Health inspection·February 26, 2024

F 0580 1/22/24, at 6:19 a.m. the CBG was 492 mg/dl. Level of Harm - Minimal harm or potential for actual harm 1/27/24, at 11:59 p.m. the CBG was 581 mg/dl. 1/28/24, at 9:55 p.m. the CBG was 472 mg/dl. Residents Affected - Some 1/29/24, at 5:42 a.m. the CBG was 424 mg/dl. 1/31/24, at 8:20 p.m. the CBG was 409 mg/dl. 2/01/24, at 6:42 a.m. the CBG was 500 mg/dl. 2/02/24, at 12:18 p.m. the CBG was 409 mg/dl. 2/02/24, at 8:13 p.m. the CBG was 413 mg/dl. 2/03/24, at 2:51 p.m. the CBG was 500 mg/dl. 2/03/24, at 6:08 p.m. the CBG was 475 mg/dl. 2/06/24, at 5:50 p.m. the CBG was 478 mg/dl. 2/06/24, at 8:51 p.m. the CBG was 488 mg/dl. 2/11/24, at 4:51 p.m. the CBG was 456 mg/dl. Review of a clinical record indicated Resident R4 was admitted to the facility on [DATE]. Review of the MDS dated [DATE], included diagnoses of dementia (a group of symptoms that affects memory, thinking and interferes with daily life) and diabetes. Review of physician's orders dated 12/5/23, indicated to inject Novolog insulin (fast-acting medication to lower blood sugar levels) per sliding scale with an additional 10 units; if blood glucose is greater than 400 to call the doctor. Review of Resident R4's February 2024 MAR failed to reveal physician notification of the following blood sugar levels: 2/02/24, at 1:41 p.m. the CBG was 485 mg/dl. 2/02/24, at 8:13 p.m. the CBG was 413 mg/dl. 2/23/24, at 12:47 p.m. the CBG was 430 mg/dl. 2/03/24, at 6:08 p.m. the CBG was 475 mg/dl. 2/06/24, at 5:50 p.m. the CBG was 478 mg/dl. Review of a clinical record indicated Resident R18 was admitted to the facility on [DATE]. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395695 If continuation sheet Page 2 of 10 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 395695 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/26/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Greenery Center for Rehab and Nursing 2200 Hill Church-Houston Road Canonsburg, PA 15317 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 Level of Harm - Minimal harm or potential for actual harm Review of the facility diagnoses list included diagnoses of metabolic encephalopathy (alteration in consciousness caused by a chemical imbalance affecting the brain) and diabetes. Review of Resident R18's physician's orders no orders for sliding-insulin. A physician order dated 2/21/24, indicated to assess Resident R18's CBG before meals and at bedtime. Residents Affected - Some Review of Resident R18's February 2024 MAR failed to reveal physician notification of the following blood sugar levels: 2/21/24, at 5:41 p.m. the CBG was 354 mg/dl. 2/21/24, at 8:47 p/m. the CBG was 366 mg/dl. 2/22/24, at 6:44 p.m. the CBG was 346 mg/dl. 2/23/24, at 5:18 a.m. the CBG was 424 mg/dl. 2/23/24, at 1:11 p.m. the CBG was 323 mg/dl. 2/23/24, at 6:17 p.m. the CBG was 388 mg/dl. 2/23/24, at 8:48 p.m. the CBG was 307 mg/dl. 2/24/24, at 5:23 a.m. the CBG was 433 mg/dl. 2/24/24, at 11:58 a.m. the CBG was 510 mg/dl. 2/24/24, at 4:36 p.m. the CBG was 529 mg/dl. 2/24/24, at 9:49 p.m. the CBG was 490 mg/dl. During an interview on 2/26/24, at approximately 2:00 p.m. the Director of Nursing confirmed that the facility failed to notify physicians of increased capillary blood glucose levels 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. 28 Pa. Code 211.12 (d)(1)(2)(3)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395695 If continuation sheet Page 3 of 10 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 395695 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/26/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Greenery Center for Rehab and Nursing 2200 Hill Church-Houston Road Canonsburg, PA 15317 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 resident observations and 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 13 of 15 residents (Resident R1, R2, R5, R6, R7, R8, R9, R10, R11, R12, R13, R14, R15, R16, and R17). Findings include: During an observation on 2/23/24, at 4:25 p.m., Resident R2 stated, when asked about facility staffing and care, There's not enough care. They are slow coming. When asked if he had ever soiled himself while waiting for care, Resident R2 stated, Instead of coming, you crap in your diaper, and live with it. During an interview on 2/23/24, at 4:28 p.m., when asked about facility staffing and care, Resident R5 stated, The staff has to bust their balls. During an interview on 2/23/24, at 4:32 p.m., when asked about facility staffing and care, Resident R6 stated, Usually ok, but you have to wait if they are busy. During an interview on 2/23/24, at 4:34 p.m., when asked about facility staffing and care, Resident R7 stated, They could definitely use a few more. During an interview with Residents R8 and R9 on 2/23/24, at 4:34 p.m., when asked about facility staffing and care, Resident R8 confirmed that call light response time can be long. Resident R9 stated, No, there's not enough