Inspection visit
Inspection
39 citations recorded
Inspector’s narrative
What the inspector wrote
This survey cited 39 deficiencies, 1 of them serious (actual harm or immediate jeopardy). The full statement and the facility’s plan of correction follow, verbatim from the federal record.
F 0554
Allow residents to self-administer drugs if determined clinically appropriate.
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, review of clinical records, observations and staff interviews, it was determined that
the facility failed to determine whether it was safe to self-administer medications for one of four residents
(Resident R77).Findings include:Review of the facility policy Self-Administration of Medications dated
6/18/25, indicated facility should comply with policy with respect to resident self-administration of
medications. The facility should assess and determine whether self-administration of medications is safe
and clinically appropriate, based on the resident's functionality and health condition. Facility should ensure
that orders for self-administration list the specific medications the resident may self-administer.Review of
the clinical record indicated Resident R77 was admitted to the facility on [DATE].Review of resident R77's
Minimum Data Set (MDS-a periodic assessment of care needs) dated 10/17/25, indicated the diagnoses of
high blood pressure, Parkinson's disease (neuromuscular disorder causing tremors and difficulty walking),
and dementia (a group of symptoms that affects memory, thinking and interferes with daily life).During an
observation on 1/5/26, at 10:17 a.m. Resident R77 was sitting on the edge of the bed with a bedside table.
On the bedside table included a paper towel with 10 medication pills laying on top. Medications included:
four white pills, two yellow pills, two red pills, one peach pill, and one pink pill. No nurse was observed in the
room at this time.Review of Resident R77's physician orders failed to include an order for
self-administration of medications.Review of Resident R77's care plan failed to address self-administration
of medications.During a review of facility provided documentation labeled Self-Administration of
Medications dated 11/30/25, indicated that resident did not want to self-administer medications.During an
interview on 1/5/26, at 10:21 a.m. Licensed Practical Nurse (LPN) Employee E3 stated We should not leave
medications in a resident's room. We are supposed to watch them take them. and confirmed the unsecured
medications at bedside for Resident R77.During an interview on 1/9/26, at 10:09 a.m. LPN Employee E14
stated, I watch residents take medication. I would not leave medications in room for them to take. There is
too much liability against my license. It's not safe for residents. Other residents could take the medication.
The resident may not take the medication.During an interview on 1/5/26, at 2:00 p.m. the Director of
Nursing confirmed the facility failed to determine whether it was safe to self-administer medications for one
of four residents (Resident R77).28 Pa. Code 201.18(b)(1)(3) Management28 Pa. Code: 211.12(d)(1)(5)
Nursing services
Residents Affected - Few
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 36
Event ID:
395986
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0568
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Properly hold, secure, and manage each resident's personal money which is deposited with the nursing
home.
Based on clinical record review and family and staff interview, it was determined that the facility failed to
provide quarterly resident trust fund statements for four of four sampled residents (Residents R11, R31,
R80, and Residents R88). Findings include: The facility Resident fund management policy dated 6/10/25,
indicated that quarterly statements are to be sent by corporate office and addresses are to be maintained
in the resident fund management system. During a resident council group interview on 1/6/26, at 1:00 p.m.
three out of nine residents voiced that the facility has not provided them with quarterly statements. Review
of the facility trust fund account (resident funds account with current accounts open and holding resident
monies) dated 1/6/25, indicated the following residents had active resident fund accounts: Residents R11,
R31, R80, and Residents R88. Further review of facility business records and resident records for did not
include evidence that the residents were provided quarterly statements. During an interview on 1/7/26, at
12:55 p.m. Business office manager Employee E15 confirmed that the facility could not provide evidence of
sending quarterly statements and the facility failed to provide a quarterly resident fund statements for
Residents R11, R31, R80, and Residents R88 as required. 28 Pa. Code 201.14(a) Responsibility of
licensee 28 Pa. Code 201.29(a) Resident rights
Event ID:
Facility ID:
395986
If continuation sheet
Page 2 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0569
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
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, closed clinical records, resident fund account statements and staff interview it was
determined that the facility failed to convey resident funds and close accounts upon discharge within 30
days for three out of three closed resident records (Closed Resident records CR110, CR111, and CR112).
Findings include: The facility Resident fund management policy dated [DATE], indicated that trust accounts
for discharged or expired residents are to be closed and funds disbursed timely. Review of Closed Resident
Record CR110's admission record indicated he was admitted on [DATE] and re-admitted to the facility on
[DATE]. Review of Closed Resident Record CR110's MDS assessment (Minimum Data Set assessment:
MDS -a periodic assessment of resident care needs) dated [DATE], indicated he was admitted with
diagnoses that included dementia (a condition characterized by memory loss and progressive or persistent
loss of intellectual functioning), depression (a state of consistent sadness and loss of interest interfering in
daily life activities), anxiety disorder (a medical condition creating a sense of acute fear, restlessness, and
worry) and restlessness. Review of Closed Resident Record CR110's physician orders dated [DATE],
indicated to release CR110's body to the funeral home. Review of Closed Resident Record CR110's clinical
progress documentation dated [DATE], indicated CR110 ceased to breathe. Hospice notified resident
expired. Review of Closed Resident Record CR111's admission record indicated she was admitted on
[DATE]. Review of Closed Resident Record CR111's MDS assessment dated [DATE], indicated she had
diagnoses that included dementia, hypertension (a condition impacting blood circulation through the heart
related to poor pressure), and Takotsubo syndrome (sudden temporary weakening in the heart muscle).
Review of Closed Resident Record CR111's clinical nurse notes dated [DATE], staff called to CR111's
room and she was observed for two minutes with no audible pulse. Review of Closed Resident Record
CR111's physician note dated [DATE], indicated to release CR111 body to morgue or funeral home. Review
of Closed Resident Record CR112's admission record indicated she was admitted on [DATE]. Review of
Closed Resident Record CR112's MDS assessment dated [DATE], indicated she had diagnoses that
included lumbar fracture, hypertension and chronic pain. Review of Closed Resident Record CR112's
clinical nurse notes dated [DATE], indicated staff heard a noise and went into CR112's room at 8:39 a.m.
CR112 was observed sitting by her roommate bed and bleeding from back of head. Other staff called and
applied compressing dressing. CR112 stated she was trying to [NAME] the bathroom. CR112 was sent to
the hospital. Review of Closed Resident Record CR112's physician order dated [DATE], indicated CR112
may discharge to other nursing facility. Review of the facility trust fund account (resident funds account with
current accounts open and holding resident monies) dated [DATE], indicated the following: Closed Resident
Record CR110 had a balance of $108.60Closed Resident Record CR111 had a balance of $79.50Closed
Resident Record CR112 had a balance of $20.03 During an interview on [DATE], at 11:13 a.m. the
Business office manager Employee E15 confirmed that the facility failed to convey resident funds and
closed resident accounts within 30 days upon discharge for Closed Resident Record CR110, CR111, and
CR112 as required. 28 Pa. Code 211.5(d) Clinical records.
Residents Affected - Some
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 3 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0580
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room,
etc.) that affect the resident.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
review of clinical record review, and staff interviews, it was determined that the facility failed to ensure the
physician was appropriately notified of change in condition for one of four residents reviewed (Resident
R99).Findings include: Review of the facility Resident Change in Condition policy dated 6/18/25, stated for
physician and family will be notified as soon as the nurse had identified the change in condition and the
resident is stable. Review of the clinical record indicated Resident R99 was admitted to the facility on
[DATE]. Review of resident R99's care plan dated 8/19/25, indicated to notify physician of any changes.
Review of Resident R99's Minimum Data Set (MDS - a periodic assessment of care needs) dated 8/22/25,
indicated diagnoses of dementia (the loss of cognitive functioning - thinking, remembering, and reasoning to such an extent that it interferes with a person's daily life and activities), anxiety, and depression. Review
of Resident R99's progress note dated 9/4/25, at 10:18 p.m. stated During evening care resident began
swinging at the staff and then started to punch himself on his head. No injuries noted at this time and
resident has been redirected and placed at the nursing station for monitoring. Review of Resident R99's
clinical record failed to reveal evidence the resident's physician was notified of the change in condition on
9/4/25. Review of Resident R99's progress note dated 10/13/25, at 10:18 p.m. stated Multiple times
throughout the evening resident stating he wants to die, asking staff to kill him, hitting self on his head.
Review of Resident R99's clinical record failed to reveal evidence the resident's physician was notified of
the change in condition on 10/13/25. During an interview on 1/8/26, at 10:52 a.m. information was
disseminated to the Regional [NAME] President of Operations, Employee E17, that the facility failed to
ensure the physician was appropriately notified of change in condition for one of four residents reviewed
(Resident R99). 28 Pa. Code: 201.14(a) Responsibility of licensee.28 Pa. Code: 201.18 (b)(1)
Management.28 Pa. Code: 211.10 (c)(d) Resident Care policies.28 Pa. Code: 211.12 (d)(1)(2)(3)(5) Nursing
services.
Event ID:
Facility ID:
395986
If continuation sheet
Page 4 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0602
Protect each resident from the wrongful use of the resident's belongings or money.
