Health inspection·June 21, 2024

F 0563 Honor the resident's right to receive visitors of his or her choosing, at the time of his or her choosing. Level of Harm - Minimal harm or potential for actual harm Based on observation, review of clinical records and staff interviews, it was determined that the facility failed to ensure that one of 12 residents reviewed was able to received visitors. (Resident R1) Residents Affected - Few Findings include: CMS issued guidance to the previously released QSO-NH-20-39 originally issued on 9/17/20 and revised on 11/12/21 regarding visitation in nursing homes. This revised guidance stated that, Visitation is now allowed for all residents at all times This will be implemented immediately by nursing home facilities. Review or Resident R1's Quarterly Minimum Data Set (MDS-federal mandated process for clinical assessment for all residents) dated May 2, 2024, revealed that Resident R1 entered the facility February 18, 2024, with diagnoses of anemia (blood disorder occurring when the blood lacks adequate healthy red blood cells), hypertension (also known as high blood pressure is a condition in which the blood pressure in artery is persistently elevated), diabetes mellitus (a metabolic disease involving inappropriately elevated blood glucose levels), hyperlipidemia (a chronic metabolic disorder characterized by elevated levels of lipids in the blood), hemiplegia (paralysis that effects one side of the body that results from disease or injury of the brain), anxiety (a mental condition characterized by excessive apprehensiveness about real or perceived thoughts), depression (a mood disorder that causes a persistent feeling of sadness and loss of interest),and asthma (a chronic lung disease that causes the airways to become inflamed and narrow making breathing difficult). Resident R1's Brief Interview for Mental Status (BIMS) measuring cognitive abilities received a BIMS score of 9 suggesting moderately impaired cognition. . Review of Resident R1's nursing note dated June 6, 2024, revealed IDT (Interdisciplinary team) attempted to conduct care conference with [resident's friend and emergency contact], regarding the resident's emergency contact aggressive behaviors with staff. During meeting [the resident's emergency contact] was aggressive using profanity and unable to redirect. IDT was unable to continue the meeting, will reschedule. Further review of Resident R1's social service documentation dated June 4, 2024, stated IDT team met with [resident's friend and emergency contact], educated to coordinate with business office and facility management in financial matters. Page 1 of 2 395687 395687 06/21/2024 York Nursing and Rehabilitation Center 7101 Old York Road Philadelphia, PA 19126

F 0563 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Interview with Resident R1's friend and emergency contact on June 21, 2024, at 9:42 a.m., revealed that he was called to come to the facility for an emergency meeting regarding Resident R1. The conference was attended by himself, the Nursing Home Administrator (NHA), Employee E1, the Director of Nursing (DON), Employee E2, and three other employees not introduced. During the conference, he was accused of stealing money from his friends Resident R1 and Resident R2. He stated that he was told he is not allowed in the building. Interview with Resident R1 June 21,2024 at 11:02 a.m. revealed that resident was told by her friend and that he was not allowed to visit her, he was banned from the facility. Resident R1 stated that he was not allowed in the facility because they (Administration) accused her friend of stealing money from her. Resident R1 stated that she has been friends for over twenty-two years and sometimes she has given him money to purchase stuff for her. Observation of Resident R1 during the above interview revealed Resident R1 visibly very upset by her friend not being allowed to visit her. Interview with Receptionist supervisor Employee E7, June 21,2024 at 10:52 a.m. revealed that, she has been employed by the facility for three years and admit being able to recognize the residents and recognize most of the visitors. Employee E7 confirmed knowing and recognizing Resident R1' friend. Employee E7 stated that on June 14, 2024, Resident R1's friend entered the building along with a bag of items intended for Resident R1. Employee E7 stated that she told the visitor that he was not allowed to enter the facility, he let the bag of items with Employee E7 to deliver to Resident R1. Employee E7 stated that she was told by the facility that this resident's visitor was not allowed to enter the building pending an investigation. Employee E7 denied knowing anything further of the investigation. Requests to NHA, Employee E1, of investigation was declined based on the failure to conduct a proper investigation. Interview with NHA Employee E1, DON, Employee E2, and ADON (Assistant Director of Nursing), Employee E3 on June 21, 2024, at 1:59 p.m. confirmed Resident R1's friend was requested to join a meeting on June 6, 2024. The meeting was arranged to investigate concerns regarding Resident R1's finances. Employee E1 stated that it was brought to the attention of the administration that an employee had concerns that Resident R1 and Resident R2 were being coached to withdraw money by Resident R1's friend. The unidentified employee stated that she overheard a phone conversation between Resident R1's friend and Resident R1 that seemed to be aggressive. Further interview with E1, E2, and E3 indicated that the meeting became emotionally intense, Resident R1's friend behavior was acrimonious and meeting concluded. Employee E1 denied any discussion or instruction of not being allowed in the building. When Employee E1 and E2 were questioned why the receptionist Employee E7 stated that she was told he was not allowed pending an investigation. The response was that it was unknown why Employee E7 said that. 28 Pa. Code 201.14(a) Responsibility of licensee 28 Pa. Code 201.18(b)(3) Management 395687 Page 2 of 2