Health inspection·March 31, 2025

F 0580 1/9/25 - 2/24/25: 5 mg twice daily. Level of Harm - Minimal harm or potential for actual harm 2/25/25 - 3/3/25: 2.5 mg twice daily. Residents Affected - Some Review of a nurse practitioner progress note dated 1/6/25, created at 9:41 p.m. indicated, Begin Eliquis 5mg BID for 3 days then 2.5mg BID (twice daily). Review of a physician progress note dated 1/8/25, created at 9:41 p.m. indicated, Continue Eliquis 5mg BID. Further review of progress notes failed to reveal a communication to the resident representative of the newly ordered anticoagulant medication. Review of Resident R11's clinical admission record indicated that resident was admitted to the facility on [DATE]. Review of Resident R11's MDS dated [DATE], included diagnoses of atrial fibrillation (disease of the heart characterized by irregular and often faster heartbeat), anemia (too little iron in the body causing fatigue), and cirrhosis (chronic damage leading to scarring and failure) of the liver. Section C: Cognitive Patterns revealed a BIMS score of 10. Review of Resident R11's demographic information in his electronic medical record indicated that Resident R11's spouse as his responsible party. Progress notes on 1/8/25, at 1:50 p.m. and 1/13/25, at 7:02 p.m. both documented Resident R11's spouse as his healthcare decision maker. Review of a progress note dated 1/5/25, at 9:21 p.m. revealed Resident R11 was on contact isolation for c-diff (Clostridium difficile, bacterium that causes diarrhea and inflammation of the colon). Review of a progress note dated 1/9/25, at 2:34 p.m. indicated that Resident R11 stated he does not want to eat because he feels as though he will have an emesis. Review of a progress note dated 1/13/25, at 2:50 p.m. indicated Resident R11 complained of not feeling well. The note additionally stated that Resident R11 was to begin intravenous fluids for hydration. Review of a nurse practitioner progress note dated 1/13/25, created at 7:02 p.m. indicated, Begin Eliquis 5mg BID for 3 days then 2.5mg BID (twice daily). Review of a physician progress note dated 1/8/25, created at 9:41 p.m. indicated, When seeing patient today he kept repeating he didn't feel well. Unable to verbalize what was wrong. Review of a progress note dated 1/12/25, at 10:31 p.m. indicted Resident R11 ate less than 25% of his meal. Review of a therapy progress note dated 1/14/25, at 1:28 p.m. indicated that therapy staff attempted to complete occupational therapy, but that Resident R11 refused stating he has been throwing up all day. Review of a progress note dated 1/14/25, at 8:30 p.m. indicated Resident R11 experienced dark (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 2 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 0580 projectile vomiting. The note indicated the provided was notified at this time. Level of Harm - Minimal harm or potential for actual harm Review of Resident R11's meal consumption record revealed the following: 1/6/25, Breakfast: No documentation of meal consumed Residents Affected - Some 1/6/25, Lunch: No documentation of meal consumed 1/6/25, Dinner: 26-50% of meal consumed 1/7/25, Breakfast: No documentation of meal consumed 1/7/25, Lunch: No documentation of meal consumed 1/7/25, Dinner: 26-50% of meal consumed 1/8/25, Breakfast: No documentation of meal consumed 1/8/25, Lunch: No documentation of meal consumed 1/8/25, Dinner: 76-100% of meal consumed 1/9/25, Breakfast: No documentation of meal consumed 1/9/25, Lunch: No documentation of meal consumed 1/9/25, Dinner: 26-50% of meal consumed 1/10/25, Breakfast: 76-100% of meal consumed 1/10/25, Lunch: 76-100% of meal consumed 1/10/25, Dinner: 0-25% of meal consumed 1/11/25, Breakfast: Resident refused 1/11/25, Lunch: Resident refused 1/11/25, Dinner: 51-75% of meal consumed 1/12/25, Breakfast: No documentation of meal consumed 1/12/25, Lunch: No documentation of meal consumed 1/12/25, Dinner: 51-75% of meal consumed 1/13/25, Breakfast: 76-100% of meal consumed 1/13/25, Lunch: 26-50% of meal consumed (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 3 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 0580 1/13/25, Dinner: 76-100% of meal consumed Level of Harm - Minimal harm or potential for actual harm Review of Resident R11's physician's orders failed to reveal any orders for medications to treat nausea and vomiting. Review of the Medication Administration record confirmed that Resident R11 did not receive any medicinal support to treat nausea and vomiting. Residents Affected - Some Further review of progress notes failed to reveal a communication to the resident representative of the initiation of intravenous fluids, and failed to reveal a communication to the medical provider to notify them of Resident R11's low food consumption, refusal of meals, or to request treatment for Resident R11's nausea and vomiting. Review of Resident R2's clinical admission record indicated that resident was initially admitted to the facility on [DATE], and readmitted on [DATE]. Review of Resident R2's MDS dated [DATE], included diagnoses of coronary artery disease (damage or disease in the heart's major blood vessels), high blood pressure, and a psychotic disorder. Section C: Cognitive Patterns revealed a BIMS score of 6. Review of Resident R2's demographic information in his electronic medical record indicated that Resident R2's daughter as her responsible party and power of attorney. Progress notes on 1/20/25, at 1:52 p.m., 1/27/25, at 1:35 p.m., and 2/17/25, at 5:27 p.m. all documented Resident R2's daughter as her healthcare decision maker. Review of a progress note dated 2/25/25, at 7:56 p.m. indicated, Resident was found sitting on the toilet (at 7PM) and not responding to verbal stimuli; as a result, she fell onto the floor where she was monitored and found to be pale and clammy; [provider] was called and then 911 was called when her vital signs were taken and found to be declining. Further review of progress notes failed to reveal documentation that Resident R2's resident representative was notified of her change in condition and transport to the hospital. Review of the Transfer/Discharge/Bed Hold Form Notice dated 3/25/2/, at 1:43 p.m. indicated under the Key Contacts section for staff to review the resident face sheet for contact information. Under the Bed Hold Notice section indicated that the resident representative was notified of the bed hold information, but no and for the staff to indicate if the bed hold was elected or not. No documentation of a choice was made. The section to document the name of the resident representative was blank, the phone number for the representative was blank, the date was listed as 2/25/25, at 00:00. The name of the staff member completing the notification was documented as RN. During an interview on 3/31/25, at approximately 1:00 p.m. the Nursing Home Administrator and the Director of Nursing confirmed that the facility failed to notify resident representative and/or medical providers of a newly ordered medication or a change in condition for three of seven residents. 28 Pa. Code 201.18 (b)(1) Management. 28 Pa. Code 201.29 (d) Resident rights. 28 Pa. Code 211.10 (c)(d) Resident care policies. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 4 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 0580 28 Pa. Code 211.12 (d)(1)(2)(3)(5) Nursing services. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 5 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 0600 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Level of Harm - Actual harm Residents Affected - Few **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of facility policies and documents, clinical record review, and staff interview, it was determined that the facility failed to protect residents from neglect that resulted in the actual harm of an elopement for one of two residents (Resident R1). This was identified as past non-compliance. Review of the facility policy Abuse and Neglect - Clinical Protocol dated 1/22/25, defined neglect as the failure of the facility, its employees or service providers to provide goods and services to a resident that are necessary to avoid physical harm, pain, mental anguish or emotional distress. Review of the facility policy Resident Elopement dated 1/22/25, indicated cognitively impaired residents at risk for elopement will be appropriately monitored to reduce the potential for injury. Elopement is defined as a resident leaving the physical structure of the facility without knowledge of facility staff. Review of the clinical record revealed Resident R1 was initially admitted to the facility on [DATE], and readmitted on [DATE]. Review of the Minimum Data Set (MDS - periodic assessment of resident care needs) dated 1/31/25, included diagnoses Alzheimer's disease (a type of brain disorder that causes problems with memory, thinking and behavior), bipolar disorder (mental illness that causes unusual shifts in a person's mood, energy, activity levels, and concentration), schizophrenia (a mental disorder characterized by delusions, hallucinations, disorganized speech and behavior), and a seizure disorder. Review of Section C: Cognitive Patterns revealed Resident R1 had severe cognitive impairment. Review of an Elopement Risk Assessment completed on 1/31/25, indicated Resident R1 wandered aimlessly/non-goal directed, that her wandering behavior was likely to affect the safety or well-being of self/others, and concluded that Resident R1 had, Risk of Elopement, proceed with identification of resident as an elopement