Level of Harm - Minimal harm
or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on a
review of facility policy, facility documents, clinical records, incident investigations, and staff interviews, it
was determined that the facility failed to ensure that residents are free from misappropriation of property for
one of two residents (Resident R88).Findings include: Review of the facility policy Pennsylvania Resident
Abuse dated 6/18/25, indicated that the facility will not tolerate abuse, neglect, mistreatment, exploitation of
residents, and misappropriation of resident property by anyone. Exploitation was defined as the unfair
treatment or use of a resident or the taking of a selfish or unfair advantage of a resident for personal gain,
through manipulation, intimidation, threats or coercion. Review of the clinical record revealed that Resident
R88 was admitted to the facility on [DATE]. Review of Resident 88's MDS (Minimum Data Set, periodic
assessment of resident care needs) dated 11/12/25, indicated diagnoses of high blood pressure, thyroid
disorder, and chronic pain. Review of a written statement dated 12/24/25, revealed that Business Office
Manager (BOM) Employee E15 stated the following: As I was reviewing the RFMS (Resident Fund
Management Service- banking account information) account for Resident R88 on 12/24/25, I noticed a
check issued to Nurse Aide Employee E29 in the amount of $750 on April 22, 2025. I asked the resident
who this person was and why he asked for the check to be issued as it was over the $500 Medicaid gifting
limit. The resident stated, 'That is a nurse aide from here (the facility) who was having a rough time, and I
felt bad and wanted to help.' I then informed the resident that he was a very generous person however;
employees are not permitted to receive gifts of any kind from residents. Review of the RFMS report for
Resident R88 that was ran on 12/30/25, and included transactions from 1/1/25, through 12/30/25, indicated
that two checks were written on 4/22/25, for the amount of $750. One was for NA Employee E29, and NA
Employee E30. The RFMS report also stated that the checks were cashed and cleared on 4/25/25. During
an interview on 1/6/25, at 9:54 a.m. Resident R88 stated that he Gave two employees $750, and they got
fired. I feel so bad. During an interview on 1/7/25, at 2:54 p.m. BOM Employee E15 was asked if the
resident is able to write his own checks from the RFMS account. BOM Employee E15 stated No. He would
have had to gotten the former BOM to write a check from that account. He (Resident R88) called me and
asked me to write him a check for his credit union for $750. I told him that anything over $500 gets
questioned by Medicaid and advised him to keep it under 500. That's when I checked his account and saw
that he had written other checks for $750 (to NA Employee E29, and E30). BOM Employee E15 was asked
if the former BOM should have advised him not to write a check out to employees, to which she responded:
Yes. During an interview on 1/8/26, at 12:20 p.m. the Regional Nurse Consultant (RNC) Employee E1
confirmed that employees should not accept gifts from residents, but that it was not felt to be
misappropriation as Resident R88 is alert and oriented. State Agency reminded RNC Employee E1 that the
regulation specifically gives an example of misappropriation of a resident who provides monetary
assistance to staff, after staff had made resident believe that staff was in a financial crisis. RNC Employee
E1 then confirmed that the facility failed to ensure that residents are free from misappropriation of money
for one of two residents. 28 Pa. Code: 201.29(a) Resident rights.
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 5 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0605
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's
ability to function.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
facility policy, clinical record review, and staff interview, it was determined that the facility failed to ensure
that residents' medication regime was free from unnecessary psychotropic (a mind-altering medication)
medication for two of five residents (Resident R2 and R9).Findings include:Review of facility Psychotropic
Medication Use policy dated 6/18/25, indicated all medications used to treat behaviors must have a clinical
indication to be used. As needed, medications shall be limited to 14 days and cannot be renewed unless
the attending physician evaluates the resident for the appropriateness of that medication. The physician
must document rationale for medication for more than 14 days.Review of the clinical record indicated
Resident R2 was admitted to the facility on [DATE].Review of Resident R2's Minimum Data Set (MDS - a
periodic assessment of care needs) dated 11/14/25, indicated diagnoses of high blood pressure, bipolar
disorder (a mental condition marked by alternating periods of elation and depression), and wound
infection.Review of Resident R2's clinical record revealed physician orders for the following psychotropic
medications and failed to have a diagnosis for use of the medication:Sertraline (used to treat depression)
100 mg (milligrams) daily - no diagnosis indicatedSeroquel (used to treat mental health disorders) 200 mg
daily - no diagnosis indicatedDuring an interview on 1/8/26, at 9:08 a.m. the Director of Nursing (DON)
stated, I've seen medications don't have diagnosis and I've been working on it.During an interview on
1/8/26, at 11:54 a.m. Registered Nurse Employee E13 stated, When we put orders in, we put the diagnosis
of the medication in the order. It's been beaten in my head over the years to do that.Review of the clinical
record indicated Resident R9 was admitted to the facility on [DATE].Review of Resident R9's MDS dated
[DATE], indicated diagnoses of heart failure (a progressive heart disease that affects pumping action of the
heart muscles), diabetes (a metabolic disorder in which the body has high sugar levels for prolonged
periods of time), and anxiety.Review of Resident R9's physician orders dated 10/16/25, indicated to
administer Ativan (used to treat anxiety) one milligram every two hours as needed (PRN) for
anxiety/restlessness.Review of Resident R9's physician order failed to include a 14 day stop date and there
was no documented rationale by the physician for the medication to extend past 14 days for Resident R9's
Ativan.During an interview on 1/8/26, at 2:00 p.m. the DON confirmed Resident R2's medications did not
include a diagnosis for use and the facility failed to make certain that medical records on each resident are
complete and accurately documented for one of five residents (Resident R2), and confirmed that the facility
failed to ensure that residents medication regime was free from unnecessary psychotropic medication for
one of five residents (Resident R9). 28 Pa. Code 211.2(d)(3) Medical Director.28 Pa. Code 211.10(a)
Resident care policies.
Event ID:
Facility ID:
395986
If continuation sheet
Page 6 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0607
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Level of Harm - Minimal harm
or potential for actual harm
Based on review of facility policy, review of personnel files, and staff interview, it was determined that the
facility failed to properly screen an employee by failing to conduct a criminal background check prior to the
start of employment for one of five personnel files reviewed (Licensed Practical Nurse (LPN) Employee
E9).Findings include: Review of facility policy Abuse, Neglect and Exploitation dated 6/18/25, indicated it is
the policy of the Facility to undertake background checks of all employees and to retain on file applicable
records or current employees regarding such checks. Review of the facility Payroll/Human Resources
Coordinator job description indicated an essential function of the position is to ensure that pre-screening of
employees is completed (license verification, exclusion checks, background checks, drug screen/physical
as required). Maintain complete employee files with accurate and up-to-date information. Review of LPN
Employee E9's personnel file revealed a hire date of 9/25/25. Review of the personnel file did not include a
completed state criminal background check prior to their date of hire. During an interview on 1/7/26, at
10:31 a.m. Human Resources Employee E2 confirmed that the facility failed to properly screen an
employee by failing to conduct a criminal background check prior to the start of employment for one of five
personnel files reviewed (LPN Employee E9). 28 Pa. Code: 201.14(a) Responsibility of licensee.28 Pa.
Code: 201.19(8) Personnel records.
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 7 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0609
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper
authorities.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
review of facility policy, resident clinical record, incident reports, reports submitted to the State, and staff
interview it was determined that the facility failed to report an incident of neglect for two of five residents
(Resident R71, and R88).
Findings include:
Review of facility Pennsylvania Resident Abuse policy dated 6/18/25, indicated all reports of resident
abuse, neglect, misappropriation of resident property are reported immediately to the administrator,
Director of nursing, and to the applicable state agency.
Review of the clinical record indicated Resident R71 was admitted to the facility on [DATE].
Review of Resident R71's Minimum Data Set (MDS - a periodic assessment of care needs) dated 10/8/25,
indicated diagnoses of dementia (the loss of cognitive functioning, thinking, remembering, and reasoning,
to such an extent that it interferes with a person's daily life and activities), Parkinson's Disease (a
degenerative brain disease that affects muscle control, among other symptoms), and depression.
Review of Resident R71's care plan dated 8/6/24, indicated to monitor the resident frequently within the
unit.
Review of Resident R71's care plan dated 9/26/24, indicated to observe frequently and place in supervised
area when out of bed.
Review of Resident R71's progress note dated 12/4/25, at 8:34 p.m. stated Resident was found in the MIU
(Memory Impaired Unit) hall sitting in a chair with a bottle of [NAME] Perineal and Skin Cleanser open and
appeared that she had drank some of the soap. Poison Control called and verified product is non-toxic and
to just monitor. Called and spoke with the on-call provider who advised to just continue to monitor. The
resident's family was notified and advised of the incident and explained the providers recommendation
along with Poison Control.
Review of Nurse Aide (NA), Employee E20's witness statement dated 12/4/25, revealed NA, Employee E20
was exiting another resident's room when Resident R71 was observed running up the hallway with a bottle
in hand. The resident then sat on a chair and tipped the bottle back in her mouth. The item was in the
resident's closet on the top shelf in a closed container. Resident has previously demonstrated that she is
capable of retrieving items.
Review of information submitted to the State Agency on 12/4/25, and 12/5/25, failed to include Resident
R71's incident of neglect.
During an interview on 1/8/25, at 12:37 p.m. the Regional Nurse Consultant, Employee E1 confirmed that
the facility failed to report an allegation of neglect for one of five residents (Resident R71).
Review of the clinical record revealed that Resident R88 was admitted to the facility on [DATE].
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 8 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0609
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Review of Resident 88's MDS (Minimum Data Set, periodic assessment of resident care needs) dated
11/12/25, indicated diagnoses of high blood pressure, thyroid disorder, and chronic pain.
Review of a written statement dated 12/24/25, revealed that Business Office Manager (BOM) Employee
E15 stated the following: As I was reviewing the RFMS (Resident Fund Management Service- banking
account information) account for Resident R88 on 12/24/25, I noticed a check issued to Nurse Aide
Employee E29 in the amount of $750 on April 22, 2025. I asked the resident who this person was and why
he asked for the check to be issued as it was over the $500 Medicaid gifting limit. The resident stated, 'That
is a nurse aide from here (the facility) who was having a rough time, and I felt bad and wanted to help.' I
then informed the resident that he was a very generous person; however, employees are not permitted to
receive gifts of any kind from residents.
