Inspection·January 9, 2025

F 0623 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review and staff interview, it was determined that the facility failed to provide a transfer notice to a representative of the Office of the Long-Term Care Ombudsman Division for two out of three residents (Residents R39, R52). Findings include: Review of Resident R39's admission record indicated he was originally admitted on [DATE], with diagnoses that included dementia(decline in mental abilities that affects thinking, memory, and reasoning), diabetes mellitus and hyperlipidemia. Review of Resident R39's clinical record revealed that the resident was transferred to the hospital on 9/9/24, and returned to the facility on 9/11/24. Review of Resident R39's clinical record indicated the facility failed to include documented evidence that the facility provided a written transportation notification to the Office of the Long-Term Care Ombudsman for the hospitalization on 9/9/24. Review of Resident R52's admission record indicated she was originally admitted on [DATE], with diagnoses that included surgical aftercare, muscle weakness and venous insufficiency. Review of the clinical record indicated Resident R52 was transferred to hospital on [DATE], and did not return to the facility. Review of Resident R52's clinical record indicated the facility failed to include documented evidence that the facility provided a written transportation notification to the Office of the Long-Term Care Ombudsman for the hospitalization on 10/13/24. During an interview on 1/9/25, at 10:30 a.m. the Director of Nursing (DON) confirmed the facility failed to provide a transfer notice to a representative of the Office of the Long-Term Care Ombudsman Division for two out of three residents (Residents R39, R52). 28 Pa. Code 201.29(a)(c)(3)(2) Resident rights. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395882 If continuation sheet Page 2 of 13 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 395882 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Longwood at Oakmont 500 Route 909 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)

F 0625 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of facility policy, clinical record review, and staff interviews, it was determined that the facility failed to notify the resident or resident's representative of the facility bed-hold policy (an agreement for the facility to hold a bed for an agreed upon rate during a hospitalization) for two of three resident hospital transfers (Residents R39 and R52). Review of Resident R39's admission record indicated he was originally admitted [DATE], with diagnoses that included dementia(decline in mental abilities that affects thinking, memory, and reasoning), diabetes mellitus and hyperlipidemia Review of Resident R39's clinical record revealed that the resident was transferred to the hospital on 9/9/24, and returned to the facility on 9/11/24. Review of Resident R39's clinical record failed to include documented evidence that the resident or the resident's representative were provided with written information about the facility's bed hold policy at the time of the transfer to the hospital on 9/9/24. Review of Resident R52's admission record indicated she was originally admitted on [DATE], with diagnoses that included surgical aftercare, muscle weakness and venous insufficiency. Review of the clinical record indicated Resident R52 was transferred to hospital on [DATE], and did not return to the facility. Review of Resident R52's clinical record failed to include documented evidence that the resident or the resident's representative were provided with written information about the facility's bed hold policy at the time of the transfer to the hospital on [DATE]. During an interview on 1/9/25, at 10:30 a.m. Director of Nursing (DON) confirmed that the facility failed to notify the resident or resident's representative of the facility bed-hold policy for two of three resident hospital transfers as required (Resident R39, R52). 28 Pa. Code 201.29 (a)(c)(2) Resident rights. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395882 If continuation sheet Page 3 of 13 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 395882 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Longwood at Oakmont 500 Route 909 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)

