Health inspection·April 3, 2025

F 0550 feel like it. Level of Harm - Minimal harm or potential for actual harm Review of the clinical record revealed Resident R2 was originally admitted to the facility on [DATE]. Residents Affected - Some Review of the MDS dated [DATE], included diagnoses of coronary artery disease (reduced blood flow to the heart muscle) and heart failure (heart cannot keep up with its workload). Review of Section C: Cognitive Patterns, indicated, intact cognition with a BIMS Score of 13. Review of Section GG: 0130 Functional Abilities, indicated Resident R2 was dependent for toileting hygiene. During an interview with Resident R2 on 4/3/25, at 11:14 a.m. the following was stated: You often wait when you use the call light to get changed. The staff come in and turn of the light and leave, they say they will be back and maybe if you're lucky they come in a half hour, if you're not lucky you can wait hours. I have sat in my poop for a half hour up to two hours. Talk to my roommate, its worse for her, she can tell you how it is. Review of the clinical record revealed Resident R3 was originally admitted to the facility on [DATE]. Review of the MDS dated [DATE], included diagnoses of nondisplaced fracture of anterior wall of right acetabulum (broken right hip) and anemia (low red blood cells). Review of Section C: Cognitive Patterns, indicated, intact cognition with a BIMS Score of 13. Review of Section GG: 0130 Functional Abilities, indicated Resident R3 was dependent for toileting hygiene. During an interview with Resident R3 on 4/3/25, at 11:30 a.m. the following was stated: You wait when you use the call light for everything including getting changed. The staff come in and turn off the light and leave, they say your aide or nurse is on break, they will tell them to come when their break is over. They said I use my call light too much; I tell them I have a broken hip I can't do things for myself. The longest I sat in poop and pee in my diaper was three and a half hours. Review of the clinical record revealed Resident R4 was originally admitted to the facility on [DATE]. Review of the MDS dated [DATE], included diagnoses of coronary artery disease (reduced blood flow to the heart muscle) renal insufficiency (kidneys aren't function properly) and hypertension (high blood pressure). Review of Section C: Cognitive Patterns, indicated, moderately impaired cognition with a BIMS Score of 9. Review of Section GG: 0130 Functional Abilities, indicated Resident R4 was substantial/maximal assistance for toileting hygiene. During an interview with Resident R4 on 4/3/25, at 11:40 a.m. the following was stated: Just this past week I sat in my bowel movement close to an hour if not a bit longer. It happens time to time here. I have a catheter, so peeing is not a problem, but the other is. I don't use my light much, at night they turn it off and say they will be back, I wait and then press the button again. Review of the clinical record revealed Resident R5 was readmitted to the facility on [DATE]. Review of the MDS dated [DATE], included diagnoses of anemia (low red blood cells) and heart failure (heart cannot keep up with its workload). Review of Section C: Cognitive Patterns, indicated, intact cognition with a BIMS Score of 14. Review of Section GG: 0130 Functional Abilities, indicated (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395731 If continuation sheet Page 2 of 5 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 395731 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/03/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE South Hills Post Acute 60 Highland 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 0550 Resident R5 was dependent for toileting hygiene. Level of Harm - Minimal harm or potential for actual harm During an interview with Resident R5 on 4/3/25, at 11:00 a.m. the following was stated: They are busy, and you have to wait to get changed. Once in a while I had to wait more than a half hour when I move my bowels to be changed. They will come in and turn off the light and will come back when they can, they are busy. Residents Affected - Some During an interview on 4/3/25, at approximately 1:10 p.m. the Nursing Home Administrator and the Director of Nursing confirmed the facility failed to provide an environment and care to promote dignity for each resident's quality of life for five of fifteen residents. 28 Pa. Code 211.12 (a)(c)(d)(4)(5) Nursing Services 28 Pa. Code 201.29 (j) Resident Rights FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395731 If continuation sheet Page 3 of 5 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 395731 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/03/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE South Hills Post Acute 60 Highland 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 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. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of facility policy, resident interviews, observation, and staff interviews, it was determined that the facility failed to ensure sufficient staffing to meet residents care needs for five of fifteen residents who require care (Residents R1, R2, R3, R4 and R5). Findings include: Review of the facility policy, Answering the Call Light dated 11/1/24, indicated the facility will listen to the resident's request, do what the resident asks if permitted, if you promised the resident you will return with an item or information, do so promptly. If assistance is needed when you enter the room, summon help by using the call signal. Review of the clinical record revealed Resident R1 was originally admitted to the facility on [DATE]. Review of the MDS dated [DATE], Review of Section I, did not have diagnosis listed. The admission record did included diagnoses of nontraumatic intracerebral hemorrhage in hemisphere, subcortical (subtype of a stroke) and ambulatory dysfunction (difficulty in walking). Review of Section C: Cognitive Patterns, indicated, intact cognition with a BIMS Score of 15. Review of Section G: indicated Resident R1 required one-person physical assist for bed mobility and no documentation for toilet use. During an interview with Resident R1 on 4/3/25, at 11:54 a.m. the following was stated: On the weekend I laid in poop from 6 p.m. to 2 a.m . I used the call bell a couple of times over these hours so I could get my brief changed. The first time the staff came in and turned off the light and said, it isn't time. The second time staff came in turned off the light and said, we will get here when we feel like it. They need more staff or staff who will do their job. Review of the clinical record revealed Resident R2 was originally admitted to the facility on [DATE]. Review of the MDS dated [DATE], included diagnoses of coronary artery disease (reduced blood flow to the heart muscle) and heart failure (heart cannot keep up with its workload). Review of Section C: Cognitive Patterns, indicated, intact cognition with a BIMS Score of 13. Review of Section GG: 0130 Functional Abilities, indicated Resident R2 was dependent for toileting hygiene. During an interview with Resident R2 on 4/3/25, at 11:14 a.m. the following was stated: You often wait when you use the call light to get changed. The staff come in and turn of the light and leave, they say they will be back and maybe if you're lucky they come in a half hour, if you're not lucky you can wait hours. I have sat in my poop for a half hour up to two hours. Talk to my roommate, its worse for her, she can tell you how it is. They need more help here. Review of the clinical record revealed Resident R3 was originally admitted to the facility on [DATE]. Review of the MDS dated [DATE], included diagnoses of nondisplaced fracture of anterior wall of right acetabulum (broken right hip) and anemia (low red blood cells). Review of Section C: Cognitive (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395731 If continuation sheet Page 4 of 5 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 395731 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/03/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE South Hills Post Acute 60 Highland 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 0725 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Patterns, indicated, intact cognition with a BIMS Score of 13. Review of Section GG: 0130 Functional Abilities, indicated Resident R3 was dependent for toileting hygiene. During an interview with Resident R3 on 4/3/25, at 11:30 a.m. the following was stated: You wait when you use the call light for everything including getting changed. The staff come in and turn off the light and leave, they say your aide or nurse is on break, they will tell them to come when their break is over. They said I use my call light too much; I tell them I have a broken hip I can't do things for myself. The longest I sat in poop and pee in my diaper was three and a half hours. Some staff doesn't want to help and maybe some are too busy. Review of the clinical record revealed Resident R4 was originally admitted to the facility on [DATE]. Review of the MDS dated [DATE], included diagnoses of coronary artery disease (reduced blood flow to the heart muscle) renal insufficiency (kidneys aren't function properly) and hypertension (high blood pressure). Review of Section C: Cognitive Patterns, indicated, moderately impaired cognition with a BIMS Score of 9. Review of Section GG: 0130 Functional Abilities, indicated Resident R4 was substantial/maximal assistance for toileting hygiene. During an interview with Resident R4 on 4/3/25, at 11:40 a.m. the following was stated: Just this past week I sat in my bowel movement close to an hour if not a bit longer. It happens time to time here. I have a catheter, so peeing is not a problem, but the other is. I don't use my light much, at night they turn it off and say they will be back, I wait and then press the button again. Review of the clinical record revealed Resident R5 was readmitted to the facility on [DATE]. Review of the MDS dated [DATE], included diagnoses of anemia (low red blood cells) and heart failure (heart cannot keep up with its workload). Review of Section C: Cognitive Patterns, indicated, intact cognition with a BIMS Score of 14. Review of Section GG: 0130 Functional Abilities, indicated Resident R5 was dependent for toileting hygiene. During an interview with Resident R5 on 4/3/25, at 11:00 a.m. the following was stated: They are busy, and you have to wait to get changed. Once in a while I had to wait more than a half hour when I move my bowels to be changed. They will come in and turn off the light and will come back when they can, they are busy. During an interview on 4/3/25, at approximately 1:10 p.m. the Nursing Home Administrator and the Director of Nursing confirmed the facility failed to ensure sufficient staffing to meet resident need for each resident's quality of care for five of fifteen residents. 28 Pa. Code 201.14(a) Responsibility of licensee. 28 Pa. Code 211.12(d)(1)(3)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395731 If continuation sheet Page 5 of 5