risk including but not limited to wander guard (electronic monitoring bracelet) placement and facility notification. Proceed to the Care Plan and Initiate. Review of the physician's orders indicated Resident R1 was ordered an electronic monitoring bracelet, initially ordered 2/9/17, continuously reordered, and remains a current order. Review of Resident R1's plan of care for At risk for elopement related to: Wandering initiated 8/20/18, undated 8/21/24, included the goal of [Resident R1] will have no incidence of elopement. Review of a late entry progress note dated for 3/12/25, at 3:05 p.m. (created on 3/13/25, at 2:25 p.m.) indicated that the physician was notified of Resident R1's elopement. Further review of Resident R1's progress notes failed to include any other notes on 3/12/25. Review of facility submitted information dated 3/13/25 by the Director of Nursing (DON), indicated that on 3/12/25, at 5:00 p.m. [Resident R1] was observed by a Nurse Aide (NA) Employee E1 outside near [Resident R3's room]. Resident was redirected and brought inside by Registered Nurse (RN) Employee E2. RN Supervisor (RNS) Employee E4 immediately performed assessment on resident with no injury noted. At 5:19 (p.m.) Resident R1 was seen in parking lot by RN Employee E3 and redirected to inside (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 6 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 0600 of facility. Resident was dressed appropriately. No injuries noted. Level of Harm - Actual harm Review of an undated employee statement written by the DON indicated, On Wednesday March 12, I had left the building at 3;45 for the day and informed the ADON and RN sup (supervisor). At 4:34 p.m. RN Employee E4 called me and stated there was an elopement. Resident R1 was located outside of a window trying to crawl in. Resident was brought back into the building by NA Employee E1. RN Employee E2 was the med cart nurse, and she was taken back to her. I told RNS Employee E4 to set up a 4-point system to mark all exits to be seen and do an immediate census count. I asked if [ADON, Assistant Director of Nursing] was available, the ADON, she stated yes, and would have her call me. Told her she could assist with this and anyone in the building. Asked her to also complete Wanderguard check and function on all elopement residents I called the [NHA, Nursing Home Administrator] to inform him of the elopement, he stated he would contact [Maintenance Director Employee E5] to assist with alarm system check, as the IDT (inter-disciplinary team) text chain did not have a response from him. He stated he would contact him, Maintenance director Employee E5 has responded back in the text chain on phone and system was reset. ADON stated she had assistance from Social Worker Employee E6, Activities Director Employee E7. I had missed a call from RN Employee E3 while on the phone with RNS Employee E4. Reported that Resident R1 was in the parking lot and had returned her safely. I spoke to RNS Employee E4 again and she had all alarms in place, complete census done/complete. Resident R1 was safe, would continue 1/2 hour checks on Resident R1 and doors thru the night until safety check done on alarm system. Residents Affected - Few Review of an undated employee statement written by the Human Resources Director (HRD) Employee E8 indicated, NA Employee E9 began telling me they just brought Resident R1 back into the building 5 minutes ago, Resident R1 was standing outside the window around I asked her if she was brought back to her room. The answer was yes. 4:43 pm, I called and texted DON to confirm. If she was aware of these things happening. I went look for NA Employee E9 was hallway ADON also was texted and called to find her. As I was looking for I was approached about Resident R3 trying to get out through the lobby around 5:01 pm. ADON told NA Employee E9 to call DON. I was walking toward the lobby when I (saw) that Resident R1 was outside and refused to come in, I ran to side 2 for nursing staff. Everyone was passing trays and told me Resident R1 was in her room. First by Employee E10, then by RN Employee E2 the nurse tells me twice she is too busy, and resident is in her room. I again state no she is not she is outside. I was told I was late that was earlier by RN Employee E2. I told all 200 (unit) staff she is in a car being brought back to the facility by RN Employee E3 then someone checked her bed. Resident R1 was brought back safe with RN Employee E3. Review of an undated employee statement written by RN Employee E3 I was driving on Monroeville Blvd, as I was about to enter [facility name/address] I noticed one of the residents, Resident R1, getting into a caravan [license plate number]. I parked my car at the entrance of Wecare Monroeville parking lot got out of my car and began to run towards the van, waving my hands yelling stop, stop, wait as the van was driving away. The caravan stopped and I ran up to the van and motioned my hands to put the window down. The lady that was driving put the window down and I asked her to open the door, and I asked her a second time in a stern voice open the door so I could get the resident out of the van. I tried to remove the resident from the caravan, and she said no, I am going home. I asked the driver where she was going, the driver stated East Liberty [neighborhood approximately 11 miles away]. I told the patient I would take her home to East Liberty and the patient exited the caravan, I walked a patient towards my car, she was very resistant to go with me. As she became aggressive. I tried to sit her on the passenger side of my car and proceeded to call the supervisor, DON and ADON. The supervisor responded, I drove into the parking lot and the supervisor and social worker met me outside in the parking lot to assist with getting the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 7 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 0600 resident back inside the building. Level of Harm - Actual harm Review of an undated employee statement written by RN Employee E2 indicated, On Wednesday March 12th, I was working the 200's hall. During the resident's first elopement, I was told she was outside by one of the CNA's (nurse aides). Assisted her back into the building. Her Wanderguard was again checked for placement and was present. During her second elopement another resident had a choking incident that utilized multiple staff members and again was notified by staff. Residents Affected - Few Review of an undated, handwritten employee statement written by RNS Employee E4 indicated, RN Employee E2 was assigned as the nurse for Resident R1. She eloped twice on the shift. She did not complete a risk management, vitals, 15 min (minute) checks, head to toe assessment, progress note, did not notify family or Md (Doctor of Medicine). RN Employee E2 was the nurse assigned for 16 hours. Review of an additional typed, undated employee statement with RNS Employee E4's name typed on it stated, Resident R1 was observed by NA Employee E1 outside near Resident R3's room, the resident was redirected and brought inside by host of staff. Head to toe assessment completed by writer and no injury noted. MD and family notified. At 5:19 Resident R1 was seen in the parking lot by staff RN and redirected to inside of facility by writer and social worker. Head to toe assessment completed. No new injuries noted. New Wanderguard placed on L (left) ankle. Door checks put in place. Resident R1 was placed on q 15 min (every 15 minute) checks. ADON spoke to maintance and checked door and Accutech (alarm system) for proper functionality, had her check q (every) door that magnets where locked, and had Wanderguard system check at each door. Maintenance provided an all clear. Family, DON, and physician notified. During a follow-up interview on 3/28/25, at 11:58 a.m. RNS Employee E4 confirmed she had been terminated by the facility for lack of actions related to Resident R1's elopement. RNS Employee E4 stated that the evening had been extremely busy, with two residents attempting to leave, one resident having a choking episode, one resident found to be smoking in the facility, and one resident having a seizure while unattended in the dining room. RNS Employee E4 confirmed that she had delegated the 15-minute checks and risk assessment form to the cart nurse, RN Employee E2. During an interview on 3/26/25, at 11:36 a.m. the Director of Nursing confirmed that after Resident R1 was brought back into the facility after her first elopement attempt, RNS Employee E4 was provided direction by the DON to notify the physician and Resident R1's emergency contact, ensure a resident assessment was completed, and have 15-minute checks begun on Resident R1. The DON confirmed that RNS Employee E4 and RN Employee E2 neglected to complete the assessment and the 15-minutes checks, which allowed Resident R1 to exit the facility again, and get into an unknown community members car. The DON and the Nursing Home Administrator confirmed that RN Employee E2 and RNS Employee E4 were terminated from their employment to this negligence of duties. Review of facility provided education documents indicated all facility staff were provided electronic education on abuse and neglect on 3/18/25, with confirmations documented that all staff received and understood the provided education. The facility has demonstrated compliance since 3/18/25. During an interview on 3/31/24, at approximately 1:00 p.m. the Nursing Home Administrator and the Director of Nursing confirmed that RN Employee E2 and RNS Employee E4 were terminated from their employment as of 3/17/25, and confirmed that the facility failed to protect residents from neglect that (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 8 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 0600 resulted in the actual harm of an elopement for one of two residents. Level of Harm - Actual harm 28 Pa. Code 201.14(a) Responsibility of licensee. Residents Affected - Few 28 Pa. Code 201.18(b)(1) Management. 