Inspection·February 20, 2025

F 0557 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 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 policies,documents, observations and staff interviews it was determined that the facility failed to provide a dignified dining experience on 2/19/25, during the lunch meal service to four of seven residents. (Resident R1, R2, R3, and R4). Findings include: A review of facility Dignity policy dated 9/25/24, indicated that residents are treated with dignity and respect at all times. During a review of facility document Residents with staff feed printed on 2/19/25, it was revealed that Resident R1 and R2 required staff to feed the resident. During an observation on 2/19/25, at 12:35 pm it was revealed that Resident R1 was laying in bed being feed by a Nursing Assistant (NA) that was standing over her at the bedside. During an interview on 2/19/25, at 12:39 Registered Dietitian (RD) Employee E1 confirmed that the NA was standing over Resident R1 while she was feeding the resident which failed to provide a dignified dining experience for the resident. During an observation at of tray delivery on 2/19/25, it was observed that the trays arrived on the nursing unit at 12:20 pm at 12:30 pm Resident R 3 was standing at the door of his room asking when he was going to receive his meal tray. He confirmed that his roommate received his meal tray a long time ago. Further observation revealed that Resident R4 had not received her meal tray and her roommate had received her meal. During an observation of meal tray service on 2/19/25, at 12:35 pm during the lunch meal service it was determined that the facility failed to properly place meal trays into the tray delivery cart to make certain that residents roomed together received their meals at the same time. During an interview on 2/19/25, at 12:40 pm RD Employee E1 confirmed that the facility failed to deliver Resident R3 and R4's meal trays on the correct delivery cart resulting in a delay of their meal tray delivery and failed to provide a dignified dining experience to Resident R3 and R4. During an observation on 2/19/25, at 12:50 pm it was revealed that Resident R2 was laying in bed and being feed by a NA that was standing over the resident while the resident was being fed. During an interview on 2/19/25, at 12:55 Registered Nurse Manager Employee E2 confirmed that by (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 5 Event ID: 395732 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 395732 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/20/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Heritage Care Center 5701 Phillips Avenue Pittsburgh, PA 15217 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)