Health inspection·July 15, 2024

F 0557 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. Based on a review of facility policy, resident medical records, facility provided documents, staff statements and staff interviews, it was determined that the facility failed to provide a dignified living experience for one of three residents (Resident R4). Findings include: A review of facility Resident Rights policy dated 12/13/23, indicated that the residents have the right to a dignified existence, self determination, communication with access to persons and services within and outside the facility. A review of facility grievance form dated 5/20/24, revealed that Resident R4 filed a grievance on 5/18/24, Licensed Practical Nurse (LPN) E1 called the resident by her non preferred name. Review of a handwritten employee statement submitted on 5/18/24, by LPN Employee E1 confirmed that she had called the resident by her non preferred name. LPN Employee E1's statement indicated that LPN Employee E1 and Resident R4 were discussing a treatment for the resident when LPN Employee E1 stated she said ***** (resident's non preferred name) I have to go look at the computer. The resident became very confrontational and stated My name is **** (Resident's preferred name). LPN Employee E1 stated ***** was the name in the computer. A review of Resident R4 computerized medical record revealed that the resident's proper name ***** is listed on her medical record. Next to that name is quotation marks is listed **** the resident's preferred name. During an interview on 7/15/24, at 11:15 am Nursing Home Administrator confirmed that LPN Employee E1 confirmed in her statement that she failed to call Resident R4 by the resident's preferred name that was listed in the resident's medical record which created a non dignified living experience for the resident. PA Code: 211.29(a) Resident rights. Page 1 of 2 395705 395705 07/15/2024 Hempfield Manor 1118 Woodward Drive Greensburg, PA 15601

F 0610 Respond appropriately to all alleged violations. Level of Harm - Minimal harm or potential for actual harm Based on a review of facility policies, documents and staff interviews it was determined that the facility failed to conduct a through investigation three of three allegations of possible abuse and neglect. (5/20/24, 6/11/24, and 6/26/24) Residents Affected - Some Findings include: A review of facility Abuse, Neglect, Exploitation and Misappropriation of Resident Property policy date 12/23/23, revealed that abuse, neglect, exploitation and misappropriation of resident property will not be tolerated. An investigation of the allegations will be conducted. A review of grievance form dated 5/20/24. revealed Resident R4 alleged that Licensed Practical Nurse (LPN)Employee E1 refused to provide treatment on 5/18/24. A statement written date 5/18/24, by LPN Employee E1 confirmed that she refused to complete the treatment as she was unaware of the physician order. A review of Resident R4's May Electronic Treatment Administration Record (ETAR) revealed that LPN Employee E1 signed off on completing the treatment on 5/16/24, and 5/17/24. A review of grievance form dated 6/11/24, Resident R5 alleged that a staff member was bullying her and refused to complete her care needs. A review of grievance form date 6/26/24, Resident R5 alleged that staff are haters and refused to engage in conversation with the resident which as the resident stated made her feel like a second class citizen. During an interview on 7/9/24, the Nursing Home Administrator confirmed that the facility failed to complete a through investigation including the possible identification of alleged perpetrators and report to regulatory agencies for the incidents of 5/20/24, 6/11/24, and 6/26/24 as required. PA Code: 201.18(e)(1) Management. 395705 Page 2 of 2