Health inspection·October 22, 2024

F 0583 Keep residents' personal and medical records private and confidential. Level of Harm - Minimal harm or potential for actual harm Based on review of facility policies, observations, and staff interviews, it was determined that the facility failed to ensure that each resident's personal privacy was maintained. Residents Affected - Few Findings include: The facility policy related to the Health Insurance Portability and Accountability Act (HIPAA- a federal law that protects the privacy and security of sensitive health information), dated January 2, 2024, included in part, that the facility will keep information regarding a resident's health private and confidential, any paper containing information will not be disposed of in a trash container that is open and easily accessible, and staff will not allow any papers, documents, or any other format with resident information unattended. Observations of the outdoor trash receptacle on October 22, 2024, at 8:30 a.m. revealed a piece of plastic on the ground beside the rear dumpster, which appeared to be a lid for a bowl or cup, that included a resident's last name and the diet orders for a pureed diet with nectar thick liquids. Interview with the Registered Dietician on October 22, 2024, at 8:50 a.m. confirmed that there was garbage on the ground beside the rear outdoor dumpster that contained a resident's personal medical information and that it should not have been there. An interview with the Director of Nursing on October 22, 2024, at 10:40 a.m. confirmed that resident information should be kept private, and information related to a resident in the facility should not have been visible near the garbage dumpster. 28 Pa. Code 201.14(a) Responsibility of Licensee. 28 Pa. Code 201.18(b)(1)(e)(1) Management. Page 1 of 6 395892 395892 10/22/2024 Kadima Rehabilitation & Nursing at Latrobe 576 Fred Rogers Drive Latrobe, PA 15650

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm Based on review of clinical records, as well as staff interviews, it was determined that the facility failed to ensure that physician's orders for medications and treatments were followed for three of seven residents reviewed (Residents 1, 2, 3). Residents Affected - Few Findings include: A quarterly Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs) for Resident 1, dated September 2, 2024, revealed that the resident was cognitively impaired, required assistance with personal care needs, and had diagnosis that included high blood pressure and seizures. Physician's orders for Resident 1, dated October 10, 2024, included orders to cleanse right shin wounds with normal saline and apply Medihoney (a wound and burn gel with antibacterial and bacterial resistant properties) and dry dressing every dayshift. A review of the Treatment Administration Record (TAR) for Resident 1, dated October 2024, revealed that there was no documented evidence that the resident received treatment to his right shin wounds per physician's orders on October 11, 2024, and October 20, 2024. A quarterly MDS assessment for Resident 2, dated August 20, 2024, indicated that the resident was cognitively intact, required assistance from staff for daily care needs, and had diagnoses that included hemiplegia (severe or complete loss of strength on one side of the body) following a stroke. Physician's orders for Resident 2, dated August 13, 2024, included an order for the resident to receive Nystatin (used to treat fungal infections) powder to her folds/groin every day for fungal irritation. Physician's orders, dated September 4, 2024, included an order for the resident to have her right shoulder wound cleansed with normal saline, pat dry, a honey-coated dressing applied to the wound base, and then covered with a border gauze daily and as needed. Physician's orders, dated October 10, 2024, included for the resident to have her right shoulder wound cleansed with normal saline, pat dry, Medihoney applied to the wound base, skin prep (barrier film that protects the skin from adhesives and bodily fluids) applied the area around the wound, and then covered with a border gauze daily and as needed. Review of the TAR for Resident 2, dated September 2024 and October 2024, revealed that there was no documented evidence that Nystatin was applied to the resident's folds/groin on September 10, 11, 15, and 24, and October 2 and 4 as ordered by the physician. There was no documented evidence that the treatment to the resident's right shoulder was completed on September 10, 15, and 20, and October 2, 4, 5, 7, 14, and 16 as ordered by the physician. An annual MDS assessment for Resident 3, dated August 2, 2024, indicated that the resident was cognitively impaired, required assistance from staff for daily care needs, and had diagnoses that included epilepsy (a brain disorder that causes seizures). Physician's orders for Resident 3, dated July 10, 2024, included an order for the resident to receive 5 milligrams (mg) of Clobazam (a controlled drug that is used to treat seizures) one time a day for epilepsy. 395892 Page 2 of 6 395892 10/22/2024 Kadima Rehabilitation & Nursing at Latrobe 576 Fred Rogers Drive Latrobe, PA 15650

F 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Review of the Medication Administration Record (MAR) for Resident 3, dated September 2024, revealed that a dose of 5 mg of Clobazam was administered on September 28, 2024; however, a review of the controlled drug record (a form that accounts for each tablet/pill/dose of a controlled drug) for Resident 3 revealed no documented evidence that a 5 mg dose of Clobazam was signed out on September 28, 2024. Interview with the Director of Nursing on October 22, 2024, at 2:39 p.m. confirmed that Resident 1 did not receive treatment to his right shin wound and Resident 2 did not receive Nystatin to folds/groin or treatment to the right shoulder as ordered by the physician. The Director of Nursing confirmed that the dose of Clobazam for Residnet 3 on September 28 was not signed out on the resident's controlled drug record, and therefore, the medication could not have been administered. 28 Pa. Code 211.12(d)(1)(5) Nursing Services. 395892 Page 3 of 6 395892 10/22/2024 Kadima Rehabilitation & Nursing at Latrobe 576 Fred Rogers Drive Latrobe, PA 15650

