Health inspection·February 3, 2024

F 0658 Ensure services provided by the nursing facility meet professional standards of quality. 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 job description, resident record review, and staff interview, it was determined that the facility failed to follow professional standards of practice for to three of four residents reviewed (Resident R1, R2, and R3). Residents Affected - Some Review of the facility Licensed Practical Nurse job description, effective 9/1/23, indicated the Licensed Practice Nurse (LPN) is responsible for rendering nursing care in terms of individualized resident needs based on the scope of practical nursing. The job description further stated the LPN performs delegated nursing functions using established procedures, policies, guidelines and standards. Review of the clinical record indicated that Resident R1 was admitted to the facility on [DATE]. Review of the Minimum Data Set (MDS, periodic assessment of resident care needs) dated 1/15/24, included diagnoses of diabetes (a metabolic disorder in which the body has high sugar levels for prolonged periods of time) and hypertension (high blood pressure in the arteries). Review of Resident R1's January 2024 vital sign record revealed LPN Employee E1 documented blood pressures (BP) and heart rates (HR) on Resident R1 on nine separate shifts, which revealed the following: -1/12/24, at 12:00 a.m.: LPN Employee E1 documented BP 152/88 and HR 80, a duplicate of the previous BP/HR completed on 1/11/24, at 9:07 p.m., approximately three hours prior. -1/16/24, at 12:31 a.m.: LPN Employee E1 documented BP 133/72 and HR 77, a duplicate of the previous BP completed on 1/15/24, at 10:56 p.m., approximately one and a half hours prior. -1/16/24, at 11:33 p.m.: LPN Employee E1 documented BP 137/85 and HR 71, a duplicate of the previous BP/HR completed on 1/16/24, at 10:36 p.m., approximately one hour prior. -1/18/24, at 12:15 a.m.: LPN Employee E1 documented BP 126/75 and HR 72, a duplicate of the previous BP/HR completed on 1/17/24, at 6:57 p.m., approximately five hours prior. -1/20/24, at 12:57 a.m.: LPN Employee E1 documented BP 163/78 and HR 70, a duplicate of the previous BP/HR completed on 1/19/24, at 6:22 p.m., approximately six hours prior. -1/21/24, at 11:55 p.m.: LPN Employee E1 documented BP 168/88 and HR 80, a duplicate of the previous BP/HR completed on 1/21/24, at 6:30 p.m., approximately five and a half hours prior. Page 1 of 4 395675 395675 02/03/2024 Waynesburg Nursing and Rehab 300 Center Avenue Waynesburg, PA 15370

F 0658 Level of Harm - Minimal harm or potential for actual harm -1/26/24, at 1:06 a.m.: LPN Employee E1 documented BP 141/86 and HR 72, a duplicate of the previous BP/HR completed on 1/25/24, at 3:26 p.m., approximately eight and a half hours prior. -1/27/24, at 12:04 a.m.: LPN Employee E1 documented BP 137/68 and HR 73, a duplicate of the previous BP/HR completed on 1/25/24, at 4:56 p.m., approximately seven hours prior. Residents Affected - Some Review of the clinical record indicated that Resident R2 was admitted to the facility on [DATE]. Review of the MDS dated [DATE], included diagnoses of atrial fibrillation (disease of the heart characterized by irregular and often faster heartbeat) and hypertension. Review of Resident R2's January 2024 vital sign record revealed Licensed Practical Nurse (LPN) Employee E1 documented BPs on Resident R2 on ten separate shifts, which revealed the following: -1/04/24, at 12:20 a.m.: LPN Employee E1 documented BP 125/74, a duplicate of the previous BP/HR completed on 1/3/24, at 8:28 p.m., approximately four hours prior. -1/08/24, at 12:18 a.m.: LPN Employee E1 documented BP 132/74, a duplicate of the previous BP/HR completed on 1/7/24, at 6:01 p.m., approximately six hours prior. -1/09/24, at 12:14 a.m.: LPN Employee E1 documented BP 137/65, a duplicate of the previous BP/HR completed on 1/8/24, at 9:54 p.m., approximately two hours prior. -1/12/24, at 11:49 p.m.: LPN Employee E1 documented BP 100/60, a duplicate of the previous BP/HR completed on 1/12/24, at 7:55 p.m., approximately four hours prior. -1/16/24, at 12:41 a.m.: LPN Employee E1 documented BP 102/67, a duplicate of the previous BP/HR completed on 1/15/24, at 10:58 p.m., approximately three hours prior. -1/18/24, at 12:07 a.m.: LPN Employee E1 documented BP 106/68 and HR 80, a duplicate of the previous BP/HR completed on 1/17/24, at 6:54 p.m., approximately five hours prior. -1/20/24, at 12:53 a.m.: LPN Employee E1 documented BP 118/56 and HR 72, a duplicate of the previous BP/HR completed on 1/19/24, at 10:27 p.m., approximately two and a half hours prior. -1/21/24, at 11:52 p.m.: LPN Employee E1 documented BP 126/66 and HR 73, a duplicate of the previous BP/HR completed on 1/21/24, at 6:33 p.m., approximately five hours prior. Review of the clinical record indicated that Resident R3 was readmitted to the facility on [DATE]. Review of the MDS dated [DATE], included diagnoses of coronary artery disease (damage or disease in the heart's major blood vessels) and muscle weakness. Review of Resident R3's January 2024 vital sign record revealed Licensed Practical Nurse (LPN) Employee E1 documented BPs and HRs on Resident R3 on nine separate shifts, which revealed the following: -1/2/24, at 12:15 a.m.: LPN Employee E1 documented BP 108/72 and HR 76, a duplicate of the previous BP/HR completed on 1/1/24, at 10:29 p.m., approximately one hour prior. 395675 Page 2 of 4 395675 02/03/2024 Waynesburg Nursing and Rehab 300 Center Avenue Waynesburg, PA 15370

