Inspection·December 14, 2023

F 0727 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. Based on review of position description and job duties and facility documentation, and staff interviews, it was determined that the facility failed to ensure that a registered nurse was employed as the Director of Nursing on a full-time basis since October 26, 2023. Findings include: Review of the position description section for the Director of Nursing - (DON) revealed that the role of the DON includes to coordinate total nursing care for residents using nursing standards and the nursing process in accordance with current Federal, State, and Local standards, guidelines, and regulations that govern the Long Tern Care Facility to assure that the highest degree of quality care can be provided to our residents at all times. The Job Duties for the DON included to promote an environment in which the resident care team can work cooperatively toward objectives, directs, supervises, delegates and evaluates all nursing care provided to the residents by using professional skills and judgements. Functions as clinical and managerial resource to guide and validate the independent decision making of staff. Review of information submitted by the facility regarding a change in the DON position revealed that Employee EI began as the DON on November 6, 2023. During an interview on December 13, 2023, at 10:30 a.m. DON Employee E1 reported he/she was serving as the temporary DON while they work to fulfill the job with a permanent employee. Employee E1 reported that they also work as the Nursing Supervisor in the acute care hospital two to three days a week. During an interview on December 13, 2023, at 10:30 a.m. the Nursing Home Administrator confirmed that Employee E1 assumed the DON role on November 6, 2023, and the former DON's last day worked was on October 26, 2023. The NHA also confirmed that the current DON does not work on a full-time basis as they also work as the Nursing Supervisor in the acute care hospital two to three days a week. 28 Pa Code 201.14 (a) Responsibility of license 28 Pa Code 211.12 (b) Nursing Services 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: 395894 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 395894 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/14/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Meadville Medical Ctr Tcu 1034 Grove Street Meadville, PA 16335 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)