F 0637 Assess the resident when there is a significant change in condition Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review and staff interview, it was determined that the facility failed to complete a significant change Minimum Data Set (MDS- assessments completed indicating a change in condition of a resident requiring change in care) assessment for two of three residents reviewed (Residents R3 and R8). Residents Affected - Few Findings include: Review of the Resident Assessment Instrument 3.0 User's Manual (reference used to complete an MDS) effective October 2023, indicated that the facility must conduct a comprehensive assessment of a resident within 14 days after the facility determines, or should have determined, that there has been a significant change in the resident's physical or mental condition. Review of the clinical record revealed that Resident R3 was admitted to the facility on [DATE]. Review of Resident R3's MDS dated [DATE], indicated diagnoses of high blood pressure, depression, and dementia (a group of symptoms that affects memory, thinking and interferes with daily life). Section O-Special Treatments, Procedures, and Programs indicated hospice care while a resident. Review of physician order dated 11/11/24, indicated Resident R3 was admitted under hospice services. Review of Resident R3's MDS assessments revealed a MDS significant change was not completed to include hospice services. Review of the clinical record revealed that Resident R8 was admitted to the facility on [DATE]. Review of Resident R8's MDS dated [DATE], indicated diagnoses of high blood pressure, dementia, and Parkinson's disease (neuromuscular disorder causing tremors and difficulty walking). Section O-Special Treatments, Procedures, and Programs indicated hospice care while a resident. Review of physician order dated 2/20/24, indicated Resident R8 was admitted to hospice on 2/20/24. Review of Resident R8's MDS assessments revealed a MDS significant change was not completed to include hospice services. During an interview on 1/8/25, at 3:07 p.m. Licensed Practical Nurse Assessment Coordinator Employee E5 confirmed that a significant change MDS was not completed for Resident R3 and R8. During an interview on 1/8/25, at approximately 3:10 p.m. the Director of Nursing confirmed the facility failed to complete a significant change MDS assessment for two of three residents reviewed (Residents R3 and R8). 28 Pa. Code: 211.5(f) Clinical records. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395882 If continuation sheet Page 4 of 13 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 395882 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Longwood at Oakmont 500 Route 909 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)

F 0655 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on a review of facility policy, clinical records, and staff interview, it was determined that the facility failed to develop a baseline care plan for one of three residents (Resident R156). Findings include: Review of facility policy Baseline Care Plans dated 11/5/24, indicated a baseline plan of care to meet the residents immediate needs and provide instruction needed to provide effective and person-centered care shall be developed for each resident within forty-eight hours of admission. Review of the clinical record revealed Resident R156 was admitted to the facility on [DATE], with diagnoses of dementia (loss of intellectual functioning), benign prostatic hyperplasia (BPH- enlargement of the prostate gland), and depression. During an observation on 1/8/25, at 10:31 a.m. Resident R156 was in his room sitting in his wheelchair, a foley catheter bag was noted attached to chair. Review of Resident R156's physician orders dated 1/4/25, indicated Resident R156 has a 16 french (size) 10cc bulb (holds catheter in place in the bladder). Review on 1/8/25, at 1:00 p.m. Resident 156's baseline care plan failed to include interventions for the care of the foley catheter. During an interview completed on 1/8/25, at 1:23 p.m. Licensed Practical Nurse (LPN) Employee E5 confirmed Resident R156's baseline care plan did not include interventions for the foley catheter, and that the facility failed to develop a baseline care plan for one of three residents (Resident R156). 28 Pa. Code: 211.11 (a)(c)(d) Resident care plan. 28 Pa. Code: 211.12(d)(1)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395882 If continuation sheet Page 5 of 13 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 395882 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Longwood at Oakmont 500 Route 909 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)

F 0695 Provide safe and appropriate respiratory care for a resident when needed. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of facility policy, observations, staff interviews, and clinical record review, it was determined that the facility failed to provide appropriate respiratory care for three of four residents (Residents R9, R20, and R205). Residents Affected - Few Findings include: Review of facility policy Oxygen Administration dated 11/5/24, indicated oxygen is administered to residents who need it, consistent with professional standards of practice, the comprehensive person-centered care plans, and the residents ' goal and preferences. Change oxygen tubing and tubing weekly and as needed if it becomes soiled or contaminated. Change humidifier bottle when empty or weekly. Review of facility policy Infection Prevention and Control Program dated 11/5/24, indicated the facility has established and maintains an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment. Review of the clinical record indicated Resident R9 was admitted to the facility on [DATE]. Review of Resident R9's Minimum Data Set (MDS - a periodic assessment of care needs) dated 10/23/24, indicated diagnoses of hypertension (high blood pressure), diabetes (a metabolic disorder in which the body has high sugar levels for prolonged periods of time), and sleep apnea (a sleeping disorder in which breathing repeatedly stops and starts). Section O0100, C1 Oxygen therapy was marked and section G1 was checked indicating use of Continuous Positive Airway Pressure (CPAP - a treatment that uses a machine to deliver air pressure to help a person breathe while sleeping). Review of a physician's active orders dated 1/3/25, indicated to administer oxygen via nasal cannula (a medical device that provides supplemental oxygen to patients through two prongs inserted into the nostrils) continuously at 4 liters per minute. Change oxygen tubing and humidifier every week. Review of physician's active orders dated 1/4/25, indicated CPAP at bedtime, pressure 12. Apply at bedtime and remove in the morning. During an observation on 1/7/25, at 12:20 p.m. Resident R9 was sitting in her wheelchair receiving 4 liters per minute of oxygen via nasal cannula. No date was present on the oxygen nasal cannula and humidification bottle. CPAP mask was laying on a chair bedside the nightstand and failed to be stored in a bag, when not in use. During an interview on 1/7/25, at 12:35 p.m. Licensed Practical Nurse (LPN) Employee E8 confirmed that no date was present on Resident R9's nasal cannula tubing and humidification bottle, and her CPAP mask was not properly stored in a bag, when not in use. Review of Resident R20's clinical record indicated an admission date of 4/23/24. Review of Resident R20's MDS dated [DATE], indicated the diagnosis of respiratory failure (not enough oxygen in the body), hypertension (high blood pressure), and diabetes (high sugar in the blood). (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395882 If continuation sheet Page 6 of 13 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 395882 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Longwood at Oakmont 500 Route 909 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)