F 0658 Level of Harm - Minimal harm or potential for actual harm -1/8/24, at 11:55 p.m.: LPN Employee E1 documented BP 108/64 and HR 72, a duplicate of the previous BP/HR completed on 1/8/24, at 10:53 p.m., approximately one hour prior. -1/11/24, at 1:04 a.m.: LPN Employee E1 documented BP 109/69 and HR 73, a duplicate of the previous BP/HR completed on 1/10/24, at 9:53 p.m., approximately three hours prior. Residents Affected - Some -1/12/24, at 2:00 a.m.: LPN Employee E1 documented BP 130/72 and HR 60, a duplicate of the previous BP/HR completed on 1/11/24, at 8:48 p.m., approximately five hours prior. -1/13/24, at 12:30 a.m.: LPN Employee E1 documented BP 124/70 and HR 75, a duplicate of the previous BP/HR completed on 1/11/24, at 7:57 p.m., approximately four and a half hours prior. -1/18/24, at 12:13 a.m.: LPN Employee E1 documented BP 104/68 and HR 68, a duplicate of the previous BP/HR completed on 1/17/24, at 6:58 p.m., approximately five hours prior. -1/20/24, at 12:44 a.m.: LPN Employee E1 documented BP 114/68 and HR 70, a duplicate of the previous BP/HR completed on 1/19/24, at 10:42 p.m., approximately two hours prior. -1/21/24, at 11:46 p.m.: LPN Employee E1 documented BP 116/64 and HR 64, a duplicate of the previous BP/HR completed on 1/21/24, at 6:46 p.m., five hours prior. During an interview on 2/3/24, at approximately 12:30 p.m. the Director of Nursing confirmed that Licensed Practical Nurse Employee E1 appeared to consistently duplicate prior blood pressure and heart rate assessments in place of completing them herself. During an interview on 2/3/24, at approximately 1:45 p.m. the Nursing Home Administrator confirmed that the facility failed to follow professional standards of practice for to three of four residents reviewed. 28 PA. Code: 201.14(a) Responsibility of licensee. 28 Pa. Code: 211.12(d)(1)(3)(5) Nursing services. 395675 Page 3 of 4 395675 02/03/2024 Waynesburg Nursing and Rehab 300 Center Avenue Waynesburg, PA 15370

F 0679 Provide activities to meet all resident's needs. Level of Harm - Minimal harm or potential for actual harm Based on a review of the Activity Calendars for two months (December 2023 and January 2024), and resident and staff interview, it was determined that the facility failed to provide an ongoing program of activities to meet the interests of and support the physical, mental, and psychosocial well-being of each resident for five of eleven residents. Residents Affected - Some Findings include: Review of Activities Calendar for December 2023, and January 2024, revealed: -No activities scheduled after 2:00 p.m. -55 of 59 days had Bible Study as an activity, daily at 10:00 a.m. -On Sundays, only three activities over the period of both months, were not religious or one-on-one visits. During an interview on 2/2/24, at 1:43 p.m. Resident R4, when asked about activities, stated, I'm bored as hell. During an interview on 2/2/24, at 2:15 p.m. Resident R5, when asked about activities, stated, Not much. Half and half. During an interview on 2/2/24, at 2:18 p.m. Resident R6, when asked about activities, stated he is Bored as shit. During an interview on 2/3/24, at 12:55 p.m. Resident R7, when asked about activities, stated There's not much to do I watch TV. During an interview on 2/3/24, at 1:01 p.m. Resident R8, when asked about activities, stated I watch television mostly. Eat. During an interview on 2/3/24, at approximately 1:45 p.m. the Nursing Home Administrator confirmed that the facility failed to provide an ongoing program of activities to meet based on the designed to meet the interests of and support the physical, mental, and psychosocial well-being of each resident for five of eleven residents. 28 Pa. Code: 201. 18(b)(3) Management. 28 Pa. Code: 207.2(a) Administrators Responsibility. 395675 Page 4 of 4