving their antibiotic ear drops. The DON further indicated that, after the surveyor spoke with Employee 6 on Monday (December 11, 2023), Employee 6 followed-up and got the order corrected. The DON indicated that she was still investigating to see where the breakdown occurred and confirmed that the review of Resident 129's physician order history showed that there were no orders entered on December 6, 2023. She again confirmed that she would have expected the antibiotic ear drops to have started in a timely (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395660 If continuation sheet Page 7 of 17 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 395660 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/14/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Claremont Nursing & Rehabilitation Center 1000 Claremont Road Carlisle, PA 17013 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)

F 0684 manner. Level of Harm - Minimal harm or potential for actual harm 28 Pa. Code 201.18(b)(1) Management 28 Pa. Code 211.10(a)(c) Resident care policies Residents Affected - Some 28 Pa. Code 211.12(d)(1)(5) Nursing services FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395660 If continuation sheet Page 8 of 17 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 395660 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/14/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Claremont Nursing & Rehabilitation Center 1000 Claremont Road Carlisle, PA 17013 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)

F 0689 Level of Harm - Minimal harm or potential for actual harm Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Based on record review and staff interviews, it was determined that the facility failed to prevent accident and hazards for one of 35 residents reviewed (Resident 139). Residents Affected - Few Findings: Review of Resident 139's clinical record revealed diagnoses that included essential hypertension (high blood pressure) and stage 3 chronic kidney disease (when your kidneys do not work as well as they should to filter waste and extra fluid out of your blood). Review of Resident 139's current comprehensive-centered care plan revealed a focus area that the Resident is at risk for falls, with an initiation date of June 14, 2022, and a revision date of December 5, 2022. Intervention areas included bilateral fall mats, date initiated on June 30, 2022. Observation on December 11, 2023, at 10:56 AM, revealed Resident 139 laying in bed with no fall mats on the floor. Observation on December 13, 2023, at 12:11 PM, revealed Resident 139 laying in bed with no fall mats on the floor. Review of fall incident reports completed by the facility revealed that Resident 139 had falls on the following dates: September 17 and 23, 2023; November 5, 2023; and December 3, 2023. The fall incident reports did not indicate if fall mats were in place during the time of the falls. Review of the fall incident reports revealed Resident 139 fell out of bed on the fall that occurred on September 23, 2023, which resulted with that Resident getting a laceration on the right side of their forehead above their eyebrow. Review of the fall incident report completed on November 5, 2023, revealed that the Resident was found on the floor at the foot of their bed, transferring to their wheelchair. Resident 139 suffered from superficial lacerations on left forehead during the incident. Review of a fall incident report completed on December 3, 2023, revealed Resident 139 was found on the floor sitting next to their wheelchair between the two beds in the room. Resident 139 suffered from a skin tear on their right hand during that incident. Review of electronic correspondence received from the Nursing Home Administrator (NHA) on December 14, 2023, at 1:28 PM, revealed that Resident 139 is to have bilateral fall mats in place when they are in bed. During an interview with the NHA on December 14, 2023, at 1:35 PM, revealed they would have expected Resident 139's bilateral fall mats to have been in place during the observations that occurred on December 11, 2023, and December 13, 2023. 28 Pa. Code 201.18(b)(1)(2)Management 28 Pa. Code 211.12(d)(3)(5)Nursing services FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395660 If continuation sheet Page 9 of 17 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 395660 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/14/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Claremont Nursing & Rehabilitation Center 1000 Claremont Road Carlisle, PA 17013 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)

F 0692 Provide enough food/fluids to maintain a resident's health. Level of Harm - Minimal harm or potential for actual harm Based on observations, clinical record review, staff interview, and facility policy review, it was determined that the facility failed to provide the physician prescribed therapeutic diet for one of five residents reviewed for nutrition (Resident 156). Residents Affected - Few Findings include: Review of facility policy, titled Therapeutic Diets, last revised December 2020, revealed it was the facility's policy that, Therapeutic diets are prescribed by the Attending Physician to support the resident's treatment and plan of care and in accordance with his or her goals and preferences. Review of Resident 156's clinical record on December 11, 2023, at approximately 1:30 PM, revealed diagnoses that included end stage renal disease (kidneys cease to function) and diabetes mellitus type II (decreased ability of the body to utilize insulin for the transport of glucose from the blood stream into the cells for nourishment). Review of Resident 156's physician orders revealed a diet order for double portion entrée with meals, dated April 28, 2023. Review of Resident 156's meal tray ticket labeled for the lunch meal for Wednesday, December 13, 2023, revealed it included instructions of, Double Portion Entrée. During meal service observations on December 13, 2023, at approximately 1:10 PM, it was observed that Resident 156 did not receive a double portion of the entrée with his meal. As of December 14, 2023, at 3:00 PM, the facility had no further information to provided regarding Resident 156 not receiving a double portion entrée with the lunch meal on December 13, 2023. 28 Pa Code 211.12(d)(1)(3)(5) Nursing services FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395660 If continuation sheet Page 10 of 17 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 395660 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/14/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Claremont Nursing & Rehabilitation Center 1000 Claremont Road Carlisle, PA 17013 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)