F 0695 Review of Resident R20's physician order dated 12/13/24, indicated to wear CPAP through nighttime. Level of Harm - Minimal harm or potential for actual harm Review of Resident R20's care plan dated 3/5/24, with revision on 11/29/24, indicated Resident R20 has CPAP machine to wear at night. Residents Affected - Few During an observation on 1/7/25, at 10:18 a.m. Resident R20's CPAP mask was sitting on dresser not properly stored in a bag. During an interview completed on 1/7/25 at 10:23 a.m. LPN Employee E1 confirmed the CPAP mask was not properly stored in a bag. Review of the clinical record indicated Resident R205 was admitted to the facility on [DATE]. Review of Resident R205's MDS dated [DATE], indicated diagnoses of pneumonia (infection that inflames air sacs in one or both lungs, which may fill with fluid), anemia (a condition in which the blood doesn't have enough red blood cells to carry oxygen all through the body), and asthma (airway becomes inflamed, narrow, and swell and makes breathing difficult). Review of a physician's active orders dated 1/3/25, indicated to administer Ipratropium-Albuterol (medication causing your airway to relax and make breathing easier) every two hours as needed for shortness of breath. During an observation on 1/7/25, at 1:02 p.m. Resident R205 was sitting in his chair with nebulizer (a machine used to administer medication) on his nightstand. Nebulizer tubing was not dated and was not stored in a bag, when not in use. During an interview on 1/7/25, at 1:14 p.m. Registered Nurse (RN) Employee E2 confirmed that no date was present on R205's nebulizer tubing, and his mask was not properly stored in a bag, when not in use. During an interview on 1/7/25, at 2:45 p.m. the Director of Nursing confirmed that the facility failed to provide appropriate respiratory care for three of four residents (Residents R9, R20, and R205). 28 Pa. Code: 201.14(a) Responsibility of licensee. 28 Pa. Code 211.12(d)(1)(2)(3)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395882 If continuation sheet Page 7 of 13 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 395882 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Longwood at Oakmont 500 Route 909 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)

F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Based on review of facility policy, observation and staff interview it was determined the facility failed to dispose or reconcile discontinued medication in a timely manner for one of two medication rooms reviewed (Countryside Medication room). Findings: Review of facility Storage of Medications policy dated 11/5/24, indicated that medications and biologicals are stored safely, securely, and properly, following manufacturer ' s recommendations or those of the supplier. The medication supply is accessible only to licensed nursing personnel, pharmacy personnel or staff members lawfully authorized to administer medications. Review of facility Disposal of Medications- Discontinued Medications policy dated 11/524, indicated medications not returned to the pharmacy are destroyed in accordance with the Medication Destruction policy. During a medication room review on 1/8/25, at 1:30 p.m. two plastic basins with medications was observed sitting on the counter, unsecured. Medications were dated November 2024 from the pharmacy. The medications observed were: - Atropine (used to decrease saliva) - 1 bottle. - Pantoprazole (used to treat acid reflex) - 40 mg 3 pills. - Pantoprazole - 20 mg 2 pills. - Calcium 600/800 mg 4 pills. - Eliquis (used to prevent or treat blood clots- 5 mg 7 pills - Tums- 1 bottle. - Centrum (a vitamin) - 1 bottle. - Scopolamine patch (used to decrease saliva)- 8 patches. - Nitroglycerin (used to treat chest pain) -1 bottle. - Simethicone (used to treat upset stomach) - 1 bottle. - Albuterol (used to breathing problems)- 12 vials. - Tylenol - 650 mg 27 pills. - Aspirin (a blood thinner) - 81 mg 2 pills. - Lisinopril (used for high blood pressure) -5 mg 2 pills. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395882 If continuation sheet Page 8 of 13 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 395882 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Longwood at Oakmont 500 Route 909 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)

