Health inspection·February 12, 2025

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. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of facility policies, as well observations and staff interviews, it was determined that the facility failed to maintain an environment free of potential safety hazards related to the facility's hot water temperatures and failed to monitor temperatures weekly as per policy. Findings include: A facility policy for safe water temperatures, dated January 13, 2025, indicated that water temperatures will be set to a temperature of no more than 110 degrees Fahrenheit (F) or the state's allowable maximum water temperature. Maintenance staff will check water heater temperature controls and temperatures of tap water in all hot water circuits weekly and as needed. Documentation of testing will be maintained for three years and kept in the maintenance office. Observations of Maintenance Worker 1 checking water temperatures in the sink in resident room [ROOM NUMBER] on February 12, 2025, at 11:11 a.m. revealed that the water temperature was 125 degrees F. Observations of Maintenance Worker 1 checking water temperatures in the sink in resident room [ROOM NUMBER] on February 12, 2025, at 11:14 a.m. revealed that the water temperature was 121.6 degrees F. Observations of Maintenance Worker 1 checking water temperatures in the sink in resident room [ROOM NUMBER] on February 12, 2025, at 11:17 a.m. revealed that the water temperature was 119.4 degrees F. Interview with Maintenance Worker 1 on February 12, 2025, at 11:25 a.m. revealed that he likes the water temperatures to be between 100 to 110 degrees F. He thought that there were water temperature logs in the maintenance shop but indicated that he has not completed any in the past week. However, the facility was not able to provide any documented evidence that the facility was completing water temperature checks of the tap water in all hot water circuits on a weekly basis. Interview with the Nursing Home Administrator on February 12, 2025, at 2:55 p.m. confirmed that the water temperatures in the residents' room should not have been that high and that he had no documented evidence that maintenance was completing water temperature checks of the tap water in all hot water circuits on a weekly basis. 28 Pa. Code 201.14(a) Responsibility of Licensee. (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 2 Event ID: 395860 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 395860 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/12/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Loyalhanna Care Center 535 McFarland Road Latrobe, PA 15650 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)