28 Pa Code 211.12(d)(1)(2)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 9 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of facility policy, clinical records and staff interviews, it was determined that the facility failed to notify physicians of increased and decreased Capillary Blood Glucose (CBG) levels for four of eight residents (Residents R7, R18, R19, and R20). Residents Affected - Some Findings: Review of the facility policy, Diabetes - Clinical Protocol dated 1/22/25, indicated, The physician will order desired parameters for monitoring and reporting information related to blood sugar management. The staff will incorporate such parameters into the Medication Administration Record (MAR) and care plan. Review of the clinical record revealed Resident R7 was admitted to the facility on [DATE]. Review of the Minimum Data Set (MDS, periodic assessment of resident care needs) dated 3/7/25, included diagnoses of coronary artery disease (damage or disease in the heart's major blood vessels) and diabetes (a metabolic disorder in which the body has high sugar levels for prolonged periods of time) Review of Resident R7's care plan initiated 7/16/24, for diabetes indicated to monitor for hyperglycemia (elevated blood sugar). Review of a physician order dated 6/26/24, indicated Hypoglycemia Protocol Observe Sign/Symptoms of hypoglycemia as needed if blood glucose is less than 70 mg/dl or ordered low parameter follow Hypoglycemia protocol. NOTIFY md > 400 BLOOD SUGAR. ADDITION OF PROGRESS NOTE Review of Resident R7's blood sugar record revealed the following elevated blood sugar levels without documentation that the provider was notified: 3/24/25, at 7:44 p.m. - 582.0 mg/dL 3/24/25, at 12:47 p.m. - 500.0 mg/dL 3/16/25, at 10:24 a.m. - 487.0 mg/dL 3/10/25, at 8:43 p.m. - 600.0 mg/dL 3/09/25, at 11:56 p.m. - 478.0 mg/dL 2/17/25, at 11:41 a.m. - 508.0 mg/dL 1/21/25, at 1:22 p.m. - 64.0 mg/dL 1/13/25, at 7:40 p.m. - 506.0 mg/dL 1/04/25, at 8:25 a.m. - 53.0 mg/dL (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 10 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 Review of the clinical record revealed Resident R18 was initially admitted to the facility on [DATE], and readmitted on [DATE]. Review of the Minimum Data Set (MDS, periodic assessment of resident care needs) dated 1/16/25, included diagnoses of multiple sclerosis (a disease that affects central nervous system) and diabetes (a metabolic disorder in which the body has high sugar levels for prolonged periods of time) Review of Resident R18's care plan initiated 4/19/24, for diabetes indicated to monitor for hyperglycemia (elevated blood sugar). Review of a physician order dated 3/13/25, indicated Resident R18 received insulin lispro (fast-acting injectable medication to treat diabetes) before meals, the amount based on the blood sugar level at the time of administration. The order indicated for staff to call the MD (Doctor of Medicine) for blood sugar levels greater that 341 mg/dl (milligrams per deciliter). Review of Resident R18's blood sugar record revealed the following elevated blood sugar levels without documentation that the provider was notified: 3/22/25, at 8:26 p.m. - 378.0 mg/dL 3/21/25, at 11:37 a.m. - 348.0 mg/dL 3/21/25, at 8:00 a.m. - 360.0 mg/dL 3/21/25, at 6:04 a.m. - 360.0 mg/dL 3/19/25, at 11:40 a.m. - 357.0 mg/dL 3/15/25, at 7:25 p.m. - 364.0 mg/dL 3/13/25, at 11:51 a.m. - 359.0 mg/dL 3/11/25, at 1:22 p.m. - 405.0 mg/dL 3/11/25, at 9:29 a.m. - 372.0 mg/dL 3/11/25, at 5:49 a.m. - 372.0 mg/dL 3/10/25, at 7:59 p.m. - 357.0 mg/dL 2/06/25, at 8:24 a.m. - 351.0 mg/dL 2/06/25, at 6:04 a.m. - 351.0 mg/dL Review of the clinical record revealed Resident R19 was admitted to the facility on [DATE]. Review of the MDS dated [DATE], included diagnoses of chronic obstructive pulmonary disease (COPD, a group of progressive lung disorders characterized by increasing breathlessness) and diabetes. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 11 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 Review of Resident R19's care plan initiated 3/4/24, for diabetes indicated to monitor for hyperglycemia. Level of Harm - Minimal harm or potential for actual harm Review of a physician order dated 11/8/24, indicated Resident R19 received Novolog insulin (rapid-acting injectable medication to treat diabetes) before meals and at bedtime, the amount based on the blood sugar level at the time of administration (in addition to 6 units before meals) The order indicated for staff to call the MD (Doctor of Medicine) for blood sugar levels greater that 400 mg/dl. Residents Affected - Some Review of Resident R19's blood sugar record revealed the following elevated blood sugar levels without documentation that the provider was notified: 2/23/25, at 4:41 p.m. - 402.0 mg/dL 2/09/25, at 11:12 a.m. - 415.0 mg/dL 1/31/25, at 11:06 a.m. - 427.0 mg/dL Review of Resident R20's clinical admission record indicated that resident was initially admitted to the facility on [DATE], and readmitted on [DATE]. Review of Resident R20's MDS dated [DATE], included diagnoses of paraplegia (paralysis of the legs and lower body, typically caused by spinal injury or disease) and diabetes. Review of Resident R20's care plan initiated 1/29/24, for diabetes indicated to monitor for hypoglycemia (decreased blood sugar). Review of Resident R20's blood sugar record revealed the following elevated blood sugar levels without documentation that the provider was notified: 3/24/25, at 9:43 p.m. - 38.0 mg/dL Review of progress notes failed to reveal a reassessment of Resident R20's blood sugar level, or treatment for the low blood sugar. During an interview on 3/31/25, at approximately 1:00 p.m. the Nursing Home Administrator and the Director of Nursing confirmed the facility failed to notify physicians of increased and decreased Capillary Blood Glucose levels for four of eight residents. 28 Pa. Code 201.18 (b)(1) Management 28 Pa. Code 201.29(d) Resident rights 28 Pa. Code 211.10 (c)(d) Resident care policies 28 Pa. Code 211.12 (d)(1)(2)(3)(5) Nursing services FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 12 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 0686 Provide appropriate pressure ulcer care and prevent new ulcers from developing. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of facility policy, clinical records, observation, and interviews with staff, it was determined that the facility failed to make certain residents were provided necessary treatment and services, consistent with professional standards of practice, for a pressure ulcer (PU/PIs- injuries to skin and underlying tissue resulting from prolonged pressure on the skin) for two of five residents (Resident R4 and R5). Residents Affected - Some Findings include: Review of the facility policy Pressure Ulcer/Skin Breakdown - Clinical Protocol last reviewed 1/22/25, indicated the physician will order pertinent wound treatments. Review of the clinical record revealed that Resident R4 was initially admitted to the facility 6/2/22, and readmitted on [DATE]. Review of Resident R4's Minimum Data Set (MDS, periodic assessment of resident care needs) dated 3/4/25, included diagnoses of heart failure (a progressive heart disease that affects pumping action of the heart muscles), arthritis (inflammation of one or more joints, causing pain and stiffness), and cancer. Section G: Functional Abilities indicated that Resident R4 required assistance to roll left and right in bed. Review of Resident R4's care plan failed to include a plan of care for risk or actual skin impairment. Review of a physician order dated 3/4/25, indicated, Licensed Nurse to perform head to toe skin check w/ (with) shower. Review of a Shower/Skin Observation dated 3/21/25, indicated a new skin impairment observed. Review of Resident R4's progress notes from 3/21/25, through 3/23/25, failed to include information related to Resident R4's new skin impairment. Review of the wound care nurse practitioner note dated 3/24/25, at 10:29 a.m. indicated Resident R4 had a new Stage 2 Pressure Injury on the right buttock and with measurements if 1.9 cm (centimeters) length x 2cm width x 0.1 cm depth. Within the note, the nurse practitioner ordered: -Cleanse wound with warm soap and water - and apply calmoseptine (wound care ointment) TID (three times daily) and as needed. -Protein supplements to promote wound healing Review of Resident R4's physician's orders on 3/27/25, failed to include any orders for the care of the new pressure injury on Resident R4's right buttock, and failed to include an order for a protein supplement for wound healing. Review of Resident R4's Treatment Administration Record (TAR) on 3/27/25, failed to include documentation that Resident R4 had received treatment for his new pressure injury. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 13 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 0686 Level of Harm - Minimal harm or potential for actual harm During an interview on 3/28/25, at approximately 9:00 a.m. the Assistant Director of Nursing confirmed a new wound was observed on 3/21/25, no interim treatment orders were put in place until Resident R4 was seen by the wound care provider, and that when new orders were placed by the wound care provider, they were not entered into the electronic medical record. Residents Affected - Some Review of the clinical record revealed that Resident R5 was admitted to the facility on [DATE]. Review of Resident R5's MDS dated [DATE], included diagnoses of diabetes (a metabolic disorder in which the body has high sugar levels for prolonged periods of time), osteomyelitis (inflammation of bone or bone marrow, usually due to infection) of the sacrococcygeal (tailbone) area, and the presence of pressure ulcers. Section G: Functional Abilities indicated that Resident R5 required substantial/maximal assistance to roll left and right in bed. Review of Resident R5's care plan initiated on 11/6/24, for pressure ulcers indicated for staff to administer medications and treatments as ordered. Monitor/document for side effects and effectiveness. Review of a physician order dated 10/19/24, indicated, Licensed Nurse to perform head to toe skin check w/ (with) shower. Review of a Shower/Skin Observation dated 3/19/25, and 3/24/25, indicated no new skin impairments observed. Review of Resident R5's progress notes from 3/17/25, through 3/23/25, failed to include information related to a new skin impairment. Review of the wound care nurse practitioner note dated 3/24/25, at 12:40 p.m. indicated Resident R5 had a new Stage 2 Pressure Injury of the right lower leg. Within the note, the nurse practitioner ordered: -Cleanse with 0.025% Acetic Acid (antimicrobial acid solution) - apply medical grade honey product, ABD pad (highly absorbent dressing that provides padding and protection for large wounds), and Kerlix (absorbent rolled bandage) daily. -Protein supplements to promote wound healing. Review of Resident R5's physician's orders on 3/28/25, failed to include any orders for the care of the new pressure injury on Resident R5's right lower leg, and failed to include an order for a protein supplement for wound healing. Review of Resident R5's Treatment Administration Record (TAR) on 3/28/25, failed to include documentation that Resident R5 had received treatment for his new pressure injury. During an interview on 3/28/25, at approximately 3:45 p.m. the Nursing Home Administrator and the Director of Nursing confirmed that the facility failed to make certain residents were provided necessary treatment and services, consistent with professional standards of practice, for a pressure ulcer for two of five residents. 28 Pa. Code: 201.29(a) Resident Rights. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 14 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 0686 28 Pa. Code 211.12(d)(1)(3)(5) Nursing services. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 15 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 - Immediate jeopardy to resident health or safety Residents Affected - Few Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on facility policy review, clinical and facility record review, facility submitted documents, and staff interviews, it was determined that the facility failed to provide adequate supervision to prevent elopement for one of two residents (Resident R1). This failure created an immediate jeopardy situation for 19 of 91 residents. This was identified as past non-compliance. Review of the facility policy Resident Elopement dated 1/22/25, indicated cognitively impaired residents at risk for elopement will be appropriately monitored to reduce the potential for injury. Elopement is defined as a resident leaving the physical structure of the facility without knowledge of facility staff. Review of the clinical record revealed Resident R1 was initially admitted to the facility on [DATE], and readmitted on [DATE]. Review of the Minimum Data Set (MDS - periodic assessment of resident care needs) dated 1/31/25, included diagnoses Alzheimer's disease (a type of brain disorder that causes problems with memory, thinking and behavior), bipolar disorder (mental illness that causes unusual shifts in a person's mood, energy, activity levels, and concentration), schizophrenia (a mental disorder characterized by delusions, hallucinations, disorganized speech and behavior), and a seizure disorder. Review of Section C: Cognitive Patterns revealed Resident R1 had severe cognitive impairment. Review of an Elopement Risk Assessment completed on 1/31/25, indicated Resident R1 wandered aimlessly/non-goal directed, that her wandering behavior was likely to affect the safety or well-being of self/others, and concluded that Resident R1 had, Risk of Elopement, proceed with identification of resident as an elopement risk including but not limited to wander guard (electronic monitoring bracelet) placement and facility notification. Proceed to the Care Plan and Initiate. Review of the physician's orders indicated Resident R1 was ordered an electronic monitoring bracelet, initially ordered 2/9/17, continuously reordered, and remains a current order. Review of Resident R1's plan of care for At risk for elopement related to: Wandering initiated 8/20/18, undated 8/21/24, included the goal of [Resident R1] will have no incidence of elopement. Review of a late entry progress note dated for 3/12/25, at 3:05 p.m. (created on 3/13/25, at 2:25 p.m.) indicated that the physician was notified of Resident R1's elopement. Further review of Resident R1's progress notes failed to include any other notes on 3/12/25. Review of facility submitted information dated 3/13/25 by the Director of Nursing (DON), indicated that on 3/12/25, at 5:00 p.m. [Resident R1] was observed by a Nurse Aide (NA) Employee E1 outside near [Resident R3's room]. Resident was redirected and brought inside by Registered Nurse (RN) Employee E2. RN Supervisor (RNS) Employee E4 immediately performed assessment on resident with no injury noted. At 5:19 (p.m.) Resident R1 was seen in parking lot by RN Employee E3 and redirected to inside of facility. Resident was dressed appropriately. No injuries noted. Review of an undated employee statement written by the DON indicated, On Wednesday March 12, I had (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 16 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 - Immediate jeopardy to resident health or safety Residents Affected - Few left the building at 3:45 for the day and informed the ADON and RN sup (supervisor). At 4:34 p.m. RN Employee E4 called me and stated there was an elopement. Resident R1 was located outside of a window trying to crawl in. Resident was brought back into the building by NA Employee E1. RN Employee E2 was the med cart nurse, and she was taken back to her. I told RNS Employee E4 to set up a 4 point system to mark all exits to be seen and do an immediate census count. I asked if [ADON, Assistant Director of Nursing] was available, the ADON, she stated yes, and would have her call me. Told her she could assist with this and anyone in the building. Asked her to also complete Wanderguard check and function on all elopement residents I called the [NHA, Nursing Home Administrator] to inform him of the elopement, he stated he would contact [Maintenance Director Employee E5] to assist with alarm system check, as the IDT (inter-disciplinary team) text chain did not have a response from him. He stated he would contact him, Maintenance director Employee E5 has responded back in the text chain on phone and system was reset. ADON stated she had assistance from Social Worker Employee E6, Activities Director Employee E7. I had missed a call from RN Employee E3 while on the phone with RNS Employee E4. Reported that Resident R1 was in the parking lot and had returned her safely. I spoke to RNS Employee E4 again and she had all alarms in place, complete census done/complete. Resident R1 was safe, would continue ½ hour checks on Resident R1 and doors thru the night until safety check done on alarm system. Review of an undated employee statement written by the Human Resources Director (HRD) Employee E8 indicated, NA Employee E9 began telling me they just brought Resident R1 back into the building 5 minutes ago, Resident R1 was standing outside the window around I asked her if she was brought back to her room. The answer was yes. 4:43 pm, I called and texted DON to confirm. If she was aware of these things happening. I went look for NA Employee E9 was hallway ADON also was texted and called to find her. As I was looking for I was approached about Resident R3 trying to get out through the lobby around 5:01 pm. ADON told NA Employee E9 to call DON. I was walking toward the lobby when I (saw) that Resident R1 was outside and refused to come in, I ran to side 2 for nursing staff. Everyone was passing trays and told me Resident R1 was in her room. First by Employee E10, then by RN Employee E2 the nurse tells me twice she is too busy, and resident is in her room. I again state no she is not she is outside. I was told I was late that was earlier by RN Employee E2. I told all 200 (unit) staff she is in a car being brought back to the facility by RN Employee E3 then someone checked her bed. Resident R1 was brought back safe with RN Employee E3. Review of an employee statement dated 3/13/25, by Activities Director Employee E7 indicated, On Wed 3/12/25 I was working and heard someone saying we had an elopement. I came to the front and noticed [Resident R2] in the doorway, and the receptionist trying to tell her she needs to get to her room to have dinner. I then took Resident