Review of the RFMS report for Resident R88 that was ran on 12/30/25, and included transactions from
1/1/25, through 12/30/25, indicated that two checks were written on 4/22/25, for the amount of $750. One
was for NA Employee E29, and NA Employee E30. The RFMS report also stated that the checks were
cashed and cleared on 4/25/25.
During an interview on 1/6/25, at 9:54 a.m. Resident R88 stated that he Gave two employees $750, and
they got fired. I feel so bad.
During an interview on 1/7/25, at 2:54 p.m. BOM Employee E15 was asked if the resident is able to write
his own checks from the RFMS account. BOM Employee E15 stated No. He would have had to get the
former BOM to write a check from that account. He (Resident R88) called me and asked me to write him a
check for his credit union for $750. I told him that anything over $500 gets questioned by Medicaid and
advised him to keep it under 500. That's when I checked his account and saw that he had written other
checks for $750 (to NA Employee E29, and E30). BOM Employee E15 was asked if the former BOM should
have advised him not to write a check out to employees, to which she responded: Yes.
Review of information submitted to the State Agency from 11/24/25 through 1/8/26, failed to include
Resident R88's misappropriation of money.
During an interview on 1/8/26, at 12:20 p.m. the Regional Nurse Consultant (RNC) Employee E1 confirmed
that the facility failed to report misappropriation of money for Resident R88.
28 Pa Code: 201.14 (a)(c) Responsibility of licensee.28 Pa Code: 201.18 (b)(1)(e)(1) Management.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 9 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0628
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Provide the required documentation or notification related to the resident's needs, appeal rights, or
bed-hold policies.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
review of facility policy, clinical record review, and staff interview, it was determined that the facility failed to
make certain that the necessary resident information was communicated to the receiving health care
provider, including bed hold policy for two of four residents sampled with facility-initiated transfers
(Residents R1 and R5). Findings include:Review of facility policy Discharge Planning dated 6/18/25,
indicated transfers and discharges will meet requirements. The facility will take steps to ensure that the
transfer or discharge is documented in the resident's medical record and necessary information is
communicated to the receiving health care institution or provider.Review of facility policy Bed Hold Letter
dated 6/18/25, indicated it is the policy of the facility to track bed hold days and notify appropriate parties
via bed hold letter.Review of the clinical record revealed that Resident R1 was admitted to the facility on
[DATE]. Review of Resident R1's MDS (Minimum Data Set, periodic assessment of resident care needs)
dated 11/12/25, indicated diagnoses of heart failure (a progressive heart disease that affects pumping
action of the heart muscles), arthritis, and cerebral infarction (necrotic tissue in the brain resulting loss of
blood and oxygen to the brain).Review of the clinical record indicated Resident R1 was transferred to the
hospital on [DATE], and returned to the facility on [DATE].Review of Resident R1's clinical record revealed
no documented evidence that the facility had communicated specific information to the receiving health
care provider for the residents transferred and expected to return, which included the bed hold policy, to
meet the resident's specific needs at the receiving facility.Review of the clinical record revealed that
Resident R5 was admitted to the facility on [DATE]. Review of Resident R5's MDS dated [DATE], indicated
diagnoses of dementia (a group of symptoms that affects memory, thinking and interferes with daily life),
heart failure, and diabetes (a metabolic disorder in which the body has high sugar levels for prolonged
periods of time).Review of the clinical record indicated Resident R5 was transferred to the hospital on
[DATE], and returned to the facility on [DATE].Review of Resident R5's clinical record revealed no
documented evidence that the facility had communicated specific information to the receiving health care
provider for the residents transferred and expected to return, which included the bed hold policy, to meet
the resident's specific needs at the receiving facility.During an interview on 1/9/26, at 9:11 a.m. Director of
Nursing confirmed that the facility failed to make certain that the necessary resident information was
communicated to the receiving health care provider for two of four residents sampled with facility-initiated
transfers (Residents R1 and R5).28 Pa. Code: 201.29 (a)(c.3)(2) Resident rights.
Event ID:
Facility ID:
395986
If continuation sheet
Page 10 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Level of Harm - Minimal harm
or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
review of clinical records and staff interview, it was determined that the facility failed to provide care and
treatment as ordered by physician for one of three residents (Residents R71).Findings include: Review of
the clinical record indicated Resident R71 was admitted to the facility on [DATE], with diagnoses of
dementia (the loss of cognitive functioning, thinking, remembering, and reasoning, to such an extent that it
interferes with a person's daily life and activities), Parkinson's Disease (a degenerative brain disease that
affects muscle control, among other symptoms), and depression. Review of Resident R71's care plan dated
4/22/25, indicated the resident has Parkinson's disease and to provide drug therapy per order. Review of
Resident R71's Minimum Data Set (MDS - a periodic assessment of care needs) dated 10/8/25, indicated
diagnoses were current. Review of Resident R71's Neurology after visit summary dated 11/19/25, revealed
the resident was ordered to increase 20 mg (milligrams) entacapone (medication used primarily to treat
symptoms of Parkinson's disease by enhancing effects of Sinemet), 1 tablet, four times a day, take with
each of the first four doses of Sinemet (medication used to treat Parkinson's symptoms) in order to extend
the benefit of Sinemet and shorten the wearing off dose. Review of Resident R71's progress note dated
11/22/25, revealed the resident was seen by Certified Registered Nurse Practitioner (CRNP), Employee
E21 after follow up with neurology appointment. Recommendations to add entacapone 200mg with first four
doses of Sinemet. Review of Resident R71's physician order dated 12/1/25, indicated to administer
entacapone tablet, 200mg, one tablet, four times a day with first four daily doses of Sinemet. A total of 12
days after it was ordered. During an interview on 1/7/26, at 12:59 p.m. Director of Nursing and Regional
Nurse Consultant, Employee E1 confirmed the facility failed to timely administer Resident R71's
entacapone to provide care and treatment as ordered by physician for one of three residents (Residents
R71). 28 Pa. Code: 201.18 (b)(1) Management.28 Pa. Code: 211.10 (c)(d) Resident Care policies.28 Pa.
Code: 211.12 (d)(1)(2)(3)(5) Nursing services.
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 11 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0688
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM
and/or mobility, unless a decline is for a medical reason.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
review of facility policy, clinical record review, observations, and staff interviews, it was determined that the
facility failed to develop and implement a comprehensive resident-specific plan of care for a resident with
limited mobility requiring equipment and assistance to maintain or improve mobility for one of two residents
(Resident R10). Review of facility policy Splint Issuance Policy dated 6/18/25, indicated that the patient
splint schedule will be communicated to the multidisciplinary team and documented in the care plan.
Review of the clinical record revealed that Resident R10 was admitted to the facility on [DATE]. Review of
Resident 10's MDS (Minimum Data Set, periodic assessment of resident care needs) dated 11/12/25,
indicated diagnoses of hemiplegia (paralysis on one side of the body), cerebral vascular accident (a loss of
blood flow to the brain, which damages brain tissue). Review of Resident R10's clinical record revealed a
physician's order dated 9/5/25, to wear resting hand splint to left upper extremity nightly as tolerated at
bedtime. Review of Resident R10's care plan failed to include the development of goals and interventions
related to Resident R10's resting hand splint usage. During an interview on 1/7/26, at 1:35 p.m. the Director
of Nursing confirmed that facility failed to develop and implement a comprehensive resident-specific care
plan for Resident R10's resting hand splint. 28 Pa. Code: 201.14(a) Responsibility of licensee.28 Pa. Code:
211.10(c)(d) Resident care policies.28 Pa. Code: 211.12(d)(1)(3)(5) Nursing services.
Event ID:
Facility ID:
395986
If continuation sheet
Page 12 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0689
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
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 policy, resident clinical record, incident reports, reports submitted to the State, and staff
interview it was determined that the facility failed to make certain each resident received adequate
supervision which resulted in a resident ingesting a skin cleanser for one of four residents (Resident
R71).Findings include: Review of the facility Resident Incident and Accident Report policy dated 6/18/25,
indicated an incident is any occurrence that is not consistent with routine care of a particular resident.
Review of the clinical record indicated Resident R71 was admitted to the facility on [DATE]. Review of
Resident R71's Minimum Data Set (MDS - a periodic assessment of care needs) dated 10/8/25, indicated
diagnoses of dementia (the loss of cognitive functioning, thinking, remembering, and reasoning, to such an
extent that it interferes with a person's daily life and activities), Parkinson's Disease (a degenerative brain
disease that affects muscle control, among other symptoms), and depression. Review of Resident R71's
care plan dated 8/6/24, indicated to monitor the resident frequently within the unit. Review of Resident
R71's care plan dated 9/26/24, indicated to observe frequently and place in supervised area when out of
bed. Review of Resident R17's progress note dated 12/4/25, at 8:34 p.m. stated Resident was found in the
MIU (Memory Impaired Unit) hall sitting in a chair with a bottle of [NAME] Perineal and Skin Cleanser open
and appeared that she had drank some of the soap. Poison Control called and verified product is non-toxic
and to just monitor. Called and spoke with the on-call provider who advised to just continue to monitor. The
resident's family was notified and advised of the incident and explained the providers recommendation
along with Poison Control. During an interview on 1/7/25, at 11:02 a.m. the Director of Nursing and
Regional Nurse Consultant, Employee E1 confirmed that the facility failed to make certain each resident
received adequate supervision to prevent a resident from ingesting a skin cleanser for one of four residents
(Resident R71). 28 Pa Code: 201.14 (a)(c) Responsibility of licensee.28 Pa Code: 201.18 (b)(1)(e)(1)
Management.
