Health inspection·November 2, 2023

F 0658 Ensure services provided by the nursing facility meet professional standards of quality. Level of Harm - Minimal harm or potential for actual harm Based on staff interview, record review, and state scope of practice, it was determined that the facility failed to follow professional standards of practice for to one of six residents reviewed (Resident R57). Residents Affected - Few Findings include: Review of the facility's Registered Nurse Job Description, last reviewed 7/1/23, indicated the purpose of this position is to provide care to the residents to ensure that the highest quality of care is maintained at all times. Review of Resident R57's clinical record indicated an admission of 11/30/21, with diagnoses that included depression, muscle weakness, and hemiplegia (paralysis of one side of the body) and hemiparesis (weakness of one entire side of the body) following cerebral infarction (occurs when poor blood flow to the brain causes cell death) affecting right dominant side. Resident R57's Minimum Data Set (MDS) assessments (mandated assessments of a resident's abilities and care needs) dated 8/22/23, indicated the diagnoses were current. Review of Resident R57's physician order dated 10/2/23, indicated to administer one tablet of 60 milligrams of Cymbalta (medication used to treat depression) once a day in the morning (7:00 a.m. to 11:00 a.m.). During an observation on 11/1/23, at 8:46 a.m. Registered Nurse (RN) Employee E3 provided Resident R57 with his morning medications and walked out of the resident's room and failed to watch the resident swallow his medication. Resident R57 spit out a pill into his empty milk carton that was left on his bedside tray. RN, Employee E3 was notified that Resident R57 spit out a pill into his milk carton. RN, Employee E3 went back into the resident's room and stated I left the room too early. RN, Employee E3 indicated the pill Resident R57 spit out was the resident's Cymbalta. During an interview on 11/1/23, am 9:36 a.m., Registered Nurse (RN) Employee E13 stated nurses must stay with the resident and observe them swallow their medications to ensure they are taken. During an interview on 11/2/23, at 12:33 p.m. the Director of Nursing and Nursing Home Administrator (NHA) confirmed the facility failed to follow professional standards of practice for to one of six residents reviewed (Resident R57). 28 Pa. Code 211.12(d)(1)(5)Nursing services FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395773 If continuation sheet Page 2 of 14 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 395773 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/02/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE East End Health & Rehab Center 745 North Highland Avenue Pittsburgh, PA 15206 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 0730 Observe each nurse aide's job performance and give regular training. Level of Harm - Minimal harm or potential for actual harm Based on review of facility policy, personnel files and staff interview it was determined that the facility failed to complete annual nurse aid employee evaluations for one of four sampled records (Nurse aide (NA) Employee E8). Residents Affected - Few Findings include: The facility assessment dated 10/3/23, indicated that required in-service training for nurse aides must be sufficient to ensure the continuing competence of nurse aides, but must be no less than 12 hours per year, and address areas of weakness as determined in nurse aide's performance review. Review of NA Employee E8 personnel record indicated she was hired on 8/17/16. Review of NA Employee E8 personnel record did not include an annual performance evaluation for 2023. During an interview on 11/01/23, at 12:59 p.m. the Director of Human Resources/ Accounts Payable Employee E1 confirmed that the facility failed to complete annual nurse aid employee evaluations as required. 28 Pa Code: 201.20 (a)(b)(c)(d) Staff development. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395773 If continuation sheet Page 3 of 14 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 395773 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/02/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE East End Health & Rehab Center 745 North Highland Avenue Pittsburgh, PA 15206 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 0756 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based upon clinical record review, and staff interview, it was determined that the facility failed to ensure that any irregularities submitted in the medication regiment reviews (MRR) by pharmacy were acted upon for one out of two residents (Resident R10). Findings include: Review of Residents R10's admission record indicated he was originally admitted on [DATE], and readmitted on [DATE], with diagnoses that included high blood pressure, heart failure(a progressive heart disease that affects pumping action of the heart muscles), and coronary artery disease (a common term for the buildup of plaque in the heart ' s arteries that could lead to heart attack.) Review of Residents R10's MDS assessment dated [DATE], indicated that the diagnoses were current upon review. Review of Residents R10's care plans dated 9/17/23, indicated that Resident R10 had an alteration in his cardiovascular status due to tachycardia (heart rhythm disorder with heartbeats faster than usual, greater than 100 beats per minute), history of myocardial infarction (damage to the heart muscle caused by a loss of blood supply due to blocks in the arteries), history of cardiogenic shock (condition where the heart is unable to pump enough oxygen-rich blood to the body organs. It causes chest pain, pain or discomfort in left arm, trouble breathing, sweating, and