Inspection·August 20, 2025

F 0602 Protect each resident from the wrongful use of the resident's belongings or money. Level of Harm - Minimal harm or potential for actual harm Based on interviews, review of facility policy and the review of facility documentation, it was determined that the facility failed to ensure one resident was free from misappropriation of resident funds and exploitation for one out of two residents reviewed (Resident R1). Findings include: Review of the facility Abuse policy with a review date of July 22, 2025.residents will be protected from abuse, neglect, and harm while they are residing at the facility. No abuse or harm of any type will be tolerated, and residents and staff will be monitored for Protection. The facility will strive to educate staff and other applicable individuals in techniques to protect all parties. Review of the August 2025 physician orders for Resident R1 included the diagnoses of heart failure (a syndrome caused by an impairment in the heart's ability to fill with and pump blood); hypertension (high blood pressure); cerebral infarction (a stroke); depression (a mood disorder that causes persistent feelings of sadness and loss of interest), and age-related cognitive decline. Review of documentation submitted to the State Survey Agency indicated that the facility became aware of an allegation when the resident's daughter contacted the facility social worker and completed a Concern Form on July 21, 2025 at approximately 3:30 p.m. regarding bank statements indicating that resident was transferring funds through a money transfer mobile phone application to someone who the family suspected was at the facility. Documentation from money transfer mobile application indicated that the money was being sent to a nurse aide who the facility verified worked at the facility (Employee E3). Continued review of the reportable event revealed that the nurse aide admitted to obtaining funds from the resident, and the resident admitted during the interview with the Director of Nursing (DON) that he provided funds to the nurse aide. The reportable event indicated that the resident admitted to giving the nurse aide money and claimed that he was in a romantic relationship with the nurse aide. Review of the facility investigation indicated that the facility was provided with statements from the resident's daughter which indicated that the resident sent money to the nurse aide on several occasions through a money transfer mobile phone application from at least January 2025 through May 2025, and that his account transferred money to an account that displayed the first and last name of the referenced nurse aide. The resident's daughter, and the facility's investigation estimated the amount sent to the nurse aide to be between $1,7800-$1,754.72. Review of an interview conducted by the facility on July 21, 2025 indicated that the resident reported that he was in love with the resident and that he chose to give her money. I am in love with this young lady I chose to give her money. Continued review of the interview indicated that the resident reported that he gave the nurse aide money on two occasions . to buy him (the resident) food. During an interview with the resident on August 18, 2025, at 11:19 a.m. the resident reported that he was romantically involved with the nurse aide. The resident denied any sexual contact or touching of each other when he was asked during this interview what he meant by being romantically involved with her. Review of an interview conducted by the facility on July 22, 2025, with the nurse aide regarding money taken by the nurse aide from Resident R1 revealed that the Residents Affected - Few (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 2 Event ID: 395687 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 395687 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/20/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE York Nursing and Rehabilitation Center 7101 Old York Road Philadelphia, PA 19126 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)