Health inspection·April 4, 2023

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of facility policy, observations and staff interviews it was determined that the facility failed to maintain a homelike environment one nursing unit for 23 of 23 residents residing on that unit (R1, R2, R3, R4, R5, R6, R7, R8, R9, R10, R11, R12, R13, R14, R15, R16, R17, R18, R19, R20 , R21, R22 and R23) residents. Findings include: Based on review of facility policy Condition of Participation dated 1/3/23, indicated that .the building housing the organization provides a functional, sanitary and comfortable environment. During observations on 4/4/23, from 10:11 a.m. to 11:00 a.m. the following was observed: Resident R1/R2: Doors to room and bathroom with scratches, base board appeared to be grey at the bottom. Resident R3/R4: Doors to room and bathroom with scratches black marks, wall paper with black marks with scratches, base board appeared to be grey at bottom. Resident R5/R6: Door to room with scratches Resident R7/R8: Base board appeared to be grey at the bottom. Resident R9/R10: Door to room and bathroom had scratches/black marks on them, base board appeared to be grey at the bottom. Resident R11/R12: Doors for room and bathroom had scratches/black marks on them. Resident R13/R14: Doors for room and bathroom had scratches/black marks on them, base board appeared to be grey at the bottom. Resident R15/R16: Door for room with scratches/black marks, wallpaper peeling, base board appeared to be grey at the bottom. Resident R17/R18: Door for room and bathroom had scratches/black marks on them, wallpaper had scratches, base board appeared to be grey at the bottom. Page 1 of 2 395783 395783 04/04/2023 Peters Township Post Acute 113 West McMurray Road McMurray, PA 15317

F 0584 Resident R19: Door to room was chipped, wallpaper was torn, Level of Harm - Minimal harm or potential for actual harm Resident R20/R21: Door to room had scratches/black marks, wallpaper had black marks and scrapes, base board appeared to be grey at the bottom. Residents Affected - Some Resident R22/R23: Door to room had marks on it and scrapes at bottom , wall paper was ripped, base board appeared grey at the bottom. During an observation, hallway on [NAME] unit had missing wood flooring. Observations on two rooms that were emptied revealed the following: room [ROOM NUMBER] base board appeared to be grey at the bottom of the wall, wallpaper was ripped and walls had black marks on them and appeared scrapped. room [ROOM NUMBER] door of room had wood that was chipped with wood hanging off door, wallpaper in room was ripped with gas and base board appeared to be grey at the bottom, door to bathroom had marks. During an interview on 4/4/23, at 3:55 p.m. Nursing Home Administrator and Director of Maintenance confirmed that doors need of repair, wallpaper in various resident rooms needed repairs and base boards needed scrapped and cleaned 28 Pa. Code 201.14(a) Responsibility of licensee. 28 Pa. Code 201.18(b)(1)(3) Management. 395783 Page 2 of 2