fast or irregular heart beat), atrial fibrillation (irregular heartbeat), cardiomyopathy (disease of the heart muscle which makes it difficult for the heart to pump blood to other parts of the body), and complete heart block (an abnormal rhythm where the heart beats too slowly), and hypertension. Interventions included to administer all cardiac medications per physician order. Review of Resident R10's medication regimen review for 7/12/23, stated the resident receives ticagrelor used along with low-dose aspirin to help prevent heart attack and stroke in people with a history of heart disease, stroke, or at increased risk for heart disease or stroke) without daily aspirin (used to prevent blood clots and risks of heart attack and strokes. Ticagrelor prescribing information states concomitant use of aspirin (75 to 100 mg daily) is necessary. The recommendation was signed and accepted by the physician on 8/18/23, and 81mg of aspirin was ordered daily. A further review indicated the Director of Nursing signed the MMR on 10/2/23, 45 days after the physician accepted the recommendations and ordered Resident R13 to start 81mg of aspirin daily. Review of Resident R10's physician order dated 7/1/23, indicated to give one tablet of 90 mg of ticagrelor two times a day related to myocardial infarction. Review of Residents R10's physician orders from 7/12/23, through 10/2/23, failed to include an order to administer 81 mg of aspirin daily as ordered. During an interview on 11/2/23, at 9:36 a.m. Registered Nurse (RN) Employee E13 confirmed the facility failed to ensure that any recommendations and orders that were submitted in the medication regiment reviews by pharmacy and the physician were acted upon for Resident R10 as required. 28 Pa Code: 201.14 (a ) Responsibility of licensee (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395773 If continuation sheet Page 4 of 14 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 395773 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/02/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE East End Health & Rehab Center 745 North Highland Avenue Pittsburgh, PA 15206 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 0756 28 Pa. Code 211.5(f) Clinical records Level of Harm - Minimal harm or potential for actual harm 28 Pa. Code 211.12(c) Nursing services 28 Pa. Code 211.12(d)(1)(2)(5) Nursing services Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395773 If continuation sheet Page 5 of 14 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 395773 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/02/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE East End Health & Rehab Center 745 North Highland Avenue Pittsburgh, PA 15206 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 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Based on a review of facility policy, resident clinical record review, medication review, and staff interview it was determined the facility failed to label open medications with a date on one of three medication carts (Third floor Medication B-Cart). Findings include: Review of the facility policy Storage and Expiration Dating of Medications, Biologicals last reviewed on 8/7/23, indicated that the facility staff should record the date opened on the primary medication container. During an observation on 10/30/23, at 11:38 a.m., of the Third floor Medication B-cart, the following medications were opened and undated. -B-12 1000mcg -Acetaminophen 500mg -Geri-Kot 8.6 mg -Vitamin D3 125mcg -Fish Oil Soft Gel 1000mg During an interview on 10/30/23, at 11:42 a.m., Licensed Practical Nurse (LPN) Employee E2 confirmed the facility failed to make certain over the counter medications were dated once opened. During an interview on 10/30/23, at 2:20 p.m., the Director of Nursing (DON) confirmed that the facility failed to ensure all medications were stored and labeled properly in one of three medications carts as required. 28 Pa. Code: 211.9(a)(1)(h)(k)(l)(1) Pharmacy services. 28 Pa. Code:211.12(d)(1)(2)(3)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395773 If continuation sheet Page 6 of 14 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 395773 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/02/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE East End Health & Rehab Center 745 North Highland Avenue Pittsburgh, PA 15206 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 0801 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. Based on review of facility documents and staff inteviews, it was determined that the facility failed to employ staff with the required skills and competencies to carry out the daily functions of the Dietary Department for three out of 12 months (August, September and October 2023). Findings include: A review of facility document Director of Dining Services Job Description indicated that a qualified candidate must have a B.S. degree in Dietetics or Foods and Nutrition, or certification as a Dietetic Technician. If a Dietetic Technician, must work under the direction of a Registered Dietitian per State requirement. During an interview on 10/31/23 at 10:56 a.m. Regional Registered Dietitian(RD) Employee E11 confirmed the Dietary Director started August 2023, he has experience in kitchen but not in nursing facilities and did not possess a Certified Dietary Manager certificate. A review of the Director of Dietary Services Employee E12 Personnel File revealed that Director of Dining Employee E12 did not possess a Certified Dietary Manager from the certifying board for dietary managers. During an interview on 10/31/23 at 11:56 a.m. Regional Registered Dietitian(RD) Employee E11 confirmed the Dietary Director Employee E11 failed to meet the state agency requirements for a food service manager. 