F 0759 Ensure medication error rates are not 5 percent or greater. Level of Harm - Minimal harm or potential for actual harm Based on observations, clinical record review, and staff interview, it was determined that the facility failed to ensure that it was free from a medication error rate of five percent or greater based on two medication errors out of 38 opportunities. Residents Affected - Few Findings Include: Observation of medication administration on December 12, 2023, at 8:30 AM, revealed Employee 1 (Licensed Practical Nurse) administering Trelegy Ellipta Inhaler 200-62.5-25 inhaler to Resident 42. Review of Resident 42's physician orders revealed an order for Trelegy Ellipta Inhaler 200-62.5-25 (an inhaled medication) inhale one puff orally one time a day for chronic obstructive pulmonary disease (COPD - a type of progressive lung disease characterized by long term respiratory symptoms and airflow limitations) with specific directions to rinse mouth and spit after administration. Employee 1 was not observed to provide Resident 42 with water or to instruct them to rinse and spit after the Trelegy inhaler was administered. Employee 1 administered Resident 42's pills after the inhaler was administered. Observation of medication administration on December 12, 2023, at 8:59 AM, revealed Employee 2 (Licensed Practical Nurse) administering Trelegy Ellipta Inhaler 100-62.5-25 inhaler to Resident 43. Review of Resident 43's physician orders revealed an order for Trelegy Ellipta Inhaler 100-62.5-25 (an inhaled medication) inhale one puff orally one time a day for COPD with specific directions to rinse mouth and spit after administration. Employee 2 was observed to providing Resident 43 with water and instructing them to rinse their mouth, but was not observed instructing them to spit after the Trelegy inhaler was administered. After Resident 43 rinsed their mouth and swallowed, Employee 2 then administered Resident 43's pills. During medication administration observation there were 2 errors and 38 opportunities resulting in a medication error rate of 5.26%. During an interview with the Nursing Home Administrator and Director of Nursing (DON) on December 13, 2023, at 11:30 AM, the aforementioned medication errors were shared. The DON confirmed that she would expect medications to have been administered as per physician orders and that special instructions or directions would be followed. 28 Pa. Code 211.9 (a)(1) Pharmacy Services 28 Pa. Code 211.12 (d)(1)(5) Nursing services FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395660 If continuation sheet Page 11 of 17 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 395660 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/14/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Claremont Nursing & Rehabilitation Center 1000 Claremont Road Carlisle, PA 17013 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)

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Based on observations, facility policy review, manufacturer product label review, and staff interviews, it was determined that the facility failed to discard expired medication in one of three medication rooms observed (second floor medication room); failed to properly store and label drugs in two of four medication carts observed (third floor, west hall medication cart and second floor, west hall medication cart); failed to properly store medications inside a locked medication cart for one of two medication carts observed during a medication pass observation (first floor); and failed to lock a mediation cart when not in direct sight of a staff member. Findings Include: Review of facility policy, titled Administering Medications, revised December 2021, revealed, The expiration/beyond use date on the medication label must be checked prior to administering. When opening a multi-dose container, the date opened shall be recorded on the container. Review of facility policy, titled Administering Medications, with a last review date of March 28, 2023, revealed 16. During administration of medications, the medication cart will be kept closed and locked when out of sight of the medication nurse or aide. It may be kept in the doorway of the resident's room, with open drawers facing inward and all other sides closed. No medications should be kept on top of the cart. The cart must be clearly visible to the personnel administering medications. Review of product packaging for Lantus prefilled syringe, dated February 23, 2016, revealed, Once you take your SoloSTAR out of cool storage, for use or as a spare, you can use it for up to 28 days. During this time, it should be kept at room temperature (15 - 30°C) and must not be stored in the refrigerator. If there is any remaining insulin after 28 days, discard it. Review of product packaging for Humalog insulin, revealed that in-use (opened), room temperature (below 86 degrees Fahrenheit) must be used within 28 days, and that any insulin remaining after 28 days must be discarded. Observation of the second-floor medication room on December 12,2023, at 10:46 AM, revealed one bottle of aspirin (pain medication) 81 mg that had expired in September 2023, and one bottle of Vitamin D 1.25 mg (5000 units) that had expired in October 2023. Observation of the second-floor, west hall medication cart on December 12, 2023, at 10: 51 AM, revealed one Lantus (glargine- long-acting insulin) prefilled syringe that was unopened, being stored in the medication cart, and not labeled with the date that it was removed from refrigeration. Observation of the third-floor, west hall medication cart on December 12, 2023, at 11:15 AM, revealed one bottle of insulin glargine (Lantus-long acting) and one bottle of Humalog insulin that were not labeled with the date that they were opened. Interview with the Nursing Home Administrator (NHA) on December 13, 2023, at 1:30 PM, revealed that he would expect the medications to be stored and labeled in accordance with facility policy and manufacturer recommendations, and that expired medications would be discarded. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395660 If continuation sheet Page 12 of 17 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 395660 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/14/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Claremont Nursing & Rehabilitation Center 1000 Claremont Road Carlisle, PA 17013 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)