Event ID:
Facility ID:
395986
If continuation sheet
Page 13 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 five residents (Resident R13, R36, and
R100).Findings include:Review of facility policy Oxygen Administration dated 6/18/25, indicated licensed
clinicians with demonstrated competence will administer oxygen via specified route as ordered by
physician.Review of the clinical record indicated Resident R13 was admitted to the facility on
[DATE].Review of Resident R13's Minimum Data Set (MDS - a periodic assessment of care needs) dated
11/3/25, indicated diagnoses of chronic obstructive pulmonary disease (COPD, a group of progressive lung
disorders characterized by increasing breathlessness), asthma (condition where the airways narrow and
swell), and dementia (a group of symptoms that affects memory, thinking and interferes with daily life).
Section O Special Treatments, Procedure and Programs O0110, C1 Oxygen Therapy is marked as while a
resident.Review of a physician's orders dated 10/29/25, indicated to administer oxygen via nasal cannula (a
thin tubing that delivers oxygen from the oxygen concentrator to the nose) two liters per minute as needed
for shortness of breath. During an observation on 1/5/26, at 10:45 a.m. Resident R13 was lying in bed with
oxygen in use. The oxygen concentrator was located beside the bed. Oxygen tubing was dated
12/15/25.Review of the clinical record indicated Resident R36 was admitted to the facility on [DATE].Review
of Resident R36's MDS dated [DATE], indicated diagnoses of high blood pressure, diabetes (a metabolic
disorder in which the body has high sugar levels for prolonged periods of time), and asthma. Section O
Special Treatments, Procedure and Programs O0110, C1 Oxygen Therapy is marked as while a
resident.Review of physician's orders dated 4/21/25, indicated to administer oxygen via nasal cannula at
two liters per minute at bedtime as needed for comfort.During an observation on 1/5/26, at 10: 50 a.m.
Resident R36 was lying in bed with oxygen in use. The oxygen concentrator was located beside the bed.
The oxygen tubing failed to have a date when it was changed. The humidification was connected to the
concentrator and failed to have a date which it was put on for use.Review of the clinical record indicated
Resident R100 was admitted to the facility on [DATE].Review of Resident R100's MDS dated [DATE],
indicated diagnoses of COPD, asthma, and heart failure (a progressive heart disease that affects pumping
action of the heart muscles). Section O Special Treatments, Procedure and Programs O0110, C1 Oxygen
Therapy is marked as while a resident.Review of a physician's orders dated 1/31/25, indicated to administer
oxygen via nasal cannula three liters per minute continuously. Add humidification for comfort, if
needed.Review of physician's orders dated 11/24/25, indicated to administer ipratropium-albuterol (a
medication used to open air ways in the lung) via nebulizer (a machine used to deliver inhaled medication
using tubing and handheld device) every four hours as needed. During an observation on 1/5/26, at 10:55
a.m. Resident R100 was lying in bed with oxygen in use. The oxygen concentrator was located beside the
bed. The oxygen tubing was dated 12/15/25, and the humidification bottle was empty and failed to have a
date on which it was put on for use. The nebulizer machine was observed on the bedside stand. The
nebulizer tubing was dated 11/11/25, and was not stored in a bag when not in use.During an interview on
1/5/26, at 11:21 a.m. Licensed Practical Nurse (LPN) Employee E3 stated that the oxygen and nebulizer
tubing should be changed weekly and stored in a bag when not in use. I was taught to date everything. How
would you know when it was changed? and confirmed the above findings.During an interview on 1/5/26, at
2:00 p.m. the Director of Nursing confirmed that the facility failed to provide appropriate respiratory care for
three of five residents (Resident R13, R36, and R100).28 Pa. Code: 201.14(a) Responsibility of licensee.28
Pa. Code: 211.12(d)(1)(2)(3)(5) Nursing services
Residents Affected - Some
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 14 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0698
Provide safe, appropriate dialysis care/services for a resident who requires such services.
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 clinical record, and staff interview, it was determined that the facility failed
to maintain a complete record of pre and post dialysis assessments for one out of three sampled resident
records (Resident R11). Findings include: The facility Hemodialysis care policy last reviewed 6/18/25,
indicated that communications between the dialysis provider and the facility staff will occur before and after
each dialysis appointment. Document the assessment in the dialysis communication tool. Review of
Resident R11's admission record indicated she was originally admitted on [DATE] and re-admitted to the
facility on [DATE]. Review of Resident R11's MDS assessment (Minimum Data Set assessment: MDS -a
periodic assessment of resident care needs) dated 11/5/25, indicated she had diagnoses that included
congestive heart failure (a progressive heart disease affecting pumping action of the heart muscles
impacting circulation, swelling and shortness of breath), diabetes (metabolic disorder impacting organ
function related to glucose levels in the human body), and end stage renal disease (gradual loss of kidney
function). Review of Resident R11's care plan dated 7/17/23, and updated 11/11/25, indicated to follow up
with Dialysis book, chart and record information as noted. Review of Resident R11's 5/10/25, indicated to
send to dialysis center on Monday, Wednesday and Fridays. Review of Resident R11's clinical nurse notes
dated 9/26/25, indicated that Resident R11 went out of the facility at 9:00 a.m. to dialysis. Review of
Resident R11's clinical nurse notes, physician notes and dialysis communication documentation did not
include dialysis communications for the month of September 2025. During an interview on 1/9/26, at 9:52
a.m. Medical records/central supply personnel Employee E16 confirmed that the facility failed to maintain a
complete record of pre and post dialysis assessments for Resident R11 as required. 28 Pa. Code:
201.14(a) Responsibility of licensee. 28 Pa. Code: 201.18 (b)(1)(e)(1) Management. 28 Pa. Code: 211.10(d)
Resident care policies. 28 Pa. Code: 211.12 (d)(1)(5) Nursing services.
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 15 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0725
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Many
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in
charge on each shift.
Based on review of facility documents, and resident and staff interviews, it was determined that the facility
failed to have sufficient nursing staff to provide nursing and related services to attain or maintain the
highest practicable physical, mental, and psychosocial well-being of eleven of 16 residents (Group Resident
(GR)1, GR2, GR3, GR4, GR5, GR6, GR7, GR8, and GR9, R51, and R88).
Findings Include:
Review of Payroll Based Journal (PBJ- a mandatory reporting system for nursing homes in which staffing
information is reported on a quarterly basis) dated 1/1/25, through 3/31/25, indicated that the facility has a
one star rating out of five stars, and that they have excessively low weekend staffing.
Review of PBJ dated 7/1/25 through 9/30/25, indicated that the facility has a one star rating out of five stars,
and that they have excessively low weekend staffing.
During an interview on 1/6/26, at 9:52 a.m. Resident R88 stated that he is supposed to get two showers a
week, and that he requires two employees for him to get a shower. I don't always get a shower as they don't
always have two employes to shower me.
During a resident council group interview on 1/6/26, at 1:00 p.m. nine out of nine residents voiced that the
facility is short staffed.
During an interview on 1/7/25, at 7:57 a.m. Resident R51 stated I'm supposed to get a shower twice a week
and I'm lucky if I get one. I'm told it's because they don't have enough staff.
During an interview on 1/8/26, at 9:32 a.m. Licensed Practical Nurse (LPN) Employee E25 confirmed that
the facility does not have enough staff. Three to eleven shift is bad. They [residents] don't get showers then.
During an interview on 1/8/25, at 10:34 a.m. Nurse Aide (NA) Employee E26 also stated that they do not
have enough staff. Today I have to skip a shower because of no staff. It happens several times a week but
has been worse in the past month. All shifts appear to be short. It's just hard in general, can't get people out
of bed, hard to find help for Hoyer lifts (a mechanical device used to safely transfer individuals who cannot
move independently and requires two employees for safe operation), and tray pass takes longer.
During an interview on 1/8/26, at 10:25 a.m. the Director of Nursing confirmed that the facility failed to have
sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable
physical, mental, and psychosocial well-being for eleven of 16 residents.
28 Pa. Code: 201.14(a) Responsibility of licensee.
28 Pa. Code 201.18(e)(6) Management.
28 Pa. Code: 211.12(d)(1)(4) Nursing services.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 16 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0730
Observe each nurse aide's job performance and give regular training.
Level of Harm - Minimal harm
or potential for actual harm
Based on review of personnel records and staff interview, it was determined that the facility failed to
complete annual performance evaluations at least once every 12 months for two of five nurse aide (NA)
personnel records (NA Employees E11 and E19).Findings include: Review of NA Employee E11's
personnel record indicated a hire date of 7/1/23. Review of NA Employee E11's personnel record failed to
include an annual performance evaluation at least every 12 months as required. Review of NA Employee
E19's personnel record indicated a hire date of 7/1/23. Review of NA Employee E19's personnel record
failed to include an annual performance evaluation at least every 12 months as required. During an
interview on 1/7/26, at 1:45 p.m. Regional Nurse Consultant Employee E1 confirmed that the facility failed
to complete annual performance evaluations at least once every 12 months for two of five nurse aide
personnel records (NA Employee E11 and E19). 28 Pa. Code: 201.14(a) Responsibility of licensee.28 Pa.
Code: 201.19(2) Personnel records.
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 17 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0732
Post nurse staffing information every day.
Level of Harm - Potential for
minimal harm
Based on observations and staff interviews, it was determined that the facility failed to ensure that current
and accurate nurse staffing information was available at the beginning of each shift.Findings include: An
observation on 1/8/26, at 1:12 p.m. revealed the nurse staffing information was posted near the facility's
main entrance and was dated 1/3/26. During the observation, the nurse staffing information had the
incorrect date and resident census, and the staffing hours did not accurately reflect the current total number
of hours worked for licensed and unlicensed nursing staff directly responsible for nursing care per shift.
During an interview on 1/8/26, at 1:22 p.m. Regional Nurse Consultant Employee E1 confirmed that the
facility failed to post the required current facility information for staffing hours and the census for 1/8/26. 28
Pa. Code: 201.14(a) Responsibility of licensee.28 Pa. Code: 201.18(b) Management.
