Health inspection·August 22, 2024

F 0600 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of facility policies, job descriptions, documents, clinical records, and staff interviews, it was determined that the facility failed to protect residents from physical neglect for one of three residents reviewed (Resident R1). Findings include: Review of the facility policy Abuse, Neglect, Exploitation and Misappropriation Prevention Program dated, 5/12/24, indicated residents have the right to be free from abuse, neglect, misappropriation of resident property and exploitation. The objective is to protect residents from abuse, neglect, exploitation, or misappropriation of property by anyone to include facility staff. Review of the facility Nurse Aide Job Description dated May 2024, indicated the Nurse Aide (NA) will provide routine Activities of Daily Living (ADL - personal care activities like bathing, dressing, eating, mobility, and toileting) care in a manner conducive to the comfort and safety of residents and will be responsible for performing person centered care. Review of admission record indicated Resident R1 was admitted to the facility on [DATE]. Review of Resident R1's Minimum Data Set (MDS - a periodic assessment of care needs) dated 5/15/24, indicated the diagnoses of stroke (damage to the brain from an interruption of blood supply), Multiple Sclerosis (immune system eats away at protective covering of nerve cells), and unspecified intellectual abilities (a diagnosis given to intellectually disabled individuals who are unable to complete the standardized testing). Section C indicated the Brief Interview for Mental Status (BIMS - a screening test that aides in detecting cognitive impairment) total score of 15 - cognitively intact. Section GG indicated resident requires moderate assistance with toileting and transfers. Review of Resident R1's care plan dated 5/20/24, indicated resident is incontinent of bowel and care plan dated 8/2/24, indicated the resident will have his daily activities of daily living care needs met through the next review date. Anticipate and meet the resident's needs. Review of Resident R1's progress notes indicated the following entries: -On 7/19/24, at 12:33 p.m. resident went on leave of absence to MRI (magnetic resonance image diagnostic test that can detail images of structures and organs inside the body) appointment via wheelchair with stretcher. (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: 395790 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 395790 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/22/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Seneca Place 5360 Saltsburg Road Verona, PA 15147 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)