Health inspection·March 14, 2024

F 0578 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of the facility policy, clinical records, and staff interviews it was determined that the facility failed to provide the opportunity to formulate an advance directive (written instructions such as a living will or durable power of attorney for health care for when the individual is incapacitated) for nine of the sixteen residents reviewed (Resident R14, R18, R48, R84, R86, R96, R98, R99, R108). Findings Include: A review of the facility policy Advanced Directives reviewed 3/1/2023 and 1/31/2024, indicated the facility will comply with the requirements related to maintaining written policies and procedures regarding advance directives, including provisions to inform and provide written information to all adult residents concerning the right to accept or refuse medical or surgical treatment and formulate an advance directive. A review of the medical record indicated Resident R14 was admitted to the facility on [DATE], with diagnoses that included Parkinson ' s disease (affects movement of muscles often seen with tremors, shaking), diabetes, and depression. A review of the clinical record failed to reveal an advance directive or documentation that Resident R14 was given the opportunity to formulate an Advanced Directive. A review of the clinical record indicated Resident R18 was re-admitted to the facility on [DATE], with diagnoses that include diabetes, high blood pressure, and paraplegia (no movement of lower body or legs). A review of the clinical record failed to reveal an advance directive or documentation that Resident R18 was given the opportunity to formulate an Advanced Directive. A review of the clinical record indicated Resident R43 was admitted to the facility on [DATE], with diagnoses that include high blood pressure, gastro-esophageal reflux disease (GERD-severe indigestion), gastro-intestinal bleed (bleeding from either the stomach or the intestines). A review of the clinical record failed to reveal an advance directive or documentation that Resident R43 was given the opportunity to formulate an Advanced Directive. A review of the clinical record indicated Resident R84 was admitted to the facility on [DATE], with diagnoses that include diabetes, morbid obesity (severely overweight) and foot drop of both feet Page 1 of 2 395675 395675 03/14/2024 Waynesburg Nursing and Rehab 300 Center Avenue Waynesburg, PA 15370

F 0578 (unable to lift the foot into a normal position to allow you to walk). Level of Harm - Minimal harm or potential for actual harm A review of the clinical record failed to reveal an advance directive or documentation that Resident R84 was given the opportunity to formulate an Advanced Directive. Residents Affected - Some A review of the clinical record indicated Resident R87 was re- admitted to the facility on [DATE], with diagnoses that include diabetes, high blood pressure, and GERD. A review of the clinical record failed to reveal an advance directive or documentation that Resident R87 was given the opportunity to formulate an Advanced Directive. A review of the clinical record indicated Resident R96 was re-admitted to the facility on [DATE], with diagnoses that include diabetes, high blood pressure, left leg below knee amputation. A review of the clinical record failed to reveal an advance directive or documentation that Resident R96 was given the opportunity to formulate an Advanced Directive. A review of the clinical record indicated Resident R98 was admitted to the facility on [DATE], with diagnoses that include high blood pressure, chronic pain, and cancer. A review of the clinical record failed to reveal an advance directive or documentation that Resident R98 was given the opportunity to formulate an Advanced Directive. A review of the clinical record indicated Resident R99 was admitted to the facility on [DATE], with diagnoses that include chronic obstructive pulmonary disease (COPD-tightening of the airways making it difficult to breath), stroke (an interruption of the blood flow within your brain that causes the death of brain cells), and depression. A review of the clinical record failed to reveal an advance directive or documentation that Resident R99 was given the opportunity to formulate an Advanced Directive. A review of the clinical record indicated Resident R108 was admitted to the facility on [DATE], with diagnoses that include dysphagia (difficulty swallowing), difficulty walking and muscle weakness. A review of the clinical record failed to reveal an advance directive or documentation that Resident R108 was given the opportunity to formulate an Advance Directive. During an interview on 3/13/2024, at 2:28 p.m. the Social Worker Employee E1 and Medical Records Employee E2 stated she confused the POLST with Advance Directives, confirming Residents (Resident R14, R18, R43, R84, R87, R96, R98, R99, R108), were not afforded the opportunity to formulate Advance Directives upon admissions and periodically during their stay in the facility. 28 Pa. Code: 201.29(b)(d)(j) Resident rights. 395675 Page 2 of 2