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Upon arrival to a first floor medication cart on December 13, 2023, at approximately 8:25 AM, for a medication pass observation, it was noted that Employee 1 had three medication blister packages lying face down on top of the medication cart. At 8:28 AM, Employee 1 said that they needed to go destroy a medication with the Supervisor and walked away from the cart. Employee 1 locked the medication cart, but left the medication blister packages on top of the medication cart while they went to the nurses' station. Employee 1 could not be observed from the cart at the nurses' station and was away for approximately two minutes. At 8:38 AM, Employee 1 indicated that they needed to verify a medication with the Supervisor. Employee 1 left the left the medication blister packages on top of the medication cart and failed to lock the cart prior to walking away from the cart. Employee 1 could not be observed from the cart at the nurses' station. Employee 1 was away for approximately one minute. During an interview with Employee 1 on December 13, 2023, at 8:43 AM, Employee 1 indicated that the blister packages were empty and did not contain any medications. Immediate inspection of the blister packages with Employee 1 revealed that one blister package contained approximately 25 doses (pills) of metoprolol (a medication that can be used to treat blood pressure, chest pain, and heart failure) belonging to Resident 217. Employee 1 then indicated that they should not have left the medication on top of the cart, and also confirmed that they should not have left the cart unlocked when they walked away from the medication cart. During an interview with the NHA and Director of Nursing (DON) on December 13, 2023, at approximately 11:30 AM, the DON confirmed that medications should not be left on top of medication carts when staff are not present and that the medication cart should have been locked when the Employee walked away from the cart. 28 Pa. Code 201.18(b)(1) Management 28 Pa. Code 211.9(a)(1) Pharmacy services FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395660 If continuation sheet Page 13 of 17 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 395660 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/14/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Claremont Nursing & Rehabilitation Center 1000 Claremont Road Carlisle, PA 17013 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)

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on facility policy review, observations, and staff interviews, it was determined that the facility failed to store food and equipment in accordance with professional standards for food service safety in the main kitchen and five of six nourishment areas. Findings include: Review of facility policy, titled Labeling and Dating Food Items, last revised December 2020, revealed, All food items opened or removed from their original packaging will have a 'use by' date. Review of facility policy, titled Use and Storage of Food Brought in by Family or Visitors, last reviewed March 28, 2023, revealed, All food items that are already prepared by the family or visitor brought in must be labeled with content and dated. The facility may refrigerate labeled and dated prepared items in the nourishment refrigerator. The prepared food must be consumed by the resident within 3 days. If not consumed within 3 days, food will be thrown away by the facility staff. Observation of the dry storage area on December 11, 2023, at 9:35 AM, revealed: one package of instant mushroom gravy not dated; one package of croutons with a use by date of September 21, 2023; five containers of ham base with one open all not dated; nine containers of beef base with one open all not dated; three packages of yellow cake mix not dated; 15 packages of instant gelatin mix not dated; three bags of potato chips with a use by date of November 7, 2023; one bag of penne pasta not dated and open to air; two bags of elbow pasta not dated; one open bag of elbow pasta not dated; one open bag of spaghetti not dated; one open bag of corkscrew pasta not dated; one bag of spaghetti not dated and open to air; one open bag of rice not dated; and one opened bag of marshmallows not dated with an open date. Interview with Employee 4 (Dietary Manager) on December 11, 2023, at 9:46 AM, revealed foods should be labeled and dated per facility policy, food packages should be labeled with an open date once opened, and beef and ham base should be refrigerated after opening. Observation of the Walk-In Freezer on December 11, 2023, at 9:48 AM, revealed 17 lemon meringue pies not dated, and two of the pies had a sticky, red substance spilled on them; one apple pie not dated; one bag of meatballs not dated, and they appeared freezer burned; and one bag of matzo balls not dated. Observation of the Walk-In Refrigerator 1 on December 11, 2023, at 9:51 AM, revealed one container of opened milk without an open date; and one container of puree pears with a use by date of November 15, 2023. Interview with Employee 4 on December 11, 2023, at 9:52 AM, revealed milk should be labeled with an open date once opened. Observation of the Walk-In Refrigerator 2 on December 11, 2023, at 9:54 AM, revealed one opened container of ketchup without an open date; and two oatmeal cookies not dated. Observation of the Walk-In Refrigerator 3 on December 11, 2023, at 9:55 AM, revealed one container of mushroom gravy with a use by date of December 7, 2023; one bin of red onions not dated; and one (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395660 If continuation sheet Page 14 of 17 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 395660 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/14/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Claremont Nursing & Rehabilitation Center 1000 Claremont Road Carlisle, PA 17013 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)