28 Pa. Code 211.6(c)(d)Dietary services FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395773 If continuation sheet Page 7 of 14 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 395773 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/02/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE East End Health & Rehab Center 745 North Highland Avenue Pittsburgh, PA 15206 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 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on a review of facility policy, observations and staff interview, it was determined that the facility failed to properly label food products in the dry storage area and maintain sanitary conditions in the dish room and kitchen which created the potential for cross contamination in the designated main kitchen (Main kitchen). Findings include: A review of the facility Kitchen Sanitation policy dated 7/1/23 , indicated food and nutriton staff will maintain the sanitation of the kitchen. During an observation of the main designated kitchen on 10/30/23, at 8:50 a.m. the following was observed: - 3 bags of cheerios- no label - 2 bags of raisin bran cereal-no label - 1 bag of rice krispies- no label - 1 bag of corn flakes-no label During an observation of the main designated kitchen on 10/30/23, at 9:15 a.m. the following was observed: -Wall fan above clean side of dishwasher, brown debris -Ice machine in the main kitchen and in the dish room contained a brown substances inside the machine During an interview on 10/31/23 at 1:03 p.m. Maintenance Director Employee E5 confirmed the ice machine's were last serviced 4/19/23. During an interview on 10/30/23 at 10:15 a.m., Dietetic Technician Employee E9 confirmed that the facility failed to properly label food products and maintain sanitary conditions which created the potential for food borne illness and cross contamination. 28 Pa. Code: 201.18(b)(1) Management. 28 Pa. Code: 211.6(c) Dietary services. 28 Pa. Code: 201.14(a) Responsibility of licensee. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395773 If continuation sheet Page 8 of 14 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 395773 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/02/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE East End Health & Rehab Center 745 North Highland Avenue Pittsburgh, PA 15206 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 0847 Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of facility documents, resident clinical record and staff interview it was determined that the facility failed to ensure a representative signed a binding arbitration agreement on the behalf of residents lacking capacity to understand the agreement terms for two out of four sampled resident records (Resident R38 and Resident R60). Residents Affected - Few Finding include: The facility Resident rights and facility responsibilities policy dated 7/1/23, indicated the facility policy is to comply with all resident rights. The facility Admissions agreement document dated 7/1/23, indicated that the resident representative to sign any and all documents that are a part of the admissions process to the facility on the resident's behalf. A review of the Resident Assessment Instrument 3.0 User's Manual effective October 2019, indicated that a Brief Interview for Mental Status (BIMS, a screening test that aides in detecting cognitive impairment). The BIMS total score suggests the following distributions: 13-15: cognitively intact 8-12: moderately cognitive impaired 0-7: severe cognitive impairment Review of Resident R38's admission record indicated she was admitted on [DATE], with diagnoses that included fractured pelvis, unspecified dementia(a condition characterized by memory loss and progressive or persistent loss of intellectual functioning), psychotic disturbance (condition involving confused thinking impacting perception of reality), hypertension(a condition impacting blood circulation through the heart related to poor pressure), and hyperlipidemia(elevated lipid levels within the blood),. Review of Resident R38's MDS assessment (Minimum Data Set assessment: MDS -a periodic assessment of resident care needs) dated 9/22/23, indicated the diagnoses were the most current upon review. Review of Resident R38's MDS assessment Section C0500 (BIMS score) indicated a score of 0-severe cognitive impairment. Review of Resident R38's nurse admission assessment dated [DATE], indicated she had memory impairment, disorientation, and disorganized thinking. Resident R38's cognitive impairment was associated with dementia. Review of Resident R38's care plan dated 9/18/23, indicated she had altered cognitive function related to dementia. Review of Resident R38's admission documentation indicated the arbitration agreement was signed (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395773 If continuation sheet Page 9 of 14 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 395773 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/02/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE East End Health & Rehab Center 745 North Highland Avenue Pittsburgh, PA 15206 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 0847 9/22/23. Level of Harm - Minimal harm or potential for actual harm Review of Resident R38's clinical notes and admission records did not indicate an attempt to ensure a representative signed the binding arbitration agreement on Resident R38's behalf. Residents Affected - Few Review of Resident R60's admission record indicated he was admitted on [DATE], and readmitted on [DATE], with diagnoses that included unspecified dementia, anxiety disorder (a medical condition creating a sense of acute fear, restlessness, and worry), and hypertension. Review of Resident