Health inspection·February 19, 2024

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 facility documents, resident observations, resident and staff 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 16 of 25 residents (Resident R1, R2, R3, R4, R5, R6, R7, R8, R9, R10, R11, R12, R13, R14, R15, and R16). Findings Include: Review of the Facility Assessment dated 1/2/24, indicated the facility will provide necessary person-centered care and services. During an observation on 2/17/24, at 12:13 p.m., Resident R1 had unkempt, greasy appearing hair. Resident R1 was eating lunch, still wearing a gown. During an interview and observation on 2/17/24, at 12:16 p.m., when asked if there were enough nursing staff to care for the residents, Resident R2 stated that she had no concerns. Observation at this time revealed Resident R2 to be still wearing a gown while eating lunch, slumped to her left side, leaning against her enabler bar. Resident R2's meal cover was still on her food, and she appeared to be struggling to open her food containers. During an observation on 2/17/24, at 12:18 p.m., Resident R3 was wearing a brief with a gown only around her neck, hanging off the side of the bed. During an interview on 2/17/24, at 12:21 p.m., Resident R4 was observed with her tray on the overbed table, not being assisted to eat. Review of this residents Minimum Data Set (MDS - periodic assessment of resident care needs) dated 12/20/23, indicated Resident R4 is dependent on staff for eating assistance. During an observation on 2/17/24, at 12:24 p.m., Resident R5 was observed to be eating lunch in a gown. During an observation on 2/17/24, at 1:15 p.m., Resident R6 and Resident R7 were observed in their room, both in gowns, eating lunch. During an observation on 2/17/24, at 1:16 p.m., Resident R8 was observed with unkempt hair. During an interview on 2/17/24, at 1:18 p.m., when asked if there were enough nursing staff to care Page 1 of 3 395719 395719 02/19/2024 Riverside Health & Rehab Center 100 8th Street McKeesport, PA 15132

F 0725 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some for the residents, Resident R9 stated, No, not enough aides. Resident R9 stated her biggest concern with the facility was not having enough people. During an interview on 2/17/24, at 1:26 p.m., when asked if there were enough nursing staff to care for the residents Resident R10 stated, There isn't enough of them. Sometimes they put my pills on the table and leave. They try to avoid work. I would never send anyone here. During a group interview of Resident R11, Resident R12, and Resident R13 on 2/17/24, at 1:30 p.m., when asked if there were enough nursing staff to care for the residents, Resident R11 stated, There aren't enough here. Resident R12 stated, There isn't. It always takes a long time (in reference to call light response). There isn't enough. Resident R13 stated These poor girls who work here. When asked about showers, Resident R13 stated, It depends on how much help there is. I would love to have my hair washed more often. Confidential staff interviews conducted during the survey about sufficient facility staffing indicated the following: Employee E1 stated, Staffing is always a problem. They bring in people to have them in the building (staff member utilized finger quotations), but they actually don't help. Employee E2 stated, I have more than the state ratio today. Employee E3 stated, For me, it's the mandations. I don't want mandated. Employee E4 stated, It's bad. We have to share nurses and nurse aides with the MIU (Memory-impaired unit). Sometimes the MIU only has one aide, and no nurse if she's passing meds on another hall. It's not safe to have 19 residents with dementia and only one person. Employee E5 stated, Staff don't show up. We have to call the DON (Director of Nursing) to ask if the on-call nurse can be called in. But they don't always bring them in. We get told, It is what it is. A review of grievances from January 2024, through February 2024, revealed the following: 1/19/24: Resident R14 reported that he sat in his own urine for four hours on 1/18/24. Resident stated that he yelled out for staff and had the call bell on. Resident reported that he was unable to get staff for 2.5 hours. 1/29/24: Resident R15 stated he was left in a soiled brief (exact dates unknown) with a delayed response to his call bell light. 1/30/24: Family member for Resident R16 reported that on 1/29/24, her father was already out of bed and did not receive morning care. Staff need to provide him with a drink throughout the day. During an interview on 2/17/24, at 3:15 p.m. the Director of Nursing was made aware that the facility failed to have sufficient nursing staff to provide nursing and related services to 16 of 25 residents. 28 Pa. Code: 201.14(a) Responsibility of licensee. 395719 Page 2 of 3 395719 02/19/2024 Riverside Health & Rehab Center 100 8th Street McKeesport, PA 15132

F 0725 28 Pa. Code: 201.18(e)(6) Management. Level of Harm - Minimal harm or potential for actual harm 28 Pa. Code: 201.20(a) Staff development. 28 Pa. Code: 211.12(a) (c)(d)(1)(2)(3)(4)(5) Nursing services. Residents Affected - Some 395719 Page 3 of 3