F 0812 bin of white onions not dated. Level of Harm - Minimal harm or potential for actual harm Observation of the three-compartment sink on December 11, 2023, at 9:59 AM, Employee 4 tested the sanitizer water concentration. The concentration color guide revealed the concentration of the water was between 50 and 100 ppm (parts per million-unit of measure). Residents Affected - Some Interview with Employee 4 on December 11, 2023, at 10:00 AM, revealed the appropriate concentration for sanitizer water is 200 ppm. He further revealed the sink was filled earlier and has possibly been diluted, and he will empty and refill the sink to an ensure it is at the appropriate concentration prior to sanitizing the pans in the water. Observation in the main kitchen on December 11, 2023, at 10:00 AM, revealed: one bin of flour not dated with a scoop inside; one bin of oatmeal not dated; one bin of breadcrumbs not dated; and the ice machine was dirty with a brown substance around the top of the bin. Follow-up observation of the ice machine on December 13, 2023, at 11:47 AM, revealed the ice machine was still dirty with a brown substance around the top of the bin. Observation of the C Wing pantry area December 11, 2023, at 10:11 AM, revealed a bin of snacks not dated, and the individual snacks did not contain use by dates; and a drawer including relish packets, saltine crackers, and individual syrup packets all not dated. Observation of the C Wing pantry area refrigerator and freezer temperature logs on December 11, 2023, at 10:13 AM, revealed temperatures were not recorded for the refrigerator or freezer on August 5, 6, 10 - 13, 19, 20, 26, and 27, 2023; September 9, 10, 16, 17, 23, 24, and 30, 2023; October 1, 7, 8, 28, and 29, 2023; November 1, 18, 19, and 22 - 25, 2023; and December 2, 4, and 10, 2023. Observation of the first Floor pantry area refrigerator December 11, 2023, at 1:49 PM, revealed a container of red fruit juice not labeled or dated; one container of Chinese food not labeled with a resident's name or date; one container of prune juice open not labeled with an open date; one pizza box not labeled with a resident's name or date; two bananas that were black; one bag of Popeye's fast food dated December 3, 2023; one container of orange juice not dated; and one bag of grapes not labeled with a resident's name or date. Observation of the first Floor pantry area freezer December 11, 2023, at 1:52 PM, revealed one frozen dessert not labeled with a resident's name or date; and one to-go box of food not labeled with a resident's name or date. Observation of the first Floor pantry area refrigerator and freezer temperature logs on December 11, 2023, at 1:55 PM, revealed temperatures were not recorded for the refrigerator or freezer on November 4, 12, 13, 18, 19, and 25 - 27, 2023; and December 1, 2, 5, 6, 7, and 9, 2023. Observation of the second Floor pantry area December 11, 2023, at 1:59 PM, 22 packs of cookies not dated; eight packs of cheese snacks not dated; and one container of thickened cranberry juice with a use by date of October 14, 2023. Observation of the second Floor pantry area refrigerator December 11, 2023, at 2:01 PM, revealed one container of thickened lemon water with a use by date of November 16, 2023; and one container of opened milk without an open date. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395660 If continuation sheet Page 15 of 17 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 395660 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/14/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Claremont Nursing & Rehabilitation Center 1000 Claremont Road Carlisle, PA 17013 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)