R60's MDS assessment dated [DATE], indicated the diagnoses were current upon review. Review of Resident R60's MDS assessment Section C0500 (BIMS score) indicated a score of 2-severe cognitive impairment. Review of Resident R60's care plan dated 8/19/23, indicated Resident R60 had memory problems due to cognitive loss and dementia. Review of Resident R60's nurse admission assessment dated [DATE], indicated Resident R60 had memory problems due to dementia. Review of Resident R60's clinical notes and admission records did not indicate an attempt to ensure a representative signed the binding arbitration agreement on Resident R60's behalf. During an interview on 10/31/23, at 9:31 a.m. the admission Coordinator Employee E10 confirmed that the facility failed to ensure a representative signed a binding arbitration agreement on the behalf of Residents R38 and Resident R60, each lacking capacity to understand the agreement terms. 28 Pa. Code 201.24 (b) admission Policy 28 Pa. Code 201.14(a) Responsibility of Licensee 28 Pa. Code 201.18(b)(2) Management 28 Pa. Code 201.29(a)(j) Resident Rights FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395773 If continuation sheet Page 10 of 14 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 395773 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/02/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE East End Health & Rehab Center 745 North Highland Avenue Pittsburgh, PA 15206 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 0849 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on a review of facility policy, resident clinical records, and staff interview, it was determined the facility failed to obtain a physician order for hospice services and to ensure the coordination of hospice services with facility services to meet the needs of each resident for end of life care for one of four residents (Resident R13). Findings include: Review of the facility's Hospice Care Policy dated 5/24/23, last reviewed 7/1/23, indicated the facility provides hospice services through collaboration with a Medicare certified hospice agency when ordered by the resident's physician. Review of Resident R13's clinical record indicated the resident was admitted to the facility on [DATE]. Diagnoses included anorexia (abnormal loss of appetite), dementia ( a decline in cognitive abilities that impacts a person's ability to perform everyday activities), and anxiety. Review of Resident R13's admission order from the resident's hospice provider dated 6/24/21, indicated the resident was admitted to their services on 6/24/21. Review of Resident R13's Minimum Data Set assessment (a mandatory review of resident care needs) dated 7/24/23, indicated the resident received hospice services. Review of Resident R13's care plan initiated 9/27/23, indicated the resident has a terminal prognosis and was receiving hospice services. Review of Resident R13's physician order dated 6/28/23, indicated the resident's code status was do not resuscitate, comfort measures only, and no tube feeds. Review of Resident R13's physician orders dated 6/28/23, through 10/31/23, failed to include a physician's order for hospice services. During an interview on 11/1/23, at 11:58 a.m. Licensed Practical Nurse (LPN) Employee E2 confirmed the facility failed to obtain a physician order for hospice services. 28 Pa. Code 211.2(a) Physician services 28 Pa. Code 211.11(d) Resident care plan FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395773 If continuation sheet Page 11 of 14 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 395773 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/02/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE East End Health & Rehab Center 745 North Highland Avenue Pittsburgh, PA 15206 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 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm Based on review of facility policy, observations, and staff interviews, it was determined that the facility failed to complete a Legionella assessment and plan, implement infection control practices to prevent cross contamination during a dressing change for one of three residents (Resident R279) and the facility failed to maintain a clean dryer filter to ensure linens and laundry are processed in accordance with accepted national standards for one of two dryers (Laundry room). Residents Affected - Some Findings include: Review of the facility Legionella Assessment and Prevention Program policy dated 5/4/22, last reviewed 7/1/23, indicated the facility will ensure a Legionella assessment is conducted in accordance wit state and federal requirements for large, complex water systems. It was indicated the Adminstrator will assign a person responsible to complete the required Legionella assessment. Once the assessment is completed, a plan must be developed for areas identified that require a plan. It was also indicated that the facility will conduct annual testing must be performed annually at four water sources which include the resident room sink faucet, one resident shower head, ice machine and one from the kitchen sink faucet. Review of the facility Skin and Wound Care Best Practices policy dated 6/10/22, last reviewed 7/1/23, indicated the purpose of this policy was to provide wound treatment to prevent unavoidable skin complications. Review of the facility's Legionella Assessment and Control Form undated was left blank and not completed. Review of the facility provided Global Analytical & Microbiology report dated 9/13/23, indicated the facility tested for Legionella. A review of the locations samples were taken from failed to include a sample from the facility's ice machine. During an interview on 10/31/23, at 2:18 p.m. the Director of Maintenance Employee E5 confirmed