Health inspection·July 9, 2025

F 0690 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review facility polices, observations, clinical records, and staff interviews it was determined that the facility failed to make certain that appropriate treatments and services were provided for the use of a foley catheter required for two of three residents (Resident R112 and R114). Findings include: Review of the facility Catheters Indwelling (Foley) last reviewed 6/3/25, stated an indwelling catheter is only to be used when there is a valid medical justification. The resident should be assessed for and provided cared and treatment needed to reach his or her highest level of continence possible. Review of the clinical record indicated Resident R112 was admitted to the facility on [DATE], with diagnoses of right below the knee amputation, high blood pressure, and weakness of both legs. During an observation on 7/7/25, at 10:28 a.m. Resident R112 was observed with a foley catheter intact. Review of Resident R112 physician orders on 7/7/25, at 11:40 a.m. failed to include and order or care plan for Resident R112's foley catheter. Review of the clinical record indicated Resident R114 was admitted to the facility on [DATE], with diagnoses of urinary tract infection, delirium, and dementia. Review of Resident R114's physician order dated 6/26/25, indicated to insert foley now. The order failed to include the size of the foley catheter. During an observation on 7/7/25, at 11:40 a.m. Resident R114 was observed with a foley catheter intact. Review of Resident R114 physician orders on 7/7/25, at 11:43 a.m. failed to include an order or care plan for Resident R114's foley catheter. During an interview on 7/7/25, at 11:47 a.m. Registered Nurse, E1 confirmed the facility failed to ensure Resident R112 and R114 had a physician order and care plan for their foley catheter. During an interview on 7/7/25, at 2:40 p.m. the Nursing Home Administrator confirmed the facility Page 1 of 4 395890 395890 07/09/2025 Snu Armstrong CO Memorial Hosp One Nolte Drive Kittanning, PA 16201

F 0690 failed to make certain appropriate treatments and services were provided for the use of a foley catheter required for two of three residents (Resident R112 and R114). Level of Harm - Minimal harm or potential for actual harm 28 Pa. Code: 201.14(a) Responsibility of licensee. Residents Affected - Few 28 Pa. Code: 211.10(c)(d) Resident care policies. 28 Pa. Code: 211.12(d)(1)(2)(3)(5) Nursing services. 395890 Page 2 of 4 395890 07/09/2025 Snu Armstrong CO Memorial Hosp One Nolte Drive Kittanning, PA 16201

F 0880 Provide and implement an infection prevention and control program. 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, resident records, a facility tour, and staff interview it was determined that the facility failed to ensure enhanced barrier precautions (EBP) were ordered and implemented creating the potential for cross contamination for four out of four sampled residents (Residents R111, R112, R113, and R114). Residents Affected - Many Findings include: The facility Infection Control Plan for SNU policy dated 8/18 and last reviewed 12/24, indicated that enhanced barrier precautions are an infection control intervention designed to reduce transmission of multi-drug resistance organisms that employs targeted gown and glove use during high contact resident care activities used on conjunction with standard precautions. The facility Care Plan policy dated 7/25, indicated each resident will have an individualized care plan that is developed by the interdisciplinary team with input from the resident, family, friends, and/or significant other. The team will refer to the care plan when providing care. Develop a care plan identifying problems, nursing diagnoses, and intervention. Review of the clinical record indicated Resident R111 was admitted to the facility on [DATE], with diagnoses of dizziness, mild dehydration, and status post right hemicolectomy (surgery to remove one side of colon). During an observation on 7/7/25, at 10:26 a.m. Resident R111 was observed with a midline. Review of Resident R111 physician orders on 7/7/25, at 11:25 a.m. failed to include an order for enhanced barrier precautions. Review of the clinical record indicated Resident R112 was admitted to the facility on [DATE], with diagnoses of right below the knee amputation, high blood pressure, and weakness of both legs. During an observation on 7/7/25, at 10:28 a.m. Resident R112 was observed with a foley catheter intact. Review of Resident R112 physician orders on 7/7/25, failed to include an order for enhanced barrier precautions. Review of the clinical record indicated Resident R113 was admitted to the facility on [DATE], with diagnoses of urinary tract infection, delirium, and dementia. During an observation on 7/7/25, at 11:40 a.m. Resident R113 was observed with a PICC (peripherally inserted central catheter) line. A review of Resident R113 physician orders failed to include an order for enhanced barrier precautions. Review of the clinical record indicated Resident R114 was admitted to the facility on [DATE], with diagnoses of urinary tract infection, delirium, and dementia. 395890 Page 3 of 4 395890 07/09/2025 Snu Armstrong CO Memorial Hosp One Nolte Drive Kittanning, PA 16201

F 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Review of Resident R114's physician order dated 6/26/25, indicated to insert foley now. A further review failed to include an order for enhanced barrier precautions. During an observation on 7/7/25, at 11:40 a.m. Resident R114 was observed with a foley catheter intact. During an interview on 7/7/25, at 11:47 a.m. Registered Nurse, E1 confirmed the facility failed to ensure Resident R111, R112, R113, and R114 had a physician order for enhanced barrier precautions. During an interview on 7/9/25, at 11:30 a.m. information was disseminated to the Nursing Home Administrator (NHA) that the facility failed to follow transmission based precautions and utilize enhanced barrier precautions (EBP) creating the potential for cross contamination for four out of four sampled residents (Residents R111, R112, R113, and R114). 28 Pa Code: 201.14 (a) Responsibility of licensee. 28 Pa Code: 201.28 (b)(1)(e )(1) Management. 28 Pa Code: 211.10 (d ) Resident care policies. 395890 Page 4 of 4