Residents Affected - Many
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 18 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0740
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Ensure each resident must receive and the facility must provide necessary behavioral health care and
services.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
review of facility policy, resident clinical records, and staff interviews, it was determined that the facility
failed to ensure a resident received appropriate behavioral health services to maintain the highest
practicable well-being as required (Resident R99).Findings include: The facility Psychotropic Medication
Use policy last reviewed 6/18/25, indicated the facility should involve the resident or the resident
representative in the discussion of potential non-pharmacologic and medication interventions to address
the management of behaviors and the involvement should be documented in the resident's medical record.
Review of the clinical record indicated Resident R99 was admitted to the facility on [DATE]. Review of
Resident R99's active diagnoses revealed a history of suicidal ideations, dementia (the loss of cognitive
functioning, thinking, remembering, and reasoning, to such an extent that it interferes with a person's daily
life and activities), anxiety, and depression. Review of resident R99's care plan dated 8/19/25, indicated to
notify physician of any changes. Review of resident R99's care plan dated 8/21/25, revealed the resident
has behavioral symptoms due to anxiety. Interventions included to monitor and report any adverse side
effects of medications, assess if anxiety endangers the resident and/or, others and to intervene as
necessary, and obtain a psych consult/psychosocial therapy. Resident R99 care plan failed to include
suicidal ideations. Review of Resident R99's Minimum Data Set (MDS - a periodic assessment of care
needs) dated 8/22/25, indicated diagnoses were current. Review of Resident R99's progress note dated
9/4/25, at 10:18 p.m. stated During evening care resident began swinging at the staff and then started to
punch himself on his head. No injuries noted at this time and resident has been redirected and placed at
the nursing station for monitoring. Review of Resident R99's progress note dated 9/27/25, at 3:21 a.m.
stated Resident is becoming increasingly aggressive during late evening and night shifts. He only sleeps
sporadically. He yells and screams at the top of his lungs and is unable to be redirected. Any time care is
attempted he is punching staff, spitting at them and on them, threatening them with physical violence, and
tonight actually threatened to shoot the CNA's (Certified Nurse Aide) and also threatened to choke the
CNAs. He is disturbing other residents, sitting in the hall outside their rooms or in their doorways yelling,
swearing, and threatening. We cannot safely leave him in bed when he is awake because his fall risk is
extremely high and he has already fallen multiple times while he was awake throughout the night and
agitated. When staff attempt to move him and his wheelchair back to the nurse's station, he is swinging and
grabbing at them while cursing and threatening. He also becomes so agitated that he punches and slaps
himself while yelling curse words. This information has been passed on in daily report, but no new orders or
treatments have been noted, and staff are now afraid that he is going to hurt himself or them. RN
(Registered Nurse) has asked all staff to begin documenting all of these types of behaviors, as we have
previously just passed in on as a verbal report. Review of Resident R99's progress note dated 10/13/25, at
10:18 p.m. stated Multiple times throughout the evening resident stating he wants to die, asking staff to kill
him, hitting self on his head. Review of Resident R99's clinical record failed to reveal evidence the
resident's physician was notified of the resident's behaviors on 9/4/25, 9/27/25, and 10/13/25. Review of
Resident R99's physician orders failed to reveal an order for psych services. Review of Resident R99's
clinical record revealed the resident had a behavioral health comprehensive diagnostic evaluation on
10/14/25. It was indicated the resident has a history of depression, with history of suicidal ideations, as well
as dementia-related behavioral disturbances. During the evaluation the resident denied any active suicidal
ideations, nor any intent or plan to harm self. Resident has history of making similar comments in the past.
During
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 19 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0740
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
an interview on 1/6/25, Licensed Practical Nurse (LPN), Employee E3 stated when working on the memory
impaired unit, staff must keep an eye out and try to calm down and redirect residents before behaviors
occur. If witnessed verbal or physical aggression, separate the resident, notify physician and obtain any
orders. During an interview on 1/8/25, at 9:24 a.m. the Director of Nursing, stated residents with a history of
suicidal ideation typically receive a psych consult and social services sees them immediately to ensure no
active ideations are present. During an interview on 1/8/25, at 9:35 a.m. Social Service Director, Employee
E18 stated if a resident has a history of suicidal ideation, then suicide screen is completed which identifies
if they have a plan to harm themselves or others would be completed immediately. Social Service Director,
Employee E18 stated psych and the resident's attending physician would be notified. Residents with suicide
ideation are care planned with interventions. During an interview on 1/8/25, at 9:47 a.m. Social Service
Director, Employee E18 confirmed Resident R99 did not see psych services until 10/14/25. The Social
Service Director confirmed the facility failed to address Resident R99's suicide ideations and behaviors
timely. During an interview on 1/8/26, at 10:52 a.m. information was disseminated to the Regional [NAME]
President of Operations, Employee E17, that the facility failed to ensure one of six residents received
appropriate behavioral health services to maintain the highest practicable well-being as required (Resident
R99). 28 Pa. Code 201.14(a) Responsibility of licensee28 Pa. Code 201.18(b)(1)(3)(e)(1) Management28
Pa. Code 211.12(c)(d)(3) Nursing services28 Pa. Code 211.16(a) Social services
Event ID:
Facility ID:
395986
If continuation sheet
Page 20 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0745
Provide medically-related social services to help each resident achieve the highest possible quality of life.
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, clinical documentation and staff interview it was determined that the facility failed to
provide sufficient and timely social services to one of three residents reviewed (Resident R99).Findings
include: Review of the clinical record indicated Resident R99 was admitted to the facility on [DATE]. Review
of Resident R99's active diagnoses revealed a history of suicidal ideations, dementia (the loss of cognitive
functioning, thinking, remembering, and reasoning, to such an extent that it interferes with a person's daily
life and activities), anxiety, and depression. Review of resident R99's care plan dated 8/21/25, revealed the
resident has behavioral symptoms due to anxiety. Interventions included to monitor and report any adverse
side effects of medications, assess if anxiety endangers the resident and/or, others and to intervene as
necessary, and obtain a psych consult/psychosocial therapy. Resident R99 care plan failed to include
suicidal ideations. Review of Resident R99's Minimum Data Set (MDS - a periodic assessment of care
needs) dated 8/22/25, indicated diagnoses were current. Review of Resident R99's progress note dated
9/4/25, at 10:18 p.m. stated During evening care resident began swinging at the staff and then started to
punch himself on his head. No injuries noted at this time and resident has been redirected and placed at
the nursing station for monitoring. Review of Resident R99's progress note dated 9/27/25, at 3:21 a.m.
stated Resident is becoming increasingly aggressive during late evening and night shifts. He only sleeps
sporadically. He yells and screams at the top of his lungs and is unable to be redirected. Any time care is
attempted he is punching staff, spitting at them and on them, threatening them with physical violence, and
tonight actually threatened to shoot the CNA's (Certified Nurse Aide) and also threatened to choke the
CNAs. He is disturbing other residents, sitting in the hall outside their rooms or in their doorways yelling,
swearing, and threatening. We cannot safely leave him in bed when he is awake because his fall risk is
extremely high and he has already fallen multiple times while he was awake throughout the night and
agitated. When staff attempt to move him and his wheelchair back to the nurse's station, he is swinging and
grabbing at them while cursing and threatening. He also becomes so agitated that he punches and slaps
himself while yelling curse words. This information has been passed on in daily report, but no new orders or
treatments have been noted, and staff are now afraid that he is going to hurt himself or them. RN
(Registered Nurse) has asked all staff to begin documenting all of these types of behaviors, as we have
previously just passed in on as a verbal report. Review of Resident R99's progress note dated 10/13/25, at
10:18 p.m. stated Multiple times throughout the evening resident stating he wants to die, asking staff to kill
him, hitting self on his head. Review of Resident R99's clinical record failed to reveal evidence social
services was provided for the resident's behaviors on 9/4/25, 9/27/25, and 10/13/25. A further review failed
to include evidence the resident's suicidal ideations were addressed. During an interview on 1/8/25, at 9:24
a.m. the Director of Nursing, stated residents with a history of suicidal ideation typically receive a psych
consult and social services sees them immediately to ensure no active ideations are present. During an
interview on 1/8/25, at 9:35 a.m. Social Service Director, Employee E18 stated I been here about a year.
When asked what the process if for a resident who is admitted with a history of suicidal ideation, Social
Service Director stated, that hasn't happened thankfully. It was indicated if a resident has a history of
suicidal ideation, then a suicide screen is completed which identifies if they have a plan to harm themselves
or others would be completed immediately. Social Service Director, Employee E18 stated psych and the
resident's attending physician would be notified. During an interview on 1/8/25, at 9:47 a.m. Social Service
Director, Employee E18 confirmed Resident R99 did not see psych until
Residents Affected - Few
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 21 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0745
Level of Harm - Minimal harm
or potential for actual harm
10/14/25. The Social Service Director confirmed the facility failed provide sufficient and timely social
services to one of three residents reviewed (Resident R99) 28 Pa. Code 201.14(a) Responsibility of
licensee.28 Pa. Code 211.16(a) Social services.28 Pa. Code 201.29(a) Resident rights.
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 22 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0756
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart,
following irregularity reporting guidelines in developed policies and procedures.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
review of facility policy, clinical records and staff interviews, it was determined that the facility failed to
ensure a physician response for medication regimen reviews (MRR) for four of six sampled resident records
(Resident R2, R5, R9, and R71).
Findings include:
The facility Medication Regimen Review policy last reviewed 6/18/25, indicated that the drug regimen
review of each resident is completed at least monthly by the consultant pharmacist and any irregularities
are reported. Facility should encourage physician/prescriber or other responsible parties receiving the MRR
and the Director of Nursing to act upon recommendation contained in MRR. For those issues that require
physician/prescriber intervention, facility should encourage physician/prescriber to either accept and act
upon the recommendations contained within the MRR or reject all or some of the recommendations and
provide and explanations as to why recommendation was rejected.
