Health inspection·January 31, 2025

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. Based on observations, interview with residents and staff, and review of facility policy, it was determined that the facility did not ensure to provide safe, homelike environment for four out of five rooms observed (Room's 301, 302, 303, 304) Findings include: Review of facility's policy 'Resident Rights - Safe/Clean/Comfortable/Homelike Environment,' revised April 1, 2022, indicates that the facility must provide a safe, clean, comfortable, and homelike environment .housekeeping and maintenance services necessary to maintain a sanitary, orderly, and comfortable interior. Observations on January 31, 2025, at 1:00 pm, on third floor unit, in room#301, revealed a missing ceiling tile in resident's restroom, six leaking stains ceiling tiles, leaking stain down the wall in restroom. Observation of room# 302 revealed leaking stains on ceiling tiles above resident's bed. Observations of room# 304 revealed missing ceiling tile and three leaking stains on ceiling tiles. Observations of room# 303 revealed leaking stains on two ceiling tiles. Interview with Resident R5, in room# 304, bed A, revealed the missing ceiling tile between bed A and bed B, occurred about a week ago, and no effort was observed to replace the missing tile. 28 Pa Code 201.18(a) Management 28 Pa Code 201.18(b)(1) Management 28 Pa Code 201.18(b)(3) Management 28 Pa Code 201.18(d) Management 28 Pa Code 201.29(a) Resident Rights Page 1 of 2 395852 395852 01/31/2025 Cliveden Nursing and Rehabilitation Center 6400 Greene Street Philadelphia, PA 19119

F 0919 Make sure that a working call system is available in each resident's bathroom and bathing area. Level of Harm - Minimal harm or potential for actual harm Based on observation's, interview with resident and staff, it was determined that the facility failed to ensure that a call device was accessible to one out of nine residents observed (Resident R6) Residents Affected - Few Findings include: Review of facility policy 'Call Bells,' revised April 1, 2022, indicates that all residents are to have access to call bells at all times, even if it is generally believed that the resident is unable to use it. Staff are expected to be as vigilant as possible in keeping the call bell within reach of the resident, and the call system must be accessible to residents: while in their bed. Review of Resident R6's clinical record on January 31st, 2025, revealed medical diagnosis of hemiplegia and hemiparesis (paralysis and weakness) following cerebral infarction affecting left non-dominant side, muscle wasting and atrophy, generalized muscle weakness, morbid obesity. Observations of R6 during lunch meal service, on January 31, 2025 at 12:30 pm, revealed Resident R6 in bed with lunch tray on bedside table over Resident R6's bed. Further observation of Resident R6 revealed resident coughing continuously while consuming meal, unable to verbalize need for assistance. Resident R6 attempted to reach for call bell which was placed on left side of bed, without success. Interview with Licensed nurse, Employee E1, on January 31, 2025, at 12:35 pm, confirmed that Resident R6 was unable to use her left upper extremity due to hemiplegia and hemiparesis. Interview with facility's Director of Nursing, Employee E3, on January 31, 2024, confirmed that Resident R6's call bell was to be placed on right side of bed. 28 Pa Code 211.12(d)(1)(2) Nursing services 28 Pa Code 211.10(c)(d) Resident care policies 395852 Page 2 of 2