Inspection·April 30, 2025

F 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Review of progress notes failed to reveal a notification to the provider of Resident R41 feeling unwell all day and of excessive feelings of cold. Review of the clinical record indicated Resident R100 was admitted to the facility on [DATE]. Review of Resident R100's MDS dated [DATE], included diagnoses of schizophrenia (a mental disorder characterized by delusions, hallucinations, disorganized speech and behavior) and paraplegia (paralysis of the legs and lower body, typically caused by spinal injury or disease). Review of the most recent BIMS assessment completed on 11/26/24, revealed a BIMS score of 05. Review of Resident R100's demographic profile indicated her sister as her emergency contact, legal guardian, and responsible party. Review of a physician order dated 2/10/25, indicated Resident R100 had a new order for a pureed diet. Resident R100 had previously had a mechanical soft diet. Review of a progress note dated 2/12/25, at 9:07 p.m. indicated, Residents sisters were in throughout the day. Sister has many questions concerning what resident ' s medications, when started, and why she is taking them. Questioning reason for changing to a pureed diet and why this sister did not receive a phone call to inform her of the change. Review of the clinical record indicates resident R143 was admitted to the facility on [DATE]. Review of the facility diagnosis list included diagnoses of chronic obstructive pulmonary disease (COPD, a group of progressive lung disorders characterized by increasing breathlessness), lung cancer, and dementia (a group of symptoms that affects memory, thinking and interferes with daily life) without behavioral disturbance. Review of Resident R143's demographic profile indicated her granddaughter as her emergency contact, legal guardian, and responsible party. Review of a physician order dated 4/8/25, indicated, Send to [hospital emergency room] for evaluation due to AMS (altered mental status), wandering, refusing to take medications. Review of a progress note dated 4/8/25, at 8:49 a.m. indicated, As this writer approached the nurses station as the resident was going out the side door, the doctor came. She walked up to the physician, became verbally and physically aggressive. at that time, the doctor stated to send the patient to the emergency department as she is exhibiting behavior trying to exit the building and for her safety she needed to be in a locked or protected unit. He ordered her to go to [hospital] as he said that [hospital] has a good psych department. Review of a progress note dated 4/8/25, at 5:14 p.m. indicated, [hospital] called again and this writer spoke with another nurse in re: resident reason for being sent to their hospital. I explained and once again, the nurse stated you have to fill out a 302 paper and she is a resident at your facility and I ' m calling the Health Department and hung up. Review of family submitted information dated 4/9/25, indicated that the faciltiy transferred Resident R143 to the hospital without family notification. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395698 If continuation sheet Page 2 of 3 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 04/30/2025 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)

F 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Review of Resident R143's progress notes failed to reveal a notification to Resident R143's emergency contact regarding the transfer to the hospital. During an interview on 4/30/25, at approximately 12:45 p.m. the Nursing Home Administrator and the Director of Nursing confirmed the facility failed to notify the resident representative and/or medical provider of a change in condition or care for three of ten 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: 395698 If continuation sheet Page 3 of 3