Review of the clinical record indicated Resident R2 was admitted to the facility on [DATE].
Review of Resident R2's Minimum Data Set (MDS - a periodic assessment of care needs) dated 11/14/25,
indicated diagnoses of high blood pressure, bipolar disorder (a mental condition marked by alternating
periods of elation and depression), and wound infection.
Review of Resident R2's MRR in the clinical record on 1/8/26, at 9:00 a.m. indicated the following:
November 2025 - facility failed to provide the completed MRR by attending physician
December 2025 - facility failed to provide the completed MRR by attending physician
Review of the clinical record indicated Resident R5 was admitted to the facility on [DATE].
Review of Resident R5's MDS dated [DATE], indicated diagnoses of dementia (a group of symptoms that
affects memory, thinking and interferes with daily life), heart failure (a progressive heart disease that affects
pumping action of the heart muscles), and diabetes (a metabolic disorder in which the body has high sugar
levels for prolonged periods of time).
Review of Resident R5's MRR in the clinical record on 1/8/26, at 9:10 a.m. indicated the following:
June 2025 – facility failed to provide the completed MRR by attending physician
July 2025 – facility failed to provide the completed MRR by attending physician
August 2025 - facility failed to provide the completed MRR by attending physician
September 2025- facility failed to provide the completed MRR by attending physician
October 2025 - facility failed to provide the completed MRR by attending physician
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 23 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0756
Review of the clinical record indicated Resident R9 was admitted to the facility on [DATE].
Level of Harm - Minimal harm
or potential for actual harm
Review of Resident R9's MDS dated [DATE], indicated diagnoses of heart failure, diabetes, and anxiety.
Review of Resident R9's MRR in the clinical record on 1/8/26, at 9:20 a.m. indicated the following:
Residents Affected - Some
February 2025 – facility failed to provide the completed MRR by attending physician
March 2025 – facility failed to provide the completed MRR by attending physician
September 2025 - facility failed to provide the completed MRR by attending physician
October 2025- facility failed to provide the completed MRR by attending physician
November 2025 - facility failed to provide the completed MRR by attending physician
December 2025 - facility failed to provide the completed MRR by attending physician
Review of the clinical record indicated Resident R71 was admitted to the facility on [DATE].
Review of Resident R71's MDS dated [DATE], indicated diagnoses of dementia (the loss of cognitive
functioning, thinking, remembering, and reasoning, to such an extent that it interferes with a person's daily
life and activities), Parkinson's Disease (a degenerative brain disease that affects muscle control, among
other symptoms), and depression.
Review of Resident R71's medication regimen reviews (MRR) dated 12/18/25, revealed the resident has
received Phenazopyridine (a medication used to treat symptoms of a urinary tract infection) for
symptomatic relief of dysuria (painful or uncomfortable urination) greater than two days. Prolonged use may
mask the symptoms of unresolved cystitis and increase the risk of complications. Recommendations
indicated to please discontinue Phenazopyridine.
A further review of Resident R71'ss MRR dated 12/18/25, failed to include a physician's response as
required.
During an interview on 1/7/26, at 12:59 p.m. the Director of Nursing and the Regional Nurse Consultant,
Employee E1 confirmed that the facility failed to provide documentation of medication regimen reviews
(MRR) were signed by physician for Resident R71.
During an interview on 1/8/26, at 9:30 a.m. the Director of Nursing confirmed that the facility failed to
ensure MRR's were completed by the facility for four of six residents (Resident R2, R5, R9, and R71).
28 Pa. Code: 201.14 (a) Responsibility of licensee.
28 Pa. Code 211.5(f) Medical records.
28 Pa. Code: 211.12(d)(1)(3)(5) Nursing services.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 24 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0757
Ensure each resident’s drug regimen must be free from unnecessary drugs.
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, clinical records and staff interviews, it was determined that the facility failed to
ensure each resident's drug regimen was free from unnecessary drugs for one of six residents (Resident
R71).Finding include: The facility Medication Regimen Review (MRR) policy last reviewed 6/18/25,
indicated that the drug regimen review of each resident is completed at least monthly by the consultant
pharmacist and any irregularities are reported. Facility should encourage physician/prescriber or other
responsible parties receiving the MRR and the Director of Nursing to act upon recommendation contained
in MRR. For those issues that require physician/prescriber intervention, facility should encourage
physician/prescriber to either accept and act upon the recommendations contained within the MRR or
reject all or some of the recommendations and provide and explanations as to why recommendation was
rejected.Review of the clinical record indicated Resident R71 was admitted to the facility on [DATE]. Review
of Resident R71's Minimum Data Set (MDS - a periodic assessment of care needs) dated 10/8/25,
indicated diagnoses of dementia (the loss of cognitive functioning, thinking, remembering, and reasoning,
to such an extent that it interferes with a person's daily life and activities), Parkinson's Disease (a
degenerative brain disease that affects muscle control, among other symptoms), and depression. Review of
Resident R71's progress note dated 12/13/25, revealed the resident was evaluated for dysuria (painful or
uncomfortable urination). The physician ordered 200mg (milligrams) phenazopyridine (a medication used to
treat symptoms of a urinary tract infection), three times a day for three days. Review of Resident R71's
physician order dated 12/13/25, indicated to administer 200mg phenazopyridine, three times a day. No end
date was entered. Review of Resident R71's medication regimen reviews (MRR) dated 12/18/25, revealed
the resident has received Phenazopyridine for symptomatic relief of dysuria greater than two days.
Prolonged use may mask the symptoms of unresolved cystitis and increase the risk of complications.
Recommendations indicated to please discontinue Phenazopyridine. A review of Resident R71's clinical
record revealed the Phenazopyridine was discontinued on12/26/25. A total of 11 days since the medication
was to be discontinued. During an interview on 1/7/26, at 12:59 p.m. the Director of Nursing and the
Regional Nurse Consultant, Employee E1 confirmed that the facility failed to ensure each resident's drug
regimen was free from unnecessary drugs for one of six residents (Resident R71). 28 Pa. Code: 201.14 (a)
Responsibility of licensee.28 Pa. Code 211.5(f) Medical records.28 Pa. Code: 211.12(d)(1)(3)(5) Nursing
services.
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 25 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0760
Ensure that residents are free from significant medication errors.
Level of Harm - Actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
review of facility policy, clinical record review, resident interview, and interviews with staff, it was determined
that the facility failed to ensure that residents are free of significant medication errors for two of six residents
reviewed (Resident R31, and R53) which resulted in actual harm (a medication overdose that caused
unresponsiveness and required the administration of Narcan- a medication used to reverse overdoses of
opioids [pain medication with a high risk of addiction] that is administered via a nasal spray) for Resident
R31.Findings include:
Residents Affected - Few
Review of facility policy General Dose Preparation and Medication Administration dated 6/18/25, stated
prior to administration of medication, facility should verify each time a medication is administered that it is
the correct medication, at the correct dose, at the correct route, at the correct rate, at the correct time, for
the resident.
Review of the clinical record revealed that Resident R31 was admitted to the facility on [DATE].
Review of Resident 31's MDS (Minimum Data Set, periodic assessment of resident care needs) dated
12/23/25, indicated diagnoses of high blood pressure, diabetes (a metabolic disorder in which the body has
high sugar levels for prolonged periods of time), and pain.
Review of Resident R31's Nurse Practitioner progress note dated 4/3/25, at 11:56 a.m. indicated that
Resident R31 was seen per staff request following patient requiring to have 1 mg (milligram) of Narcan due
to unresponsiveness. Per staff resident asked for diazepam (medication used to treat anxiety), around
midnight. He was given oxycontin (an opioid pain medication containing oxycodone that is slow released
over a 12-hour period) by error which was discovered during pill count at end of shift this morning. He also
received his regular two Percocet (an opioid pain medication containing oxycodone and acetaminophen) at
12:31 a.m. and one Percocet at 7:31 a.m. When going to retrieve his lunch tray staff found him lying face
down on his bed. He was not waking up easily. Supervisor gave him 1 mg Narcan and, at that time resident
had a pulse, and was coming around awake, and talking. Continues to feel drowsy and is complaining of a
dry mouth. Vitals are stable. Patient not to receive any further narcotics today. Will reevaluate orders.
Review of a written statement from Licensed Practical Nurse (LPN) Employee E28 dated 4/3/25, stated I'm
trying to do everything so perfectly that I'm seeming to be making mistakes instead. If I would have only
gave the resident his Valium when I moved the card to the right spot this surely wouldn't of happened.
Review of Resident R31's clinical record revealed that resident was not ordered oxycontin.
During an interview on 1/7/26, at 7:48 a.m. Resident R31 stated They overdosed me on pain meds. I'm on
Percocet, and I asked for Valium. They gave me someone else's pain meds, and they had to Narcan me
During an interview on 1/8/26, at 9:23 a.m. LPN Employee E10 stated that she worked the day that
Resident R31 was overdosed and had to be administered Narcan. She stated that LPN Employee E28
Realized the count (number of drugs) was off, and she said she couldn't afford to make a mistake. The
resident went unresponsive. It was terrifying. You have to read the MAR (medication administration record a document used to track and record the administration of medications), double check the med
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 26 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0760
cart, and if you're confused you need to clarify. You need to make sure you have the right resident, and the
right med. The med card has a resident name on it.
Level of Harm - Actual harm
Residents Affected - Few
During an interview on 1/7/26, at 9:32 a.m. LPN Employee E25 stated that she was aware of the above
incident, and that you have to double check everything when you give medications, including the resident,
the medications, the dose, the route, and the time. It was a bad mistake because he already received a
medication that included oxycodone and then got another dose of it that wasn't his, with an extended
release.
