Health inspection·December 10, 2024

F 0578 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of the facility policy and clinical records and staff interviews, it was determined that the facility failed to provide the opportunity to formulate an advance directive (written instructions such as a living will or durable power of attorney for health care for when the individual is incapacitated) for four of the nine residents reviewed (Resident R24, R29, R57, R71). Findings Include: A review of the facility policy Advanced Directives last reviewed 1/18/24, indicated the facility will comply with the requirements related to maintaining written policies and procedures regarding advance directives, including provisions to inform and provide written information to all adult residents concerning the right to accept or refuse medical or surgical treatment and formulate an advance directive. A review of the medical record indicated Resident R24 was admitted to the facility on [DATE], with diagnoses that included type II diabetes (long-term condition in which the body has trouble controlling blood sugar and using it for energy), dysphagia (difficulty swallowing), muscle weakness, left below knee amputation. A review of the clinical record failed to reveal and advance directive or documentation that Resident R24 was given the opportunity to formulate an Advanced Directive. A review of the clinical record indicated Resident R29 was admitted to the facility on [DATE], with diagnoses that include type II diabetes, dysphagia, high blood pressure, difficulty walking. A review of the clinical record failed to reveal and advance directive or documentation that Resident R29 was given the opportunity to formulate an Advanced Directive. A review of the clinical record indicated Resident R57 was admitted to the facility on [DATE], with diagnoses that include high blood pressure, history of falling, chronic kidney disease, stage III (moderate level of kidney damage where the kidneys have mild to moderate impairment in filtering waste from the blood). A review of the clinical record failed to reveal and advance directive or documentation that Resident R57 was given the opportunity to formulate an Advanced Directive. A review of the clinical record indicated Resident R71 was admitted to the facility on [DATE], with Page 1 of 3 395851 395851 12/10/2024 Rehab & Nursing Ctr Greater Pittsburgh 890 Weatherwood Lane Greensburg, PA 15601

F 0578 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few diagnoses that include multiple sclerosis (the immune system eats away at the protective covering of nerves , this damage disrupts communication between the brain and the body), dysphagia, chronic kidney disease, stage III. A review of the clinical record failed to reveal and advance directive or documentation that Resident R71 was given the opportunity to formulate an Advanced Directive. During an interview on 12/10/24 at 12:45 p.m. the Social Worker and the Director of Nursing (DON) confirmed that the clinical record did not include documentation that Resident R24, R29, R57, R71, were not afforded the opportunity to formulate Advance Directives. 28 Pa. Code: 201.29(b)(d)(j) Resident rights. 395851 Page 2 of 3 395851 12/10/2024 Rehab & Nursing Ctr Greater Pittsburgh 890 Weatherwood Lane Greensburg, PA 15601

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 review of facility policy, observation and staff interview, it was determined that the facility failed to properly secure medication in one of two medication carts on the 300 hall nursing unit (B cart). Findings include: Review of the facility policy Medication Labeling and Storage last reviewed on 1/18/24, indicated the facility stores medications in locked compartments and only authorized have access to the keys. During an observation on 12/8/24, at 12:10 p.m., the 300 hall B medication cart was left unsecured and unattended and accessible to any passerby. During an interview on 12/8/24, at 12:15 p.m., the Director of Nursing confirmed the facility failed to properly secure medications on one of two medication carts on the 300 hall nursing unit accessible to any passerby. 28 Pa. Code: 211.9(a)(1)(k) Pharmacy services. 28 Pa. Code: 211.10(c) Resident care policies. 28 Pa. Code: 211.12(d)(1)(2)(5) Nursing services. 395851 Page 3 of 3