F 0755 - Lisinopril- 40 mg 1 pill. Level of Harm - Minimal harm or potential for actual harm - Metoprolol (used for high blood pressure) -25 mg 2 pills. - Zoloft (used for depression) -100 mg 2 pills. Residents Affected - Few - Tylenol Cold and Flu -5 capsules. - Vitamin D -1000 units 2 pills. - Atorvastatin (used for high cholesterol) 40 mg 3 pills. - Montelukast (used to treat allergies) -10 mg 3 pills. - Senna (used for constipation)- 8.6 mg 3 pills. - Melatonin (used to help sleep) -3 mg 1 pill. - Seroquel (used for mental health conditions)- 25 mg 1 pill. - Carvedilol (used for high blood pressure) - 6.25 mg 2 pills. - Depakote (used for seizures) - 125 mg 2 pills. - Fluoxetine (used to treat depression) - 20 mg 1 pill. - Remeron (used to treat depression) - 15 mg 1 pill. - Simvastatin (used to treat high cholesterol) - 20 mg 1 pill. - Ferrous Sulfate (an iron supplement) - 325 mg 1 pill. - Multivitamin -1 pill. During an interview on 1/8/25, at 1:05 p.m. Licensed Practical Nurse (LPN) Employee E8 stated, These are old medications. We don't have any paperwork to complete prior to destroying the medications. They tell us to destroy the medications when we have time using the med buster (a solution that dissolves medication). There is no accountability paperwork that goes in residents medical record that I know of. During an interview on 1/8/25, at 1:30 p.m. the Director of Nursing confirmed that the facility failed to dispose or reconcile discontinued medication in a timely manner for one of two medication rooms reviewed (Countryside Medication room). 28 Pa. Code: 211.12(d)(1)(3)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395882 If continuation sheet Page 9 of 13 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 395882 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Longwood at Oakmont 500 Route 909 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)

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 policies, observations, and staff interviews, it was determined that the facility failed to store medications and biologicals properly and securely in one of three medications carts (Riverside medication cart). Findings include: Review of the facility policy Storage of Medications dated 11/5/24, indicates medications and biologicals are stored safely, securely, and properly. Orally administered medications are kept separate from externally used medications and treatments such as including but not inclusive to ointments, creams, and vaginal products. During an interview and observation on 1/7/25, at 10:26 a.m. it was revealed that the Riverside medication carts fourth drawer contained dividers that were labeled with room numbers and contained various creams, ointments, and gels. Licensed Practical Nurse (LPN) Employee E1 stated we don't have a separate treatment cart; all the treatments are kept in the medication cart. LPN Employee E1 referred to this drawer as the treatment drawer. The fifth drawer contained: . An open box of paper tape. . A container of antifungal powder. . A box of vaginal cream commingling with seven oral Tussin liquid medication bottles. . One Ventolin inhaler and three Nasal sprays commingling with dry dressing supplies that included but not inclusive to abdominal pads, 4x4 gauze sponges, and multiple different cover dressings. The bottom drawer contained the following items commingling with respiratory treatment agents: . A tube of antifungal cream. . A tube of Voltaren gel. . A tube of hydrocortisone cream. . Two containers of Silvadene ointment. During an interview completed on 1/7/25, at 10:38 a.m. LPN Employee E1 confirmed the above observations and confirmed that the facility failed to store medications and biologicals properly and securely in one of three medications carts (Riverside medication cart). 28 Pa. Code: 211.9(a)(1)(h)(k)(l)(1) Pharmacy services. 28 Pa. Code:211.12(d)(1)(2)(3)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395882 If continuation sheet Page 10 of 13 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 395882 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Longwood at Oakmont 500 Route 909 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)

