Health inspection·December 19, 2024

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations and resident and staff interviews, it was it was determined that the facility failed to make certain that residents were provided appropriate treatment and care for five of ten residents (Resident R1, R2, R3, R4, and R5). Residents Affected - Some Findings include: Review of Resident R1's admission record indicated he was admitted to the facility on [DATE]. Review of the Minimum Data Set (MDS, periodic assessment of resident care needs) dated 11/5/24, included diagnoses of heart failure (a progressive heart disease that affects pumping action of the heart muscles), high blood pressure, and edema (swelling caused by too much fluid trapped in the body's tissues). Review of an active physician order dated 9/6/24, indicated Resident R1 should have ACE wraps (stretchable elastic bandages) removed from both legs at the hour of sleep. No active order was noted to place ACE wraps on. During an observation on 12/11/24, at approximately 11:35 a.m. Resident R1 had the ACE wraps on both legs applied in the direction from the toes to the knees, and then reversing from the knees to the toes. Review of Resident R2's admission record indicated she was admitted to the facility on [DATE]. Review of the MDS dated [DATE], included diagnoses of heart failure. high blood pressure, and arthritis (inflammation of one or more joints, causing pain and stiffness). Review of an active physician order dated 7/20/24, indicated Resident R2 should have ACE wraps applied to both legs from toes to knees, on in the morning prior to getting out of bed, and remove nightly. During an observation on 12/11/24, at approximately 2:07 p.m. Resident R2 had the ACE wrap on her left leg applied in the direction from the toes to the knees, and then reversing from the knees to the toes. Review of Resident R3's admission record indicated she was admitted to the facility on [DATE]. Review of the MDS dated [DATE], included high blood pressure, chronic kidney disease (gradual loss (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 8 Event ID: 395743 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 395743 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/19/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Carnegie Park Post Acute 1848 Greentree Road Pittsburgh, PA 15220 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)