F 0814 Dispose of garbage and refuse properly. Level of Harm - Minimal harm or potential for actual harm Based on review of facility policy, observations, and staff interviews, it was determined that the facility failed to properly contain and dispose of garbage in one of two outside dumpsters. Residents Affected - Few Findings include: Review of facility policy for garbage and rubbish disposal, dated January 2, 2024, indicated that outside dumpsters provided by the garbage pick-up services must be kept closed and free of litter around the dumpster area. Observation of the facility's outdoor trash receptacle on October 22, 2024, at 8:30 a.m. revealed that the rear dumpster was uncovered, and there was garbage on the ground around the dumpster that included two plastic bags with garbage, white plastic gloves, washcloths, paper trash, and cardboard. An interview with the Registered Dietician on October 22, 2024, at 8:50 a.m. confirmed that the lid on the rear dumpster was open and should have been closed, and that there was garbage on the ground around the dumpster. An interview with the Director of Nursing on October 22, 2024, at 10:40 a.m. confirmed that the facility failed to properly contain and dispose of garbage in the outside trash receptacles. 28 Pa. Code 201.18(b)(3) Management. 395892 Page 4 of 6 395892 10/22/2024 Kadima Rehabilitation & Nursing at Latrobe 576 Fred Rogers Drive Latrobe, PA 15650

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm Based on review of facility policy, observations, and staff interviews, it was determined that the facility failed to provide a safe and sanitary environment in three of three soiled utility rooms. Residents Affected - Some Findings include: The facility's policy for Infection Control, dated January 2, 2024, indicated that the facility is committed to preventing adverse outcomes such as health care associated infections and their related events, improving resident care by supporting the staff in all areas of the facility, minimizing occupational hazards associated with the delivery of healthcare, and fostering evidence-based decision making. The goal of the program is to provide a safe and sanitary environment. The facility's policy for the laundry process, dated January 2, 2024, indicated that proper laundry processing is done to ensure resident and facility linen items are correctly cleaned and stored. Observations of the facility's three separate utility rooms revealed that the rooms were full of soiled linen bags thrown on the floor. Interview with Laundry Attendant 1 on October 22, 2024, at 9:38 a.m. confirmed that all three laundry rooms were filled with soiled linen and resident personal laundry. She stated that the facility's washer and dryer have not been working and that the laundry was behind. Interview with the Director of Nursing on October 22, 2024, at 12:30 p.m. confirmed that all three soiled utility rooms were filled with dirty linen and residents' personal laundry and that was not sanitary. 28 Pa. Code 201.14(a) Responsibility of Licensee. 28 Pa. Code 201.18(e)(1) Management. 28 Pa. Code 211.12(d)(1)(5) Nursing Services. 395892 Page 5 of 6 395892 10/22/2024 Kadima Rehabilitation & Nursing at Latrobe 576 Fred Rogers Drive Latrobe, PA 15650

F 0921 Level of Harm - Minimal harm or potential for actual harm Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Based on observations and interviews with staff, it was determined that the facility failed to provide a safe, comfortable, and functional environment related to laundry services. Residents Affected - Few Findings include: Interview with Laundry Worker 1 on October 22, 2024, at 9:38 a.m. revealed that she was behind on completing the laundry because one washer and one dryer was broken, and that the facility was taking clothing to the laundromat to try to keep up. A new dryer was installed three weeks ago, and a new washer was installed last week. She was unsure how long they were without one washer and one dryer. Interview with Nurse Aide 2 on October 22, 2024, at 11:34 a.m. revealed that the facility's clothes washer had been broken recently and that she has observed some residents' clothing being returned to the residents appearing moldy and stained. Interview with Resident 7 on October 22, 2024, at 1:20 p.m. revealed that sometimes the facility is without clean washcloths and that on one occasion, when she was incontinent of bowel, staff provided incontinent care using paper towels, because she was told there were no clean washcloths available, and the facility does not use disposable wipes. Interview with Maintenance Worker 3 on October 22, 2024, at 10:15 a.m. revealed that one of the facility's clothes washers and one of the facility's clothes dryers was broken at the same time recently, and that the facility was using their transportation van to take the facility's laundry to local laundromats. He reported that a new washer was installed and was functional on October 18, 2024, and a new dryer was installed prior to that. He revealed that he had no maintenance work orders and was unable to identify exact dates when the washer broke. A review of a purchase order for a new washer revealed that a new washer was ordered on September 5, 2024. Interview with the Director of Nursing on October 22, 2024, at 10:15 a.m. revealed that she was not aware of any concerns in the facility of not having clean linens or washcloths available or of the residents not getting their clothes washed appropriately or timely. Further interview with the Director of Nursing revealed that both washing machines were functional until September 30, 2024, when one broke, and that a new washer was ordered prior to the old washer completely malfunctioning and was delivered on October 17, 2024. 28 Pa. Code 207.2(a) Administrator's Responsibility. 28 Pa. Code 211.12(d)(5) Nursing Services. 395892 Page 6 of 6