Health inspection·October 17, 2024

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of facility policy, observations and staff interviews it was determined that the facility failed to provide a clean, safe, comfortable, and homelike environment for two of four residents (Resident R1 and R2). Findings include: Review of the facility policy Resident Rights dated 8/9/24, indicated the facility recognizes the resident right to a quality of life that supports privacy, confidentiality, dignity independent expression, choice, and decision making, consistent with State law and Federal regulation. Review of Title 42 Code of Federal Regulations §483.10(i) Safe Environment. The resident has a right to a safe, clean, comfortable, and homelike environment, including but not limited to receiving treatment and supports for daily living safely. §483.10(i)(2) Housekeeping and maintenance services necessary to maintain a sanitary, orderly, and comfortable interior. Review of the admission record indicated Resident R1 was admitted to the facility on [DATE]. Review of Resident R1's Minimum Data Set (MDS - a periodic assessment of care needs) dated 9/4/24, indicated the diagnoses of high blood pressure, diabetes (a long-term condition in which the body has trouble controlling blood sugar and using it for energy), and depression. During an observation on 10/16/24, at 11:55 a.m. Resident R1 was lying in the bed covered up. There were 12 -15 flies noted to be flying about her arms, face, blanket, and bed. Fall mat (a pad on the floor to soften falls) was covered in dry sticky debris, the floor was dirty with the same dry, sticky debris. There were flies around the garbage can. When spoken to and Resident R1 moved in the bed five or six flies flew off the blanket about the bed area. During an interview on 10/16/24, at 11:55 a.m., Licensed Practical Nurse (LPN) Employee E1 confirmed Resident R1's appearance, the flies, and the dirty floor mat, and floor. Review of the admission record indicated Resident R2 was admitted to the facility on [DATE]. Review of Resident R2's MDS dated [DATE], indicated the diagnoses of quadriplegia (a symptom of paralysis that affects all of a person ' s limbs and body from the neck down), anxiety, and depression. During an observation on 10/16/24, at 11:58 a.m. Resident R2 was lying in her bed sideways. Three flies were noted around her head, on her feet, and calves. The floor was sticky with debris. Page 1 of 3 395695 395695 10/17/2024 Greenery Center for Rehab and Nursing 2200 Hill Church-Houston Road Canonsburg, PA 15317

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few During an interview on 10/16/24, at 11:58 a.m., LPN Employee E1 confirmed Resident R2's appearance, the flies, and the dirty floor. During an interview on 10/16/24, at 12:05 p.m., the Nursing Home Administrator confirmed the appearance of Residents R1 and R2, the uncleanliness of their room, and that the facility failed to provide a clean, safe, comfortable, and homelike environment for two of four residents (Resident R1 and R2). 28 Pa. Code 201.18(b)(3)(e)(2) Management. 28 Pa code 211.12(d)(1) Nursing services. 395695 Page 2 of 3 395695 10/17/2024 Greenery Center for Rehab and Nursing 2200 Hill Church-Houston Road Canonsburg, PA 15317

F 0623 Level of Harm - Potential for minimal harm Residents Affected - Many Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. Based on a review of federal regulation and staff interview, it was determined that the facility failed to provide transfer notices to representatives of the Office of the Long-Term Care Ombudsman Division for four of 10 months (July, August, September, and October 2024). Findings include: Review of Title 42 Code of Federal Regulations §483.15(c)(3) Notice Before Transfer: Before a facility transfers or discharges a resident, the facility must(i) Notify the resident and the resident's representative(s) of the transfer or discharge and the reasons for the move in writing and in a language and manner they understand. The facility must send a copy of the notice to a representative of the Office of the State Long-Term Care Ombudsman. Federal Regulations further define emergency transfers as, When a resident is temporarily transferred on an emergency basis to an acute care facility, this type of transfer is considered to be a facility-initiated transfer. During an interview on 10/17/24, at 11:00 a.m., the Nursing Home Administrator confirmed the facility failed to provide transfer notices to representatives of the Office of the Long-Term Care Ombudsman Division since 6/12/24. 28 Pa. Code 201.18(b)(3)(e)(2) Management. 395695 Page 3 of 3