During an interview on 1/8/26, at 12:24 p.m. the Regional Nurse Consultant Employee E1 confirmed the
facility failed to ensure that residents were free from any significant medication errors for Resident R31
which resulted in harm.
Review of the clinical record indicated Resident R53 was admitted to the facility on [DATE].
Review of Resident R53's MDS dated [DATE], indicated diagnoses of high blood pressure, depression, and
diabetes.
Review of Resident R53's care plan dated 3/7/25, indicated to administer diabetic medications and insulin
as per orders.
Review of a physician order dated 5/9/25, indicated to administer insulin lispro 100 unit/ml (units per
milliliter), 12 units with breakfast and dinner plus sliding scale, twice a day.
During an observation on 1/6/25, at 9:13 a.m. of Resident R53's medication pass, Licensed Practical Nurse
(LPN), Employee E27 failed to prepare or administer Resident R53's insulin.
During an interview on 1/6/25. at 9:14 a.m. Resident R53 confirmed she already ate breakfast and did not
receive insulin.
During an interview on 1/6/25, at 9:15 a.m. LPN, Employee E27 confirmed Resident R53's insulin was not
administered as ordered.
During an interview on 1/6/25, at 10:38 a.m. the DON confirmed that the facility failed to ensure that
residents are free of significant medication errors for one of six residents reviewed (Resident R53) as
required.
28 Pa. Code: 201.14(a) Responsibility of licensee.28 Pa. Code: 201.18 (b)(1) Management.28 Pa. Code:
211.10 (c)(d) Resident Care policies.28 Pa. Code: 211.12 (d)(1)(2)(3)(5) Nursing services.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 27 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0842
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in
accordance with accepted professional standards.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
review of facility policies, clinical records, and staff interview, it was determined that the facility failed to
make certain that medical records on each resident are complete and accurately documented for one of
five residents (Resident R2). Findings include:Review of the clinical record indicated Resident R2 was
admitted to the facility on [DATE].Review of Resident R2's Minimum Data Set (MDS - a periodic
assessment of care needs) dated 11/14/25, indicated diagnoses of high blood pressure, bipolar disorder (a
mental condition marked by alternating periods of elation and depression), and wound infection.Review of
Resident R2's clinical record revealed physician orders for the following medications and failed to have a
diagnosis for use of the medication:Tylenol (used to treat pain) 325 mg (milligram) every six hours - no
diagnosis indicatedDocusate Sodium (used to treat constipation) 100 mg at bedtime - no diagnosis
indicatedFamotidine (used to treat acid reflux) 20 mg daily - no diagnosis indicatedLasix (used to treat
edema) 20 mg every other day - no diagnosis indicatedSynthroid (used to treat thyroid disorder) 50 mcg
(microgram) daily - no diagnosis indicatedMeropenem (antibiotic) 500 mg every eight hours - no diagnosis
indicatedMilk of Magnesia (used to treat constipation) 400 mg daily as needed - no diagnosis
indicatedMontelukast (used to treat asthma) 10 mg at bedtime - no diagnosis indicatedOmeprazole (used
to trat acid reflux) 20 mg daily - no diagnosis indicatedOyster Shell Calcium (vitamin) one tab at bedtime no diagnosis indicatedPotassium Chloride (used for low potassium) 20 [NAME] (milliequivalent) twice daily no diagnosis indicatedQulipta (used to treat headaches) 60 mg daily - no diagnosis indicatedSolifenacin
(used to treat overactive bladder) 5 mg daily - no diagnosis indicatedDuring an interview on 1/8/26, at 9:08
a.m. the Director of Nursing (DON) stated, I've seen medications don't have diagnosis and I've been
working on it.During an interview on 1/8/26, at 11:54 a.m. Registered Nurse Employee E13 stated, When
we put orders in, we put the diagnosis of the medication in the order. It's been beaten in my head over the
years to do that. During an interview on 1/8/26, at 2:00 p.m. the DON confirmed Resident R2's medications
did not include a diagnosis for use and the facility failed to make certain that medical records on each
resident are complete and accurately documented for one of five residents (Resident R2).28 Pa. Code:
211.5(f) Clinical records.
Event ID:
Facility ID:
395986
If continuation sheet
Page 28 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0868
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Level of Harm - Minimal harm
or potential for actual harm
Based on review of facility policy, Quality Assurance attendance records, and staff interview, it was
determined that the facility failed to conduct Quality Assessment and Assurance (QAA) meetings at least
quarterly with all of the required committee members for two of four quarters (January 2025 through March
2025 and July 2025 through September 2025).Findings include: A review of the QAA Committee meeting
sign-in sheets from the period of January 2025 through March 2025, did not reveal that the Medical Director
or Infection Preventionist were in attendance. A review of the QAA Committee meeting sign-in sheets from
the period of July 2025 through September 2025, did not reveal that the Director of Nursing or Infection
Preventionist were in attendance. During an interview on 1/9/25 at 10:33 a.m. Regional Nurse Consultant
Employee E1 confirmed that the facility failed to conduct QAA meetings at least quarterly with all of the
required committee members as required. 28 Pa. Code: 201.14(a) Responsibility of licensee.28 Pa. Code:
201.18(e)(1)(2)(3)(4) Management.
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 29 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 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, observations, and staff interviews it was determined that the facility failed to ensure
that fit testing of NIOSH-approved N-95 masks (a respirator mask used to care for residents with suspected
or confirmed Covid-19) was completed to care for residents with suspected or confirmed Covid-19 (an
infectious disease caused by a virus) during an outbreak in order to prevent the transmission of
communicable diseases and infections during a COVID-19 outbreak from 12/29/25 through 1/9/26, and
failed to properly monitor residents refrigerator temperatures for one of two residents (Resident R88).
Residents Affected - Many
Findings include:
A review of facility policy Respiratory Protection dated 6/18/25, indicated that it is designed to protect
employees by establishing accepted practices for respirator use. The infection preventionist or designee is
responsible for the implementation with training, oversight, medical evaluation procedures, annual review,
and enforcement of the policy. Employees have responsibilities to wear their respirator when required to. Fit
Testing: The Infection Preventionist and at least one backup will be the designated fit test administrators at
the facility. Fit testing administrators will complete applicable training before administering fit testing to
employees.
Fit testing: A procedure to ensure a tight- fitting respirator forms a proper seal on a person's face.
Review of the Pennsylvania Department of Health Bureau of Epidemiology, Respiratory Virus Outbreak
Toolkit dated 9/25/25, revealed the following:
Masking
The long-term care facility should encourage masking of health care providers, residents, and visitors
during any respiratory virus outbreak. This provides protection for the wearer and protection for others.
When masking, the masks:
Should be well-fitting with minimal gaps
Should cover both nose and mouth
Should be changed if they become soiled, damaged, or had to breathe through
Health Care Providers working with suspected of confirmed COVID residents should use fit-tested,
NIOSH-approved N95's.
Review of the facility policy Food Brought in From Outside the Facility dated 6/18/25, indicated that the
refrigerator where the food will be stored will have an internal thermometer. Units will maintain safe internal
temperatures in accordance with state and federal standards for safe food storage temperatures.
Temperatures will be monitored daily. Residents with personal refrigerators will be assisted by staff in
ensuring their personal unit is in compliance with all of the above storage
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 30 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0880
guidelines.
Level of Harm - Minimal harm
or potential for actual harm
During entrance into the facility on 1/5/26, at 9:00 a.m. a notification of facility having a COVID outbreak
was observed hanging on the front door.
Residents Affected - Many
During an interview on 1/5/26, at 9:15 a.m. the Regional Nurse Consultant/Infection Preventionist Employee
E1 confirmed that the facility had positive cases of COVID and were in an outbreak.
During a review of documentation provided by facility on 1/5/26, at 9:30 a.m. 11 out of 29 residents were in
isolation precaution for positive COVID tests results or being exposed to someone with COVID.
During a tour of the facility on 1/5/26, at 9:30 a.m. Isolation signs and Personal Protective Equipment (PPE)
were hanging on exposed or confirmed COVID resident's door.
During a tour of unit one from 1/5/26, through 1/9/26, N95's were observed being worn by staff to provide
care for exposed or confirmed COVID residents.
During an interview on 1/6/26, at 10:20 a.m. Regional Nurse Consultant/Infection Preventionist Employee
E1 stated that the facility has not fit tested any staff for N-95 respirators since working at the facility, which
has been since March 2025. We do not have anyone trained to fit test staff for N-95's at the facility and that
staff are not wearing fit tested N-95's to provide care and treatment to residents who are exposed or are
confirmed with COVID.
During an interview on 1/9/26, at 10:00 a.m. Registered Nurse Employee E13 stated, Not here, No I haven't
been fit tested, and I take care of residents who are COVID positive.
During an interview on 1/9/26, at 10:03 a.m. Licensed Practical Nurse Employee E14 stated, I have not
been fit tested for a N-95 at the facility. I take care of positive COVID residents.
During an interview on 1/9/26, at 10:06 a.m. Nurse Aide Employee E7 stated, No, I have not been fit tested
for a N-95. I go into all the COVID rooms to care for the residents. We have to wear a gown, googles,
gloves, and N-95's to enter the room.
During an interview on 1/9/26, at 1:00 p.m. Regional Nurse Consultant/Infection Preventionist Employee E1
confirmed that the facility failed to ensure that fit testing of NIOSH-approved N-95 masks was completed in
order to care for residents with suspected or confirmed Covid-19 during an outbreak in order to prevent the
transmission of communicable diseases and infections during a COVID-19 outbreak from 12/29/25 through
1/9/26.
Review of the clinical record revealed that Resident R88 was admitted to the facility on [DATE].