R2 by the hand and she walked back on the unit. A little bit later, I was getting my things together to leave for the day when I heard staff saying Resident R1 was out front. I went to get a wheelchair, they put her in the chair, and I pushed her to her room and got her sitting on her bed and advised her to eat her dinner. She was calm and agreed to eat. I then took the chair back and helped staff make sure all residents were accounted for. Review of an undated employee statement written by RN Employee E3 I was driving on Monroeville Blvd, as I was about to enter [facility name/address] I noticed one of the residents, Resident R1, getting into a caravan [license plate number]. I parked my car at the entrance of Wecare. Monroeville parking lot got out of my car and began to run towards the van, waving my hands yelling stop, stop, wait as the van was driving away. The caravan stopped and I ran up to the van and motioned my hands to put the window down. The lady that was driving put the window down and I asked her to open the door, and I asked her a second time in a stern voice open the door so I could get the resident out of the van. I tried to remove the resident (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 17 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 - Immediate jeopardy to resident health or safety Residents Affected - Few from the caravan, and she said no, I am going home. I asked the driver where she was going, the driver stated East Liberty [neighborhood approximately 11 miles away]. I told the patient I would take her home to East Liberty and the patient exited the caravan, I walked a patient towards my car, she was very resistant to go with me. As she became aggressive. I tried to sit her on the passenger side of my car and proceeded to call the supervisor, DON and ADON. The supervisor responded, I drove into the parking lot and the supervisor and social worker met me outside in the parking lot to assist with getting the resident back inside the building. Review of a community member witness statement indicated, I was driving home on Wednesday 3/12 and turning right onto Monroeville Blvd at the stoplight around 5:15 p.m. I saw a gold minivan parked on Monroeville Blvd with its hazard lights on and an older woman with tied back gray hair wearing a dark pink shirt standing beside the van on the sidewalk. She was standing between the WeCare sign and the speed limit sign. Another car was parked crooked in the facility driveway, and what appeared to be a staff member was walking towards the older woman. I turned my car around up the street on [NAME] Drive back onto Monroeville Blvd and pulled into the facility driveway in front of the crooked car as the staff member was helping put the woman into her car. I asked her if she needed help and who to get for help. She stated to go to the front door and ask for [RN Employee E3's name]. I drove up to the facility and was able to tell the receptionist that a resident was down the driveway with a staff member. At that time, staff had come to the front and were notified that a resident was down the driveway with a staff member at that current time. They brought out a wheelchair to the lobby, and were able to transfer the resident into the wheelchair and back into the facility safely. No further questions were asked and no nursing staff acknowledgment, except the staff member who was with the resident outside saying thank you. I left the facility. Review of an undated employee statement written by RN Employee E2 indicated, On Wednesday March 12th, I was working the 200's hall. During the resident's first elopement, I was told she was outside by one of the CNA's (nurse aides). Assisted her back into the building. Her Wanderguard was again checked for placement and was present. During her second elopement another resident had a choking incident that utilized multiple staff members and again was notified by staff. Review of an undated, handwritten employee statement written by RNS Employee E4 indicated, RN Employee E2 was assigned as the nurse for Resident R1. She eloped twice on the shift. She did not complete a risk management, vitals, 15 min (minute) checks, head to toe assessment, progress note, did not notify family or Md (Doctor of Medicine). RN Employee E2 was the nurse assigned for 16 hours. Review of a second, typed, undated employee statement written by RNS Employee E4 stated, Resident R1 was observed by NA Employee E1 outside near Resident R3's room, the resident was redirected and brought inside by host of staff. Head to toe assessment completed by writer and no injury noted. MD and family notified. At 5:19 Resident R1 was seen in the parking lot by staff FN and redirected to inside of facility by writer and social worker. Head to toe assessment completed. No new injuries noted. New Wanderguard placed on l (left) ankle. Door checks put in place. Resident R1 was placed on q 15 min (every 15 minute) checks. ADON spoke to maintance and checked door and Accutech (alarm system) for proper functionality, had her check q (every) door that magnets where locked, and had Wanderguard system check at each door. Maintenance provided an all clear. Family, DON, and physician notified. During a follow-up interview on 3/28/25, at 11:58 a.m. RNS Employee E4 confirmed she had been terminated by the facility for lack of actions related to Resident R1's elopement. RNS Employee E4 stated that the evening had been extremely busy, with two residents attempting to leave, one resident having a choking episode, one resident found to be smoking in the facility, and one resident having a (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 18 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 - Immediate jeopardy to resident health or safety seizure while unattended in the dining room. RNS Employee E4 confirmed that she had delegated the 15 minute checks and risk assessment form to the cart nurse, RN Employee E2. The NHA and the DON were made aware that an Immediate Jeopardy situation existed for residents on 3/26/25, at 11:36 a.m. and a corrective action plan was requested. The Immediate Jeopardy template was provided to the facility administration at 11:45 a.m. Residents Affected - Few On 3/26/25, at 4:29 p.m. an acceptable Corrective Action Plan was received which included the following interventions: 1. Immediate action(s) taken for the resident(s) found to have been affected include: -Facility immediately recovered resident and provided safety. RN assessed resident and provided safety. -Physician and Resident Representative was notified of event. -Wander guard device -checked for placement and function. -All door alarms checked for function and lock mechanism to ensure facility is secure. -Resident care plan reviewed and updated to ensure accurate and appropriate interventions in place. -Witness statements were obtained, and immediate headcount checks completed. -On 3/12/25 Supervisor immediately conducted door securement and alarm audit and initiated a 4 point system to monitor doors to ensure security -On 3/12/25 Supervisor posted staff at each door while audit conducted to ensure doors are shut, locked, and alarms are on and functioning -On 3/12/25 DON directed RN supervisor and assigned nurse to ensure Resident receives an assessment, and notify physician and family of incident, as well as ensure resident is monitored to prevent reoccurrence. -On 3/13/25 RN Supervisor immediately performed assessment on the resident for injuries; none noted. -On 3/13/25 Door audits completed to ensure doors are secure every 30 minutes. Door alarm checks are completed to ensure alarms are functioning. -On 3/13/25 New alarms were ordered to ensure that alarm sounds are loud enough to hear. -On 3/13/25, Facility notified the attending physician to report findings and conditions of the resident and the resident's legal representative -On 3/13/24, Documentation of incident in residents record completed (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 19 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 -On 3/13/25, resident's care plan and orders were reviewed and updated to ensure Wanderguard and exit seeking behaviors addressed in care plan and orders as appropriate Level of Harm - Immediate jeopardy to resident health or safety -On 3/13 all residents were assessed for Elopement Risk Residents Affected - Few -On 3/13/25, residents newly identified to have potential for elopement had care plans updated with appropriate interventions. -On 3/13, facility-initiated house audit for exit/entry points to ensure alarm function and doors lock appropriately -On 3/13, facility conducted whole house resident head count to ensure accountability of residents. -On 3/13, house audit conducted on resident wanderguard orders to ensure accuracy. -On 3/13, all Wanderguards placed on residents were assessed for function, care plans updated as needed. -On 3/13, Elopement Books were audited to ensure accuracy and placed at each nurses station and reception area. -On 3/17/25- RN Supervisor was provided a discipline due to not following DON directive to ensure that Resident was assessed and notifications occurred and documented- RN was terminated due to failing to complete these tasks. -On 3/17/25 Nurse assigned to resident on cart also failed to ensure resident was accounted for and skin checks performed following incident. DON provided discipline to this nurse for failure to complete tasks. Termination resulted. 