the legionella assessment was not completed, thus the facility does not have a water mangement plan in place. The Director of Maintenance, Employee E5 confirmed the facility failed to test Legionella locations per policy. The facility failed to test the ice machine. During an interview on 10/31/23, at 2:23 p.m., the Nursing Home Administrator confirmed the facility failed to test one of the facility's ice machines for Legionella, and the facility failed to have measures in place to prevent the growth of Legionella and other opportunistic waterborne pathogens in the building water system. Review of Resident R279's clinical record revealed an admission date of 9/30/23. Review of R279's Minimum Data Set (MDS-periodic assessment of resident care needs) dated 10/7/23, included diagnoses of high blood pressure, stroke (Occurs when the supply of blood to the brain is reduced or blocked completely, which prevents brain tissue from getting oxygen and nutrients), and psychotic disorder. Section M: Skin Conditions indicated the resident had one pressure ulcer on the sacrum. Review of Resident R279's physician order dated 9/30/23, indicated to cleanse coccyx with wound (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395773 If continuation sheet Page 12 of 14 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 395773 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/02/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE East End Health & Rehab Center 745 North Highland Avenue Pittsburgh, PA 15206 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 0880 cleanse and apply a foam adhesive dressing every three days. Level of Harm - Minimal harm or potential for actual harm During an observation of Resident R279 dressing change on 10/31/23, at 9:57 a.m. Registered Nurese (RN)Employee E6 failed to place a barrier under the resident's coccyx to prevent cross contamination. The resident had a bowel movement and the nurse failed to clean the resident before she changed the resident's coccyx dressing. Residents Affected - Some During an interview on 10/31/23, at 10:06 a.m. Registered Nurese (RN) Employee E6 confirmed she failed to implement infection control practices to prevent cross contamination during a dressing change for Resident R279. During an interview on 11/1/23, at 11:20 a.m. the Director of Nursing confirmed the facility the facility failed to implement infection control practices to prevent cross contamination during a dressing change for one of three residents. During an observation of the laundry room on 11/2/23, at 10:10 a.m. a thick layer of lint was observed on the filter of the dryer that was not in use. It was written on the dryer to clean the filter after each use. Review of the facility's November Dryer Cleaning Log that was located on the front of the dryer indicated the dryer filter was not cleaned on 11/1/23. It was left blank and not signed off for completion. During an interview on 11/2/23, at 10:16 a.m. Housekeeper Employee E7 stated the dryer filter must be cleaned after each use and must be signed off for completion. During an interview on 11/2/23, at 1:02 p.m. the Director of Maintenance Employee E5 confirmed the facility failed to maintain a clean dryer filters to ensure linens and laundry are processed in accordance with accepted national standards for one of two dryers. 28 Pa. Code 211.10(c)(d) Resident Care Policies 28 Pa. Code 211.12 (d)(2) Nursing Services 28 Pa. Code 211.12(d)(1)(5) Nursing Services FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395773 If continuation sheet Page 13 of 14 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 395773 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/02/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE East End Health & Rehab Center 745 North Highland Avenue Pittsburgh, PA 15206 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 0925 Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. Level of Harm - Minimal harm or potential for actual harm Based on facility policy, documents and observations and staff interviews it was determined the facility failed to maintain an effective pest control program related to fruit flies in the kitchen (Main Kitchen). Residents Affected - Some Findings include: Review of the Pest Control Policy dated 7/1/23, indicated routine pest control procedures will be in place to prevent pest infiltration. Fly strips are prohibited in the kitchen areas. Appropriate action will be taken to eliminate any reported pest situation in the department. During an observation on 10/30/23 at approximately 8:50 a.m. in the dishroom of the Main Kitchen there were three gold fly stick traps full of fruit flies, as staff were doing dishes several fruit flies were observed in the area. Review of provided documentation included pest-control logs dated from 7/20/23-10/6/23. Treatments to the dishwash area were provided on the following dates: 7/20/23 Spot treatment for fruit flies in dishwasher area. Floor drain in front of garbage disposal needs cleaned daily and fans left on to circulate air and dry up excess water. 8/3/23 Gold Stick fly traps dropped off 8/16/23 Fruit flies in dishwash area 9/19/23 Breakroom, dishwash area, kitchen inspected and serviced insect monitoring devices 10/6/23 Inspected and serviced insect monitoring devices Interview with Dietetic Technician Employee E9 on 10/31/23 at 9:45 a.m. confirmed the fruits flies in the dishroom and that she did not report it to the maintenance department as required to avoid improper infection control. 28 Pa. Code 201.14(a) Responsibility of licensee 28 Pa. Code 201.18(a)(b)(3) Management 28 Pa. Code 207.2(a) Administrator's responsibility FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395773 If continuation sheet Page 14 of 14