Health inspection·November 10, 2022

F 0610 Respond appropriately to all alleged violations. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on facility policy, clinical record reviews, and staff interviews it was determined the facility failed to investigate an injury of unknown origin for two of seven residents reviewed (Residents R42 and R50) and failed to identify, investigate and/or report two allegations of abuse and one allegation of possible neglect for one of seven residents (Resident R45). Residents Affected - Few Findings include: A review of the facility policy Incident Report Documentation and Follow Up dated 6/30/21 and reviewed 6/29/22, indicated all incidents will be reported and investigated in a timely manner. An incident is any unusual occurrence that occurs to the resident and may include injuries of known or unknown origin. A review of the facility policy Abuse Prevention reviewed on 6/29/22, indicated that the facility maintains a comprehensive program dealing with all facets of abuse, neglect and mistreatment through education, which encompasses screening, training, prevention, identification, investigation, protection and reporting. Abuse is defined by the facility as a willful infliction of injury, intimidation, punishment with resulting physical harm, pain or mental anguish; or necessary to attain or maintain physical, mental and psychosocial well -being. The facility has mechanisms in place to identify and recognize abuse with utilizing accident and incident reporting, grievance and complaint procedures, resident council minutes and the Ombudsman program. A review of the clinical record indicated Resident R42 was admitted to the facility 2/7/13, with diagnoses that include dementia. A review of the MDS (Minimum Data Set-resident assessment and care screening) dated 9/5/22, indicated the diagnoses remain current and the resident is severely cognitively impaired. A review of a nurse progress note dated 10/10/22, indicated resident R42 had a skin tear to the right forearm measuring 6.3 cm (centimeters) x 0.5 cm, area cleansed and steri strips (dressing used to close a wound) applied. A review of the facility Incident and Accident logs dated October 2022, indicated Resident R42 sustained a skin tear on 10/10/22. A review of an incident report dated 10/10/22, indicated Resident R42 had a skin tear to the right forearm. There was no investigation into the cause of the skin tear. During an interview on 11/10/22 at 11:00 a.m., the Nursing Home Administrator (NHA) verified the above findings and no investigation into the cause of the skin tear was completed. A review of the clinical record indicated Resident R50 was admitted to the facility 6/5/15 with diagnoses that included dementia. A review of the MDS dated [DATE] and 11/8/22, indicated the diagnoses remain current and the resident is severely cognitively impaired. A review of a nurse progress note dated 1/18/22, indicated Resident R50 had a bruise 2 cm x 1.5 cm to left upper chin close to mouth and Nursing Assistant (NA) suspects it may have happened during dinner while trying to retrieve a foreign object from resident's mouth and she resisted. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395823 If continuation sheet Page 2 of 6 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 395823 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/10/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Townview Health and Rehabilitation Center 300 Barr Street Canonsburg, PA 15317 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 0610 Level of Harm - Minimal harm or potential for actual harm A review of the facility Incident and Accident logs dated January 2021, indicated Resident R50 sustained a bruise on 1/18/21. A review of an incident report dated 1/18/21, indicated Resident R50 had a bruise to the chin 2 cm x 1.5. cm. There was no investigation into the cause of the bruise. Residents Affected - Few During an interview on 11/9/22, at 11:50 a.m. the NHA verified the above findings and no investigation into the cause of Resident R50's bruise was completed. A review of a complaint received from the Ombudsman office indicated that the facility had removed property of Resident R45's from her room that had been ordered by the physician causing Resident R45 potential for skin breakdown. A review of the clinical record indicated that Resident R45 had been admitted to the facility on [DATE], with diagnoses that included irregular heart rhythm, osteoarthritis, hearing loss and cervical cancer. A review of Resident R45's plan of care dated 5/28/21, indicated Resident R45 was to be out of bed into her wheelchair with a ROHO cushion (cushion used to prevent pressure ulcers). A review of a Physician visit dated 12/22/21, indicated that Resident R45 complained of low back pain while standing for nurse aide and felt a pop in her back with pain. A review of a Physician visit dated 2/2/22, indicated that Resident R45 stated an aide was transferring her on 1/24/22, and hurt her ribs. A review of the facility incident and accident reports dated December 2021 and January 2022, did not include the above incidents during transfer to be investigated as the potential for abuse/neglect. A review of a Physician visit dated 9/21/22, indicated Resident R45 was seen for leg weakness and review of MRI of spine of 9/14/22. Resident R45 had been identified as having compression fractures of multiple areas of her spine requiring her need to be referred to a pain management group. A review of a Physician visit dated 10/19/22, indicated that Resident R45 was upset because the facility had mistakenly taken her ROHO cushion. A review of the facility incident and accident reports and the grievance log dated October 2022, did not include documentation that the facility had identified and or investigated the removal of the ROHO cushion. A review of the current Physician orders dated November 2022, indicated the use of the ROHO cushion for Resident R45's wheelchair. A review of a progress note dated 10/15/22, indicated that the resident's son had called in about the ROHO cushion and that therapy had removed the cushion. The cushion was not available for Resident R45 to use in her wheelchair. During an interview on 11/9/22, at 10:19 a.m., Resident R45 stated that the cushion had been returned to her. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395823 If continuation sheet Page 3 of 6 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 395823 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/10/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Townview Health and Rehabilitation Center 300 Barr Street Canonsburg, PA 15317 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 0610 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few During an interview on 11/9/22, at 12:15 p.m., Therapy Manager Employee E2 stated that she had her staff remove the cushion from Resident R45's wheelchair as she no longer required it as it was for pressure ulcers and the facility needed the cushion for another resident however, after the call from the son, the facility returned it to the resident. During an interview on 11/9/22, at 12:25 p.m. the Unit Manager Employee E3 stated that she remembers the occurrence with the Roho cushion and when the statement was made she had begun to look into it and never got around to it. During an interview on 11/9/22, at 12:45 p.m. the Nursing Home Administrator, the Director of Nursing and the Assistant Director of Nursing confirmed that the above allegations were not identified, investigated and reported to rule out abuse/neglect. 28 Pa. Code 201.14(a) Responsibility of Licensee Previously cited 8/8/22. 28 Pa. Code 201.18(b)(1)(3)(e)(1) Management 28 Pa. Code 201.29(a)(d) Resident Rights 28 Pa. Code 211.5(f) Clinical Records FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395823 If continuation sheet Page 4 of 6 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 395823 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/10/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Townview Health and Rehabilitation Center 300 Barr Street Canonsburg, PA 15317 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 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Based on facility policy, review of facility provided documentation, clinical records and staff interview, it was determined that the facility failed to make certain each resident receives adequate supervision and assistance to prevent accidents for one of seven residents (Resident R10). Findings include: Review of the facility policy Incident Report Documentation and Follow Up reviewed on 6/29/22, indicated that an incident is any unusual occurrence that occurs and all incidents reported are investigated timely and plans of care revised. Any employee who provided care that contributed to the incident or who did not follow the plan of care will receive in-servicing addressing the concern. Disciplinary action will also be determined. Review of the facility provided documentation dated 10/12/22, indicated that Resident R10 had an incident identified as neglect when Nurse Aide (NA) Employee E1 left Resident R10 in the bathroom with no supervision or adequate assistance according to Resident R10's plan of care. Resident R10 attempted to self transfer and fall which required neuro checks and xrays of her right wrist and hand and increased pain medication. On 10/20/22, Resident R10 required additional xrays of her left shoulder due to pain. Radiology reports indicated no fractures. Review of the clinical record indicated that Resident R10 had been admitted to he facility on 11/11/21, with diagnoses which included Alzheimer's disease, dementia with behavioral disturbances, diabetes, anxiety disorder, osteoporosis, and a history of falls. An MDS (Minimum Data Set- periodic review of resident care needs) dated 9/20/22, indicated the diagnoses remained current and Section (G 0110 I) indicated resident was an assistance of one for toileting and Section (G 0300 D) indicated Resident R10 required assistance for moving on and off toilet and unsteady with balance only stabilized with staff assistance. During an interview on 11/9/22, at 12:45 p.m the Nursing Home Administrator confirmed that the facility failed to provide adequate supervision and assistance for Resident R10. 28 Pa. Code: 201.14(a) Responsibility of licensee. Previously cited 8/8/22. 28 Pa. Code: 201.18(e)(1) Management. 28 Pa. Code: 207.2(a) Administrator's responsibility. 28 Pa. Code: 211.10(d) Resident care policies. 28 Pa. Code: 211.12(d)(1)(2)(3)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395823 If continuation sheet Page 5 of 6 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 395823 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/10/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Townview Health and Rehabilitation Center 300 Barr Street Canonsburg, PA 15317 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 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on observations and staff interviews it was determined that the facility failed to maintain sanitary conditions in the Main Kitchen which created the potential for cross contamination (Main Kitchen). Residents Affected - Many Findings include: Review of facility policy Cleaning Instructions: Ice Machine and equipment dated 6/29/22, indicated the ice machine and equipment (scoops and receptacles that are used to hold or transport ice) will be cleaned and sanitized on a regular basis. During an observation on 11/7/22, at 9:30 a.m. it was revealed the ice machine in the main kitchen contained a brown substance inside the machine. During an interview on 11/7/22, at 9:50 a.m. the Dietary Manager Employee E4 confirmed the brown substance in the ice machine creating the potential for cross contamination. 28 Pa Code: 201.14(a) Responsibility of licensee Previously cited 8/8/22 FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395823 If continuation sheet Page 6 of 6