F 0808 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law. Based on review of facility policy, clinical record, observations and staff and resident interviews, it was determined that the facility failed provide food items consistent with the prescribed diet order for one of four residents observed during dining (Resident R4). Findings include: Review of physician orders for Resident R4 confirmed a diet order dated 11/18/24, for Low Lactose diet, Mechanical Soft Ground Meat texture, Nectar/Mildly Thick liquids. During observations during dining, on 1/7/24, at 12:15 p.m. revealed Resident R4 was served turkey vegetable soup and had her liquids in a sippy cup. Resident R4 revealed no orders for adaptive equipment. Interview with Dietary Director Employee E9 confirmed the above-mentioned findings. Interview with Director of Nursing (DON) on 11/8/24, at 2:00 p.m. confirmed Resident R4 should have not been served the soup or the sippy cup. 28 Pa. Code 211.6(a) Dietary Services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395882 If continuation sheet Page 11 of 13 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 395882 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Longwood at Oakmont 500 Route 909 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)

F 0849 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of resident clinical records and staff interviews, it was determined the facility failed to obtain a physican order for hospice services and to ensure the coordination of hospice services (supportive services for end stage terminal illness) with facility services to meet the needs of each resident for end-of-life care for three of four residents ( Resident R3, R8, and R39). Findings include: Review of the facility policy Hospice Program dated 11/5/24, indicated that when a resident has been diagnosed as terminally ill, the facility will contact hospice agency. When a resident participates in a hospice program, a coordinated plan of care between the facility, hospice agency and resident or family will be developed and shall include directives for managing pain and other uncomfortable symptoms. The care plan shall be revised and updated as necessary to reflect the resident's status. Review of the clinical record revealed that Resident R3 was admitted to the facility on [DATE]. Review of Resident R3's MDS (Minimum Data Set- periodic assessment of resident care needs) dated 11/7/24, indicated diagnoses of high blood pressure, depression, and dementia (a group of symptoms that affects memory, thinking and interferes with daily life). Section O-Special Treatments, Procedures, and Programs indicated hospice care while a resident. Review of Resident R3's clinical record revealed a physician order dated 11/11/24, that resident is under hospice services, but did not include a diagnosis related to the need of hospice services. The facility failed to provide documentation completed by the hospice service, including admission into hospice, plan of care, communication between hospice service and facility, and contact information. Review of Resident R3's current comprehensive care plan failed to indicate a plan of care by the facility that displayed the coordination of hospice services by failing to include contact information for the hospice agency and how to access the hospice's 24 hour on-call system. Review of the clinical record revealed that Resident R8 was admitted to the facility on [DATE]. Review of Resident R8's MDS dated [DATE], indicated diagnoses of high blood pressure, dementia, and Parkinson's disease (neuromuscular disorder causing tremors and difficulty walking). Section O-Special Treatments, Procedures, and Programs indicated hospice care while a resident. Review of Resident R8's clinical record revealed a physician order dated 2/20/24, that resident admitted to hospice services, but did not include a diagnosis related to the need of hospice services. Review of Resident R8's current comprehensive care plan failed to indicate a plan of care by the facility that displayed the coordination of hospice services by failing to include contact information for the hospice agency and how to access the hospice's 24 hour on-call system. Review of the admission record indicated Resident R39 was admitted to the facility on [DATE]. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395882 If continuation sheet Page 12 of 13 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 395882 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Longwood at Oakmont 500 Route 909 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)

F 0849 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Review of Resident R39's MDS, dated [DATE], indicated the diagnosis of dementia (decline in mental abilities that affects thinking, memory, and reasoning), diabetes mellitus and hyperlipidemia. Review of Resident R39's current physician orders indicated consult hospice care for evaluation and admit if appropriate on 12/13/2024. The order failed to include what vendor, and the diagnosis qualifying the resident for Hospice Services. Review of Resident R39's progress notes indicated resident's wife would like Bridges Hospice as the vendor. During an interview on 1/9/25, at 10:30 a.m. the Director of Nursing (DON) confirmed the facility failed to obtain a physican order for hospice services and to ensure the coordination of hospice services with facility services to meet the needs of each resident for end-of-life care for three of four residents ( Resident R3, R8, and R39). 28 Pa. Code: 201.14(a) Responsibilities of licensee 28 Pa. Code: 201.18(a)(b)(1)(3) Management 28 Pa. Code: 201.20(a)(b)(c)(d) Staff development 28 Pa. Code: 211.10(c)(d) Resident care policies FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 395882 If continuation sheet Page 13 of 13