and confirmed that she has waited over an hour for call light response. When asked if either resident had soiled themselves waiting for staff assistance, both Resident R8 and R9 confirmed that they both have. During an observation on 2/23/24, at 4:40 p.m., Resident R10 was observed with a large amount of facial hair. When asked about facility staffing and care, she stated that she did not want to say anything bad about staff. During an interview on 2/23/24, at 7:30 p.m., when asked if there were enough nursing staff to care for the residents Resident R10 stated (emphatically), No, no-way. They are short of everything, we have to wait and wait because they are so backed up, 17 patients to one aide. The aides are beat to death. Way too short-staffed. I've waited an hour to go to the bathroom. During a group interview of Resident R12, Resident R13, and a family member for Resident R12 on 2/23/24, at 7:37 p.m., when asked if there were enough nursing staff to care for the residents, the family member for Resident R12 stated, There are never enough. The evening shift sucks. My father doesn't get his showers. He's supposed to have assistance to go to the bathroom, but he tells me he gets up on his own because he cannot wait the aides to come and help him. I was here on Sunday, and (Resident R13) wanted to get into bed. He waited from 6:30 p.m. until I left at 8:00 p.m. and still hadn't gotten into bed. His sister told me he didn't get into bed until after 9:00 p.m. The family member for Resident R12 stated she and the family member for R13 each watch out for the other resident because they are so worried about the care their family members receive. Resident R13 stated I'm paralyzed on one side; I can't do anything on my own. They tell me they will be right back, and they never (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395695 If continuation sheet Page 4 of 10 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 395695 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/26/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Greenery Center for Rehab and Nursing 2200 Hill Church-Houston Road Canonsburg, PA 15317 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 come. Level of Harm - Minimal harm or potential for actual harm During an interview on 2/23/24, at 8:01 p.m., when asked if there were enough nursing staff to care for the residents the family member for Resident R14 stated, Sometimes they are short-handed, that's why I come in and try to fill-in. When asked about call light response, Resident R14 stated it depends on how many are here, they work really hard. When asked if there was a particular time of day where they had more concerns, the family member for Resident R14 confirmed that it is worse on the evening shift. Residents Affected - Some A review of facility provided grievance forms from December 2023, through February 2024, revealed the following: 12/26/23: Resident R15 entered a concern that he wasn't bathed since admission. Review of grievance resolution on 1/3/24, indicated that care was given, referencing the bathing record attached to the investigation. This document provided bathing information for the Previous 14 days from when the record was opened. The final date showing on the record was 1/7/24, revealing that the previous 14 days of the report would be 12/25/23, through 1/7/24. No bathing was revealed from 12/25/23, through 1/1/24, confirmed Resident R17's concern. Bathing was revealed from 1/2/24, through 1/7/24, which was after the grievance was filed. 2/1/24: Family member for Resident R1 stated There was not enough staff and that the nurse left the building at 5:00 a.m. Review of facility documents reveal this concern was substantiated. 2/13/24: Family member for Resident R16 had concerns about Resident R16's showers. Review of grievance resolution revealed Resident R16 had missed a shower. 2/20/24: Resident R17 entered a concern that she does not have a regular aide on the day shift, and that she would like to get up between 7:30 a.m. and 8:00 a.m., but is not able to as staff come in late. Review of grievance resolution provided a plan to attempt to have regular staff, but did not address Resident R17's concern with not being assisted to get up at her desired time. During an interview on 2/26/24, at approximately 2:00 p.m. the Director of Nursing confirmed the facility failed to have sufficient nursing staff to provide nursing and related services to 13 of 15 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)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395695 If continuation sheet Page 5 of 10 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 395695 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/26/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Greenery Center for Rehab and Nursing 2200 Hill Church-Houston Road Canonsburg, PA 15317 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 