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Observation of the second Floor pantry area freezer December 11, 2023, at 2:03 PM, revealed one bottle of Gatorade not labeled with a resident's name or date; and one container of ice cream from an outside source not labeled with a resident's name or date. Observation of the second Floor pantry area refrigerator and freezer temperature logs on December 11, 2023, at 2:05 PM, revealed temperatures were not recorded for the refrigerator or freezer on September 2, 6, 7, 8, 10 - 15, 17 - 21, and 23 - 25, 2023; October 8, 14, 15, and 22, 2023; and November 2 and 24, 2023. Observation of the Rehab Floor pantry area December 12, 2023, at 9:50 AM, revealed one drawer of snacks and the individual snacks were not labeled with a use by date; a drawer with 19 packs of hot chocolate not dated; five packets of thickened tea with a use by date of January 17, 2022; two packets of thickened coffee with a use by date of November 2, 2020; and one packet of thickened tea with a use by date of August 13, 2021. Further observation of the Rehab Floor pantry area December 12, 2023, at 10:00 AM, failed to reveal any temperature logs for the refrigerator and freezer. Interview with Employee 5 (Registered Nurse) on December 12, 2023, at 10:04 AM, revealed it is the facility's process for staff to record temperatures of the refrigerator and freezer daily. Employee 5 was unable to locate a December 2023 temperature log, and one was printed and started upon surveyor inquiry. Observation of the third Floor pantry area December 12, 2023, at 10:09 AM, revealed three packs of peanut butter crackers not dated; three packs of hot chocolate not dated; seven packages of cheese snacks not dated; and a drawer of 19 packages of chips not individually labeled with a use by dates. Observation of the third Floor pantry area refrigerator December 12, 2023, at 10:13 AM, revealed nine individual cartons of milk with a use by date of December 11, 2023; five individual cartons of milk with a use by date of December 5, 2023; two individual cartons of milk with a use by date of December 9, 2023; and one individual carton of milk with a use by date of November 25, 2023, that was open. Observation of the third Floor pantry area refrigerator and freezer temperature logs on December 12, 2023, at 10:16 AM, revealed temperatures were not recorded for the refrigerator or freezer on October 17 - 19, 22, 28, and 29, 2023; November 5, 19, 20, 23, 26, and 28, 2023; and December 2, 4, 6, and 9, 2023. Interview with the Nursing Home Administrator on December 13, 2023, at 11:04 AM, revealed it was the facility's expectation that expired items are discarded, food items are labeled and dated per facility policy, and food items and kitchen equipment are stored, cleaned, and utilized in accordance with professional standards. 28 Pa. Code 211.6(f) Dietary services FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395660 If continuation sheet Page 16 of 17 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 395660 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/14/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Claremont Nursing & Rehabilitation Center 1000 Claremont Road Carlisle, PA 17013 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)

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm Based on review of facility policy, observations, and staff interviews, it was determined that the facility failed to maintain an effective infection control program related to storage of staff personal items in a medication cart in one of three carts observed and the preparation and administration of medications to one of four Residents observed (Resident 42). Residents Affected - Few Findings include: Review of facility policy, titled Administering Medications, with a last review date of March 28, 2023, revealed 22. Staff shall follow established facility infection control procedures (e.g., handwashing, antiseptic technique, gloves, isolation precautions, etc.) for the administration of medications, as applicable. During a medication cart observation conducted on the first floor nursing unit on December 12, 2023, at 10:52 AM, with Employee 3, it was observed that Employee 3 had their purse stored in the bottom left hand drawer of the medication cart. The purse was sitting on top of Resident medication inhalers. During an immediate interview with Employee 3, the Employee stated that they were paranoid and liked to keep it with them. Employee 3 then asked Is it not allowed? Employee 3 then removed their purse and locked the medication cart. During a medication pass observation on December 13, 2023, at 08:30 AM, Employee 1 was observed preparing medications to administer to Resident 42. Employee 1 was observed punching a total of seven pills from Resident 42's medication blister packages with their left hand into the fingers of their right hand, and then placing the pills into a medication cup. The medications were then administered to Resident 42. There was no visible indication noted that Employee 1's hands were soiled, but they had been observed touching the drawers of the medication cart, the mouse for the medication administration computer, as well as the house-stock pill bottles, inhaler boxes, and the medication blister packages. During an interview with Employee 1 on December 13, 2023, at 08:43 AM, Employee 1 indicated that they should have popped the medications directly into the cup and not touched them. During an interview with the Nursing Home Administrator and Director of Nursing (DON) on December 13, 2023, at approximately 11:30 AM, the DON confirmed that Employee 3 should not be storing their purse or personal items in the medication cart with Resident medications, and that Employee 1 should not have touched Resident 42's pills with their fingers. 28. Pa Code 211.12(c)(d)(1)(2)(3)(5) Nursing services FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395660 If continuation sheet Page 17 of 17