Inspection·May 16, 2024

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 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 maintain a clean, homelike environment on two of two nursing units ([NAME] Lane and Garden Lane) and failed to provide a homelike environment for seven of 21 residents of the Garden Lane nursing unit (Residents R24, R4, R22, R34, R25, R16 and R17). Findings include: Review of the facility policy Homelike Environment, last reviewed on 1/4/24, indicated that the facility will ensure that residents are provided with a safe, clean, comfortable, homelike environment and encouraged to use their personal belongings. During an observation on 5/14/24, from 6:32 a.m., through 7:20 a.m., the following was identified: -The main resident lounge located on [NAME] Lane nursing unit had six wheelchairs, a Hoyer lift and a floor scale which did not allow access for resident use. -The dining room at the end of [NAME] hall had a broken baseboard heating unit allowing for sharp edges to be protruding. -The dining room of the Garden Lane nursing unit had two wheelchairs that were marked with a tag to lean 4/21/24, with debris and the large w/c had broken arm rests. A closet with personal items(shave cream, razors, mouthwash) was open and had items on the floor and was accessible to residents. -The emergency exit near therapy room had six wheelchairs at exit then six wheelchairs in hall to the outer exit blocking emergency doors. During an interview on 5/14/24, at 7:22 a.m., the Nursing Home Administrator(NHA) confirmed that the facility failed to maintain a clean, homelike environment on two of two nursing units ([NAME] Lane and Garden Lane). During a observation on 5/14/24, from 9:45 a.m., through 10:32 a.m., the following was identified: -Resident R24's wall behind dresser, by her closet, behind her bed and behind the night stand all has areas with broken plastered walls. -Residents R4 and R22 had broken plaster behind beds with baseboard heater unit broken, the (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: 395698 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 395698 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/16/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Meadowcrest Rehabilitation & Healthcare Center 1200 Braun Road Bethel Park, PA 15102 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)