2. Identification of other residents having the potential to be affected was accomplished by: -All residents in house will be assessed for elopement risk by the Director of Nursing or designee by 3/18/25. -All care plans for residents identified with elopement risks will be reviewed and updated with elopement risks will be reviewed and updated with interventions to prevent elopement by the Director of Nursing or designee by 3/18/25. -All residents identified to be elopement risk will have wanderguard placed and added to Elopement Binder per protocol by 3/18/25. -House audit on all doors and exit points will be conducted by Maintenance to ensure that facility is secure and alarms are functional by 3/18/25. -House audit on all wanderguards will be conducted to ensure placement and function by 3/18/25. 3. Actions taken/systems put into place to reduce the risk of future occurrence include: (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 20 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 - Immediate jeopardy to resident health or safety -Facility Director of Nursing or designee will conduct education to all facility staff regarding dementia/behavior in LTC residents, Elopement risk and mitigation, and Elopement Policy and Procedures to include keeping doors secure by 3/21/25. -Education will be completed for all clinical staff on Elopement Risks, Assessments, Care Plans, and Supervision of Residents by the Director of Nursing or designee by 3/21/25. Residents Affected - Few -Elopement Books with identified resident photos will be placed on all nurses' stations in addition to the current one at the receptionist's desk by the Administrator or designee 3/21/25. 4. How the corrective action(s) will be monitored to ensure the practice will not recur: -Audits will be conducted on all doors/exits by Supervisor twice per shift daily for 4 weeks and then weekly thereafter. -Maintenance Director or designee will conduct daily (twice per shift) audit on doors to ensure secure and alarmed. Audit will remain ongoing. -All new admissions will be reviewed for elopement risks by IDT 5 days per week weeks and ongoing. -Elopement assessments will be audited for compliance by IDT 5 days per week and will remain ongoing. -An Ad Hoc Quality Assurance and Process Improvement Meeting will be held by the Administrator or designee. This plan of correction will be monitored at the Quality Assurance and Process Improvement meeting until such time consistent substantial compliance has been met. Review of facility provided information indicated the facility staged an elopement drill on 3/20/24, at 11:40 a.m. to familiarize staff with procedures. During staff interviews on 3/26/25, between 1:00 p.m. and 4:00 p.m. NA Employees E12, E13, E14, E15, E16, E17, and E18 and LPN Employee E19 confirmed they received education on the elopement policy, elopement prevention and actions to take in the instance of elopement. During an observation on 3/27/25, at approximately 10:00 a.m. Resident R1's and Resident R2's pictures and information were present in the elopement book at the entrance/exit of the building. Further review of the elopement book with resident charts revealed all residents identified as elopement risks were included in the elopement book. During staff interviews on 3/27/25, between 9:00 a.m. and 11:00 a.m. LPN Employees E20 and E21, RN Employee E22, NA Employees E23 and E24, Occupational Therapy Employee E25, Dietary Employees E26, E27, and E28, Environmental Services Employees E29, E30, and E31, and Laundry Employee E32 were provided scenarios to test their knowledge on and confirmed they received education on the elopement policy, elopement prevention and actions to take in the instance of elopement. The Immediate Jeopardy was removed on 3/27/25, at 11:00 a.m. when the action plan implementation was verified. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 21 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 The facility had demonstrated compliance as of 3/18/25. Level of Harm - Immediate jeopardy to resident health or safety During an interview on 3/31/25, at approximately 1:00 p.m. the Nursing Home Administrator and the Director of Nursing confirmed that the facility failed to provide adequate supervision to prevent elopement for one of two residents. This failure created an immediate jeopardy situation for 19 of 91 residents. Residents Affected - Few 28 Pa. Code 201.14(a) Responsibility of licensee. 28 Pa. Code 201.18(b)(e)(1) Management. 28 Pa. Code 211.10(c)(d) Resident care policies. 28 Pa Code 211.12(d)(1)(2)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 22 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 0691 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on facility policy review, clinical record review, resident, and staff interviews, it was determined that the facility failed to provide colostomy care and services consistent with professional standards of practice for two of two residents (Resident R5 and R6). Findings include: Review of facility policy Colostomy/Ileostomy Care dated 1/22/25, indicated for staff to review the resident's care plan. Review of Resident R5's clinical admission record indicated that resident was initially admitted to the facility on [DATE], and readmitted on [DATE]. Review of Resident R5's Minimum Data Set (MDS, periodic assessment of care needs) dated 2/3/25, included diagnoses of diabetes, Ogilvie's syndrome (dilation of the colon in the absence of an anatomic lesion that obstructs the flow of intestinal contents), and the presence of pressure ulcers. Section H: Bladder and Bowel indicated the presence of an ostomy. Review of Resident R5's physician order dated 10/22/24, indicated Colostomy Appliance: Change wafer [Coloplast-Sensura Mio Convex Light/red stripe]/[16911] and bag [Coloplast-Sensura Mio click high output/red stripe]/[18640] q (every) week and prn (as needed). Review of plan of care initiated on 8/14/24, for potential to restore function / ileostomy characterized by inability to control bowel movements related to Ogilvie syndrome indicated for staff to change appliance per order. Specifications for the type and size were not included in the care plan. During an interview on 3/28/25, at approximately 11:18 a.m. Registered Nurse Employee E11 confirmed she was unaware of what size appliance and water to use, and that she uses the supplies in Resident R5's room or in the supervisor's office. Observation of Resident R5's ostomy supplies at this time revealed bags that were not in a box, without a type or size visible. Review of Resident R6's clinical admission record indicated that resident was admitted to the facility on [DATE]. Review of Resident R6's MDS dated [DATE], included diagnoses of ulcerative colitis (a chronic, inflammatory bowel disease that causes inflammation in the digestive tract), malnutrition, and history of a stroke. Section H: Bladder and Bowel indicated the presence of an ostomy. Review of Resident R6's physician order dated 1/13/25, indicated Colostomy Appliance: Change wafer [manufacturer]/[product number] and bag [manufacturer]/[product number] q week and prn. Review of Resident R6's plan of care on 3/28/25, failed to include a care plan developed for the presence of an ostomy. During an observation on 3/28/25, at 12:45 p.m. of Resident R6's room revealed a box with Coloplast bag 18640 in her room, and an empty box for Coloplast wafer 16911 on the floor. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 23 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 0691 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some During an interview on 3/28/25, at 1:07 p.m. Central Supply Employee E12 stated that the sizes are present on the shipping receipt from the supplier. Review of an email dated 3/28/25, at 3:59 p.m. indicated Resident R5 utilizes Coloplast wafer 16911 and bag 18640 (which agrees with the order), and Resident R6 Coloplast wafer 10571 and bag 18658 (which does not agree with supplies in Resident R6's room). During an interview on 3/31/25, at approximately 1:00 p.m. the Nursing Home Administrator and the Director of Nursing confirmed the facility failed to provide colostomy care and services consistent with professional standards of practice for two of two residents. 28 Pa. Code: 201.18 (b) (1) (e) (1) Management. 28 Pa. Code: 211.10(c)(d) Resident care policies. 