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of clinical records, and staff interview, it was determined that the facility failed to implement procedures to ensure availability of prescribed medications for three of four residents (Residents R1, R2, and R3). Findings include: Review of facility policy Medication Ordering and Prescribing dated 6/21/23, indicated that residents receive newly ordered medications in a timely manner. Review of Resident R1's admission record indicated he was admitted to the facility on [DATE]. Review of the Minimum Data Set (MDS - periodic assessment of care needs) dated 1/24/24, included diagnoses of end stage renal disease (ESRD, an inability of the kidneys to filter the blood), heart failure (a progressive heart disease that affects pumping action of the heart muscles), and diabetes (a metabolic disorder in which the body has high sugar levels for prolonged periods of time). Review of hospital discharge paperwork dated 1/16/24, at 11:41 a.m. indicated that Resident R1 was to be ordered the following scheduled medications: -Aspirin (medication used to prevent blood clots) 81 mg (milligrams), once a day. -Atorvastatin (medication used to high cholesterol) 40 mg, once a day. -Calcium acetate (medication used to control high blood levels of phosphorus in people with kidney disease who are on dialysis) 667 mg, three times per day. -Clopidogrel (medication used to prevent blood clots) 75 mg once a day. -Labetalol (medication used to treat high blood pressure) 1000 mg, once a day. -Lidoderm 5% patch (medicated patch placed on the skin for pain relief). once a day. -Melatonin (supplement to assist in falling asleep) 6 mg, at bedtime. -Protonix (medication used to stomach and esophageal problems) 40 mg, once a day. -Rena Vite (vitamin supplement for people with kidney disease) one tablet, once a day. Review of physician's orders indicated that these medications were ordered on 1/16/24, in the evening. Review of Resident R1's Medication Administration Record (MAR) for January 2024, indicated the following on 1/17/24: -Aspirin documented as received. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395695 If continuation sheet Page 6 of 10 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 395695 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/26/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Greenery Center for Rehab and Nursing 2200 Hill Church-Houston Road Canonsburg, PA 15317 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 0755 -Atorvastatin documented as 9 (9 is code for See Nurse's Note). Level of Harm - Minimal harm or potential for actual harm -Calcium acetate documented as 9for all three scheduled administrations. -Clopidogrel documented as 9. Residents Affected - Some -Labetalol documented as 9. -Lidoderm 5% patch documented as 9. -Melatonin documented as received. -Protonix documented as received. -Rena Vite documented as 9. Review of progress notes entered on 1/17/24, indicated that the facility was awaiting delivery from the pharmacy for the medications documented as 9. No progress notes indicated notification of the medical provider of Resident R1's missed medications. Review of Resident R2's admission record indicated he was admitted to the facility on [DATE]. Review of the MDS dated [DATE], included diagnoses of Parkinson's disease (neuromuscular disorder causing tremors and difficulty walking), high blood pressure, history of a stroke, and a seizure disorder. Review of hospital discharge paperwork dated 1/16/24, at 11:53 a.m. indicated that Resident R2 was to be ordered the following scheduled medications: -Carbidopa-levodopa (Combination medication to treat Parkinson's disease) 10-100 mg, twice daily. -Enoxaparin (injected medication used to prevent blood clots) 40 mg, injected daily. -Lacosamide (medication used to treat seizures) 100 mg, twice daily. -Levetiracetam (medicated used to treat seizures). 1500 mg, twice daily. -Melatonin (supplement to assist in falling asleep) 6 mg, at bedtime. -Tamsulosin (medication used to an enlarged prostate gland) 0.8 mg at night. Review of physician's orders indicated that these medications were ordered on 1/16/24, in the evening. Review of Resident R2's Medication Administration Record (MAR) for January 2024, indicated the following on 1/17/24: -Carbidopa-levodopa morning dose documented as given, evening dose documented as 9. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395695 If continuation sheet Page 7 of 10 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 395695 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/26/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Greenery Center for Rehab and Nursing 2200 Hill Church-Houston Road Canonsburg, PA 15317 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 0755 -Enoxaparin documented as given. Level of Harm - Minimal harm or potential for actual harm -Lacosamide documented as 9 for both administrations. -Levetiracetam morning dose documented as given, evening dose documented as 9. Residents Affected - Some -Melatonin documented as given. -Tamsulosin documented as 9. Review of progress notes entered on 1/17/24, indicated that the facility was awaiting delivery from the pharmacy for medications documented as 9. Review of a progress note dated 1/17/24, at 12:13 p.m. indicated that a prescription for Lacosamide was sent to the pharmacy (Lacosamide is a controlled medication and requires a signed prescription by a physician with each order). Review of the facility provided inventory for the automated medication dispensing machine included levetiracetam. During an interview on 2/26/24, at approximately 2:00 p.m. the Director of Nursing was unable to provide a reason how the morning dose of Carbidopa-levodopa was provided to Resident R2, when the facility was still awaiting pharmacy delivery of Resident R2's medications in the evening, and Carbidopa-levodopa was not available in the automated medication dispensing machine. Review of Resident R3's admission record indicated he was admitted to the facility on [DATE]. Review of the MDS dated [DATE], included diagnoses of hemiplegia (paralysis on one side of the body), high blood pressure, and history of a stroke. Review of hospital discharge paperwork dated 2/6/24, at 1:48 p.m. indicated that Resident R3 was to be ordered the following scheduled medications: -Amlodipine (medicated used to high blood pressure). 10 mg, once daily. -Aspirin 81 mg, once daily. -Atorvastatin 40 mg, once daily at night. -Baclofen (medication used to treat muscle spasms) 10 mg, three times daily. -Buspirone (medication to treat depression) 7.5 mg, three times per day. -Carvedilol (medication used to treat high blood pressure) 12.5 mg, twice daily. -Dantrolene (medication to treat muscle spasms) 50 mg, three times daily. -Finasteride (medication used to treat an enlarged prostate) 5mg, daily. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395695 If continuation sheet Page 8 of 10 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 395695 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/26/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Greenery Center for Rehab and Nursing 2200 Hill Church-Houston Road Canonsburg, PA 15317 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 0755 -Heparin sodium (injected medication to prevent blood clots) 5000 units, injected every eight hours. Level of Harm - Minimal harm or potential for actual harm -Hydralazine (medication used to treat high blood pressure) 10 mg, four times daily. -Melatonin 3 mg, every 24 hours. Residents Affected - Some -Protonix 40 mg, daily. -Senokot (medication to treat/prevent constipation) 17.2 mg, once daily at night. -Tamsulosin 0.4 mg, twice daily. Review of physician's orders indicated that these medications were ordered on 2/7/24, in the early evening, with the exception of the hydralazine. Review of Resident R3's Medication Administration Record (MAR) for February 2024, indicated the following for 2/7/24, and 2/8/24: -Amlodipine documented as given. -Aspirin 81 mg, documented as given. -Atorvastatin documented as 9 on 2/7/24, given on 2/8/24. -Baclofen documented as 9 on 2/7/24, given on 2/8/24. -Buspirone documented as 9 on 2/7/24, given on 2/8/24. -Carvedilol documented as 9 on 2/7/24, given on 2/8/24. -Dantrolene documented as 9 on 2/7/24, given on 2/8/24. -Finasteride documented as given. -Heparin sodium documented as 9 for evening dose on 2/7/24, and morning dose on 2/8/24. -Melatonin documented as 9 on 2/7/24, given on 2/8/24. -Protonix documented as given. -Senokot documented as 9 on 2/7/24, given on 2/8/24. -Tamsulosin documented as 9 on 2/7/24, given on 2/8/24. Review of progress notes entered on 2/7/24, indicated that the facility was awaiting delivery from the pharmacy for medications documented as 9. No progress notes indicated notification of the medical provider of Resident R3's missed medications. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395695 If continuation sheet Page 9 of 10 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 395695 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/26/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Greenery Center for Rehab and Nursing 2200 Hill Church-Houston Road Canonsburg, PA 15317 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 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Review of the facility provided inventory for the automated medication dispensing machine included carvedilol and heparin sodium. During an interview on 2/26/24, at approximately 2:00 p.m. the Nursing Home Administrator confirmed that the facility failed to implement procedures to ensure availability of prescribed medications for three of four residents. 28 Pa. Code 211.9(a)(1) Pharmacy services. 28 Pa. Code 211.12(d)(1)(3)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395695 If continuation sheet Page 10 of 10