28 Pa. Code: 211.12(d)(1)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 24 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 0725 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. Based on review of facility policy, resident observations, resident and staff interviews, and grievance review, it was determined that the facility failed to have sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of ten of 18 residents (Residents R4, R5, R12, R13, R14, R15, R16, R17, R18, and R19). Findings Include: Review of the facility policy Answering the Call Light dated 1/22/25, indicated staff will ensure timely responses to the resident's requests and needs. During an observation on 3/26/25, at 3:39 p.m. the call light for Residents R19 was alarming. At this time, six nursing staff members were noted to be seated at the nursing station, without responding. When staff observed the surveyor noting the time, Nurse Aide Employee E13 responded to the call light. During an interview on 3/27/25, at 11:10 a.m. Resident R5 when asked if he felt the facility maintained enough staff, Resident R5 responded, No. Resident R5 stated that call light response time can be long, and further stated they don ' t have enough aides and the ones they do have are on break half the time. During an interview on 3/27/25, at 11:26 a.m. Resident R4 when stated that he often has late medication and that call lights can take up to an hour for response. During interviews and observations completed on 3/27/25, between 2:30 p.m. to 4:00 p.m. the following was noted: Resident R12 stated call lights can take up to a half hour. Resident R13 stated that there have been times when his call light was not responded to. Resident R14 stated that call lights can take 30-60 minutes. Resident R15 stated that often half of the time he waits a half hour or longer. Review of a grievance filed on 3/3/25, on behalf of Resident R16 indicated a concern of, There has only been 1 aide to work shifts. It ' s not fair to patients and the aides. Daughter is not being put to bed until 10:30. Today, 3/3/25, fed daughter breakfast and went back at lunch and she had not been moved, changed, or taken care of. She was put to bed at 9:30 p.m. and has not been touched since 6:30 a.m. because of diaper. Moaned all night due to diaper. They aided work hard but they need more help. Review of a grievance filed on 3/3/25, on behalf of Resident R17 indicated a concern of, Resident came to my office to say the aide was busy and told her she had to wait until the next shift to be changed. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 25 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 0725 Review of a grievance filed on 3/3/25, on behalf of Resident R18 indicated a concern of that the aide didn ' t take the time to listen that he was asking to have his shirt changed and left room. Level of Harm - Minimal harm or potential for actual harm Review of Resident Council concerns indicated: Residents Affected - Some -1/22/25: 3-11 call light response and weekend call light response. -2/19/25: 3-11 call light response and weekend call light response. -3/19/25: call light response. During an interview on 3/31/25, at approximately 1:00 p.m. the Nursing Home Administrator and the Director of Nursing confirmed that the facility failed to have sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of ten of 18 residents 28 Pa. Code: 201.14(a) Responsibility of licensee. 28 Pa. Code 201.18(e)(6) Management. 28 Pa. Code: 201.20(a) Staff development. 28 Pa. Code: 211.12(a)(c)(d)(1)(2)(3)(4) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 26 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 0726 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on a review facility policy, clinical records, and staff interviews, it was determined that the facility failed to assure that licensed nurses displayed the appropriate competencies and skills sets to provide nursing services for one of two residents (Resident R11). Findings include: Review of the facility policy, Management of Hypoglycemia (low blood sugar) dated 1/22/25, indicated that Level 3 hypoglycemia is when a resident has altered mental status and/or physical status requiring assistance for the treatment of hypoglycemia. In the actions listed to take include: 1. Call 911 (in accordance with resident ' s advance directives); 2. Administer glucagon (emergency injectable medicine used to treat severe hypoglycemia); 3. Notify the provider immediately ' Review of the Facility Assessment dated 1/1/25, indicated the facility is able to provide care for residents with diabetes (a metabolic disorder in which the body has high sugar levels for prolonged periods of time). Review of the clinical record indicated Resident R11 was originally admitted to the facility on [DATE], and readmitted on [DATE]. Review of the Minimum Data Set (MDS, mandated assessment of a resident's abilities and care needs) for Resident R11 dated 3/5/25, included diagnoses of coronary artery disease (damage or disease in the heart's major blood vessels), chronic kidney disease (gradual loss of kidney function), and diabetes. Review of a physician's order dated 3/1/25, for Glucagon: Inject 1mg (milligram) intramuscularly every 1 hours as needed for hypoglycemia of less than or equal to 70 mg/dl who are unresponsive or cannot swallow. Review of a physician's order dated 3/1/25, for Glucose Gel 40 % (edible dextrose gel) Give 1 applicatorful by mouth every 1 hours as needed for hypoglycemia of less than or equal to 70 mg/dl in patients who are asymptomatic or symptomatic and able to swallow. Review of a physician's order dated 3/8/25, for Glucagon: Inject 1 application intramuscularly every 8 hours for hypoglycemia. Review of a progress note written by Registered Nurse (RN) Employee E33 dated 3/23/25, at 10:45 a.m. indicated, Res became unresponsive. Son here at bedside. CBG (capillary blood glucose) was 59. 1/2 tube of glucose gel given. Only 1/2 tube because re (resident) was not swallowing and sounded slightly gurling (gurgling). Administered 1 glucagon injection. cbg only came up to 65. During interviews on 3/26/25, Licensed Practical Nurse (LPN) Employee E20, LPN Employee E34, RN (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 27 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 0726 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Employee E35, LPN Employee E36 were able to correctly answer questions on the appropriate care to give to residents with hypoglycemia, that are unresponsive. During an interview on 3/26/25, at approximately 3:45 p.m. LPN Employee E37 when asked to describe the actions to take when a resident has hypoglycemia and is unresponsive, LPN Employee E37 stated she would try to get them up (raise their blood sugar) and would give them glucose gel. When asked if glucose gel was appropriate to give to a resident that is unresponsive, LPN Employee E37 corrected herself and stated that she would not give glucose gel. When asked if she would provide any medications to the resident, LPN Employee E37 stated that she would not. During an interview on 3/26/25, at approximately 4:15 p.m. the Director of Nursing provided documentation of a corrective action provided to RN Employee E33 related to Diabetes protocol with low blood sugar. During an interview on 3/31/25, at approximately 1:00 p.m. the Nursing Home Administrator and the Director of Nursing confirmed that the facility failed to assure that licensed nurses displayed the appropriate competencies and skills sets to provide nursing services for one of two residents. 28 Pa. Code: 201.14(1) Responsibility of licensee. 28 Pa. Code: 201.18(a)(3) Management. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 28 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 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 the review of facility policy, observations, clinical records, and staff interviews, it was determined that the facility failed to appropriately document physician notification for three of eight residents (Residents R7, R8, and R9). Findings include: Review of the facility policy, Charting and Documentation dated 1/22/25, indicated All services provided to the resident, progress toward the care plan goals, or any changes in the resident's medical, physical, functional or psychosocial condition, shall be documented in the resident's medical record. The medical record should facility communication between the interdisciplinary team regarding the resident's condition and response to care. Review of a physician order for Resident R7 dated 6/26/24, indicated, Hypoglycemia Protocol Observe Sign/Symptoms of hypoglycemia as needed if blood glucose is less than 70 mg/dl or ordered low parameter follow Hypoglycemia protocol. NOTIFY md (Doctor of Medicine) > 400 BLOOD SUGAR. ADDITION OF PROGRESS NOTE. Review of Resident R7's blood sugar record revealed the following: 1/23/25, at 5:40 p.m. the blood sugar was documented as 438.0 mg/dL. 2/03/25, at 5:23 p.m. the blood sugar was documented as 416.0 mg/dL. 2/05/25, at 1:27 p.m. the blood sugar was documented as 410.0 mg/dL. 2/16/25, at 7:06 p.m. the blood sugar was documented as 479.0 mg/dL. 2/17/25, at 11:42 a.m. the blood sugar was documented as 408.0 mg/dL. 2/21/25, at 5:27 p.m. the blood sugar was documented as 477.0 mg/dL. 2/26/25, at 6:14 a.m. the blood sugar was documented as 61.0 mg/dL. 3/02/25, at 11:44 a.m. the blood sugar was documented as 438.0 mg/dL. 3/05/25, at 11:08 a.m. the blood sugar was documented as 427.0 mg/dL. 3/08/25, at 11:22 a.m. the blood sugar was documented as 499.0 mg/dL. 3/10/25, at 11:45 a.m. the blood sugar was documented as 478.0 mg/dL. 3/10/25, at 1:29 p.m. the blood sugar was documented as 503.0 mg/dL. 3/14/25, at 11:52 a.m. the blood sugar was documented as 420.0 mg/dL. 3/15/25, at 5:18 p.m. the blood sugar was documented as 507.0 mg/dL. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 29 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Review of Resident R7's progress notes indicated late entries for each of the above out-of-range blood sugar levels, created on 3/20/25, by the Director of Nursing (DON), that indicated the physician was notified. Review of the DON's punch report from 1/13/25, through 3/20/25, indicated that the DON was not present in the facility on 1/23/25, 2/16/25, 2/21/25, 3/2/25, 3/5/25, 3/8/25, and 3/15/25. Review of a physician order for Resident R8 dated 3/23/25, indicated, indicated Resident R8 receives Humalog insulin (injectable medication for diabetes), and to notify the physician for blood sugar levels above 341. Review of Resident R8's blood sugar record revealed the following: 3/23/25, at 2:13 p.m. the blood sugar was documented as 581.0 mg/dL. 3/23/25, at 6:14 p.m. the blood sugar was documented as 553.0 mg/dL. 3/23/25, at 9:43 p.m. the blood sugar was documented as 415.0 mg/dL. 3/24/25, at 6:11 p.m. the blood sugar was documented as 449.0 mg/dL. Review of Resident R8's progress notes indicated late entries for each of the above out-of-range blood sugar levels, created on 3/25/25, by the DON, that indicated the physician was notified. Review of a physician order for Resident R9 dated 3/23/25, indicated, indicated Resident R8 receives Humalog insulin, and to notify the physician for blood sugar levels above 400. Review of Resident R9's blood sugar record revealed the following: 3/21/25, at 12:06 p.m. the blood sugar was documented as 498.0 mg/dL. 3/21/25, at 8:39 p.m. the blood sugar was documented as 505.0 mg/dL. 3/22/25, at 8:17 a.m. the blood sugar was documented as 555.0 mg/dL. 3/23/25, at 7:28 a.m. the blood sugar was documented as 419.0 mg/dL. Review of Resident R9's progress notes indicated late entries for each of the above out-of-range blood sugar levels, created on 3/26/25, DON, that indicated the physician was notified. During an interview on 3/27/25, the DON confirmed that the late entries were entered based on audits completed of the charts. When asked, the DON stated that there is a book at the nurses' station that documents the physician notifications. At this time, the DON was asked to provide that book for inspection. On 3/27/25, at approximately 2:30 p.m. the DON provided a photocopy of a one page, with dates of 3/21/25, through 3/26/25. The documentation included the following notifications: -3/21/25, Resident R9, 498 BS (blood sugar) LPN Employee E38. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 30 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 0842 -3/21/25, Resident R9, 505 BS RN Employee E11. Level of Harm - Minimal harm or potential for actual harm -3/22/25, Resident R9, 550 BS RN Employee E39. -3/24/25, Resident R7, 500 BS, LPN Employee E20. Residents Affected - Some -3/24/25, Resident R7, 501 BS, documented in the medical record by LPN Employee E20. -3/24/25, Resident R7, 582 BS, documented in the medical record by RN Employee E3. -3/25/25, Resident R7, 400 BS, documented in the medical record by LPN Employee E36. -3/26/25, Resident R9, 490 BS, RN Employee E22. Review of the facility-provided photocopy revealed all of the above entries were written in the same handwriting. During an interview on 3/31/25, at approximately 1:00 p.m., the Nursing Home Administrator and the Director of Nursing confirmed that the facility failed to appropriately document physician notification for three of eight residents. 28 Pa. Code: 211.5(f)(g)(h) Clinical records. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 31 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 0865 Have a plan that describes the process for conducting QAPI and QAA activities. Level of Harm - Minimal harm or potential for actual harm Based on a review of facility documentation, cited deficiencies from previous surveys, review of plan of correction documentation, and staff interview, it was determined that the facility's Quality Assurance and Performance Improvement (QAPI) program failed to correct previously cited deficiencies. This has the potential to affect 18 of 91 residents. Residents Affected - Some Findings include: Review of the facility policy, Quality Assurance and Performance Improvement (QAPI) Program dated 1/22/25, indicated objectives of the QAPI program include providing a means to establish and implement performance improvement projects to correct identified negative or problematic indicators and to establish systems through which to monitor and evaluate corrective actions. The facility's deficiencies and plan of correction for the State Survey and Certification (Department of Health) survey ending 2/28/24, revealed the facility developed a plan of correction that included quality assurance systems to ensure the facility maintained compliance with cited nursing home regulations. Review of the plan of correction for the survey ending 3/22/24, revealed the following: - The Director of Nursing (DON) completed a whole house audit of all diabetics on 6/26/24 assure all diabetic residents receiving blood glucose checks, had parameters for physician notification for both high and low blood sugars. - An education will be completed by 7/17/24, for licensed nurses on proper notification and documentation on blood sugars that fall out of established physician parameters for blood glucose levels. - The DON/designee will complete a weekly audit of five residents receiving blood glucose levels to assure that all reading out of parameters have been followed up according to policy and the attending physician has been made aware. This will be done for six weeks. - The DON/designee will submit a report to QAPI on the compliance with notification of physicians on high or low blood sugar levels. This will be done for a period of two months. The results of the current survey, ending 3/31/25, identified a repeated deficiency related to the lack of notification of medical providers for out-of-range blood sugar levels for four of eight residents. During the survey process the following was revealed: Review of Resident R7's blood sugar record revealed the following elevated blood sugar levels without documentation that the provider was notified: 3/24/25, at 7:44 p.m. - 582.0 mg/dL 3/24/25, at 12:47 p.m. - 500.0 mg/dL (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 32 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 0865 3/16/25, at 10:24 a.m. - 487.0 mg/dL Level of Harm - Minimal harm or potential for actual harm 3/10/25, at 8:43 p.m. - 600.0 mg/dL 3/09/25, at 11:56 p.m. - 478.0 mg/dL Residents Affected - Some 2/17/25, at 11:41 a.m. - 508.0 mg/dL 1/21/25, at 1:22 p.m. - 64.0 mg/dL 1/13/25, at 7:40 p.m. - 506.0 mg/dL 1/04/25, at 8:25 a.m. - 53.0 mg/dL Review of Resident R18's blood sugar record revealed the following elevated blood sugar levels without documentation that the provider was notified: 3/22/25, at 8:26 p.m. - 378.0 mg/dL 3/21/25, at 11:37 a.m. - 348.0 mg/dL 3/21/25, at 8:00 a.m. - 360.0 mg/dL 3/21/25, at 6:04 a.m. - 360.0 mg/dL 3/19/25, at 11:40 a.m. - 357.0 mg/dL 3/15/25, at 7:25 p.m. - 364.0 mg/dL 3/13/25, at 11:51 a.m. - 359.0 mg/dL 3/11/25, at 1:22 p.m. - 405.0 mg/dL 3/11/25, at 9:29 a.m. - 372.0 mg/dL 3/11/25, at 5:49 a.m. - 372.0 mg/dL 3/10/25, at 7:59 p.m. - 357.0 mg/dL 2/06/25, at 8:24 a.m. - 351.0 mg/dL 2/06/25, at 6:04 a.m. - 351.0 mg/dL Review of Resident R19's blood sugar record revealed the following elevated blood sugar levels without documentation that the provider was notified: 2/23/25, at 4:41 p.m. - 402.0 mg/dL 2/09/25, at 11:12 a.m. - 415.0 mg/dL (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 33 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 0865 1/31/25, at 11:06 a.m. - 427.0 mg/dL Level of Harm - Minimal harm or potential for actual harm Review of Resident R20's blood sugar record revealed the following elevated blood sugar levels without documentation that the provider was notified: Residents Affected - Some 3/24/25, at 9:43 p.m. - 38.0 mg/dL During an interview on 3/31/25, at approximately 1:00 p.m. the Nursing Home Administrator and the Director of Nursing confirmed that facility failed to maintain an effective Quality Assurance Committee to ensure that the concerns related to the use of elastic bandages were identified, with the potential to affect 18 of 91 residents. 28 Pa. Code 201.18(e)(1) Management. 28 Pa. Code 201.18(e)(2)(3)(4) Management. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 34 of 35 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 395670 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/31/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wecare at Monroeville Rehabilitation and Nsg Ctr 4142 Monroeville Blvd Monroeville, PA 15146 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 0919 Make sure that a working call system is available in each resident's bathroom and bathing area. Level of Harm - Minimal harm or potential for actual harm Based on review of facility documents, observations and staff interview, it was determined that the facility failed to maintain an effective call system for three of five restrooms accessible to residents. Residents Affected - Some Findings include: Review of the Facility Assessment dated 1/1/25, indicated that listed under the Physical Environment resources was a nurse call system. During an observation on 3/27/25, at 9:38 a.m. the staff restroom across from the 200-Unit nursing station was observed unlocked, with the door open. Observation of the restroom revealed no emergency call light or call cord attached for emergency use. During an observation on 3/28/25, at approximately 1:00 p.m. the two staff restrooms across from the Activities room were observed unlocked, with the doors open. Observation of the restrooms revealed no emergency call light or call cord attached for emergency use. During an interview on 3/28/25, at approximately 1:00 p.m. the Nursing Home Administrator confirmed the restrooms were unlocked, which allowed access by residents, and confirmed that no call lights were available for resident use in the event of an emergency. During an interview on 3/28/25, at approximately 1:00 p.m. the Nursing Home Administrator confirmed the facility failed to maintain an effective call system for three of five restrooms accessible to residents. 28 Pa. Code 201.14 (a) Responsibility of licensee 28 Pa. Code 201.18 (b) (1) Management FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395670 If continuation sheet Page 35 of 35