Review of Resident 88's MDS (Minimum Data Set, periodic assessment of resident care needs) dated
11/12/25, indicated diagnoses of high blood pressure, thyroid disorder, and chronic pain.
During an observation on 1/6/26, a Refrigerator Temperature Log was posted on Resident R88's wall above
his personal refrigerator.
Review of the Refrigerator Temperature Log had dates for September 2025, and October 2025.
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 31 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0880
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Many
September 2025 did not have temperatures recorded on 9/6/25, 9/7/25, 9/8/25, 9/9/25, 9/12/25, 9/13/25,
9/14/25, 9/20/25, 9/21/25, 9/22/25, 9/24/25, 9/26/25, 9/29/25, 9/30/25 (missing 14 out of 30 days)
October 2025 had no data recorded for the whole month (missing 31 out of 31 days).
During an interview on 1/8/26, at 12:25 p.m. the Director of Nursing confirmed that there were no
Refrigerator Temperature logs kept for November 2025, and December 2025, which indicated that there
was missing data for 30 out of 30 days for November 2025, and missing data for 31 days out of 31 days for
December 2025, and that the facility failed to monitor refrigerator temperatures as required.
28 Pa. Code 201.14(a) Responsibility of licensee.
28 Pa. Code 201.18(b)(1)(3)(d)(e)(1) Management.
28 Pa. Code 211.10(d) Resident care policies.
28 Pa. Code 211.12(d)(1)(5) Nursing services.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 32 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0887
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and
staff after education, and properly document each resident and staff member's vaccination status.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
facility policy, clinical record review and staff interview, it was determined that the facility failed to provide
accurate and timely documentation related to the COVID-19 (a respiratory disease) vaccine for two of five
residents (Resident R83, and R95). Findings include:Review of facility policy Resident Vaccination dated
6/18/25, indicated that residents or their responsible party will be asked about prior vaccinations at
admission. Prior doses of influenza, pneumococcal, COVID-19, and other vaccines will be documented in
the immunization portal in the electronic health record. The Infection Preventionist will track resident
immunizations and that vaccines are administered timely.Review of Resident R83's clinical record indicated
the resident was admitted to the facility on [DATE].Review of Resident R83's Minimum Data Set (MDS - a
periodic assessment of care needs) dated 11/24/25, indicated diagnoses of depression, chronic obstructive
pulmonary disease (COPD, a group of progressive lung disorders characterized by increasing
breathlessness), and epilepsy (disorder of the brain characterized by repeated seizures). Resident R83's
MDS assessment section C0200 Brief Interview for Mental Status (BIMS, a screening test that aides in
detecting cognitive impairment). The BIMS total score suggests the following distributions: 13-15:
cognitively intact, 8-12: moderately impaired, 0-7: severe impairment. Resident R83's BIMS score was a 11
indicating Resident R83 was moderately impaired. MDS Section O- Special treatment, Procedures, and
Programs O0350 indicated COVID-19 vaccine was coded a 0- resident not up to date.During a review of
clinical records indicated that Resident R83 last received a COVID-19 vaccination on 11/27/23.During a
review of Resident R83's clinical documentation labeled, Preventive Health Care indicated that on 10/17/25,
no consent for vaccine was obtained and resident refused. Resident R83 is cognitively impaired and unable
to provide consent and has a guardian that oversees the residents' care and treatment.During a review of
Resident R83's clinical record on 1/7/26, at 9:00 a.m. failed to include documentation of an up-to-date
Covid-19 booster vaccine was offered and that education was provided to Resident R83's guardian.Review
of Resident R95's clinical record indicated the resident was admitted to the facility on [DATE].Review of
Resident R95's MDS dated [DATE], indicated diagnoses of quadriplegia (paralysis of all four limbs),
cerebral infarction (necrotic tissue in the brain resulting loss of blood and oxygen to the brain), and vitamin
deficiency. MDS Section O- Special treatment, Procedures, and Programs O0350 indicated COVID-19
vaccine was coded a 0- resident not up to date.During a review of clinical records indicated that Resident
R95 was last offered a COVID-19 vaccination on 11/14/23.During a review of Resident R95's clinical record
on 1/7/26, at 9:05 a.m. failed to include documentation that an up-to-date Covid-19 booster vaccine was
offered and that education was provided to Resident R95 this year.During an interview on 1/7/26, at 9:20
a.m. Regional Nurse Consultant Employee E1 stated the facility has no documentation that Resident R83,
and R95 were offered a COVID-19 vaccination this year.During an interview on 1/7/26, at 9:30 a.m.
Regional Nurse Consultant Employee E1 confirmed that the facility failed to provide accurate and timely
documentation related to the COVID-19 vaccine for two of five residents (Resident R83, and R95).28 Pa.
Code 211.5(f) Clinical records
Event ID:
Facility ID:
395986
If continuation sheet
Page 33 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0908
Keep all essential equipment working safely.
Level of Harm - Minimal harm
or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
observations, review of facility documentation, and staff interviews, it was determined that the facility failed
to make certain that equipment was in safe operating condition for two of two of the facilities crash carts (a
cart that contains supplies in the event of an emergency), (Common Room and Memory Impaired Unit) and
two of two Automated External Defibrillator (AED-a portable, electronic device designed to diagnose and
treat life-threatening cardiac arrhythmias), (Common Room and Main Dining Room).Findings
include:Review of facility Emergency Equipment Check policy dated [DATE], indicated the emergency
equipment will be checked daily and items which are outdated or opened will be replaced. The cart will be
re-stocked promptly after any use.During a review of facility provided document labeled Emergency Cart
Daily Checklist of the facilities crash cart (common room) on [DATE], at 10:30 a.m. revealed missing
signatures for [DATE], and [DATE].The Emergency Cart Daily Checklist indicated that if AED on site, check
battery life and presence of pads daily.During an observation of the facilities crash cart, located in the
common room, on [DATE], at 10:35 a.m. revealed the following supplies to be expired:(3) suctioning tubing expired [DATE](1) Ambu bag (a handheld manual resuscitator used to provide positive pressure ventilation)
was opened and had a date of 07/2015 on the package.During an interview on [DATE], at 10:40 a.m.
Registered Nurse Employee E13 confirmed the above missing signatures, expired supplies, and that AED
battery checks were missing.During an observation of the facilities crash cart, located in Memory Impaired
Unit, on [DATE], at 10:40 a.m. revealed the following supplies to be expired:(1) Continu-Flo Solution IV
tubing - expired [DATE](2) IV start kits - expired [DATE](3) suction tubing - expired [DATE]During an
interview on [DATE], at 10:48 a.m. Licensed Practical Nurse Employee E12 confirmed the expired supplies
on Memory Impaired Unit crash cart.During an interview on [DATE], at 1:00 p.m. the Director of Nursing
confirmed that the facility failed to make certain that equipment was in safe operating condition for two of
two of the facilities crash carts (Common Room and Memory Impaired Unit) and two of two Automated
External Defibrillator (Common Room and Main Dining Room).28 Pa Code: 201.14(a) Responsibility of
licensee.
Residents Affected - Many
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 34 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0940
Develop, implement, and/or maintain an effective training program for all new and existing staff members.
Level of Harm - Minimal harm
or potential for actual harm
Based on review of facility in-service documentation, personnel files, and staff interviews it was determined
that the facility failed to implement and maintain an effective training program for three out of five personnel
files reviewed (Licensed Practical Nurse (LPN) Employee E10, Nurse Aide (NA) Employee E11, and LPN
Employee E12).Findings include: Review of LPN Employee E10's personnel file indicated a date of hire on
10/2/23. Review of LPN Employee E10's personnel file did not include annual in-service training on
Effective Communication, Resident Rights, Abuse, QAPI (Quality Assurance and Performance
Improvement), Infection Control, Compliance and Ethics, and Behavioral Health from 1/1/25 through
12/31/25. Review of NA Employee E11's personnel file indicated a date of hire on 7/1/23. Review of NA
Employee E11's personnel file did not include annual in-service training on Effective Communication,
Resident Rights, Abuse, Infection Control, Compliance and Ethics, and Behavioral Health from 1/1/25
through 12/31/25. Review of LPN Employee E12's personnel file indicated a date of hire on 7/1/23. Review
of LPN Employee E12's personnel file did not include annual in-service training on QAPI and Behavioral
Health from 1/1/25 through 12/31/25. During an interview on 1/7/26, at 11:31 a.m. Regional Nurse
Consultant Employee E1 confirmed that the facility failed to implement and maintain an effective training
program for three out of five personnel files reviewed (LPN Employee E10, NA Employee E11, and LPN
Employee E12). 28 Pa. Code: 201.14(a) Responsibility of licensee.28 Pa. Code: 201.20(a)(d) Staff
development.
Residents Affected - Some
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395986
If continuation sheet
Page 35 of 36
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
395986
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Kittanning Health & Rehab Center
120 Kittanning Care Drive
Kittanning, PA 16201
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 0947
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in
dementia care and abuse prevention.
Based on review of facility policy, personnel files and staff interview it was determined that the facility failed
to conduct the minimum 12 hours of nurse aide (NA) training per year for one of five NA personnel records
(NA Employee E11).Findings include: Review of NA Employee E11's personnel record indicated a hire date
of 7/1/23. Review of NA Employee E11's personnel record revealed 4.67 hours of in-service education from
1/1/25 through 12/31/25. During an interview on 1/7/26, at 11:31 a.m. Regional Nurse Consultant Employee
E1 confirmed that the facility failed to conduct the minimum 12 hours of nurse aide training per year for one
of five NA personnel records (NA Employee E11). 28 Pa. Code: 201.14(a) Responsibility of licensee.28 Pa.
Code: 201.20(a) Staff development.
Event ID:
Facility ID:
395986
If continuation sheet
Page 36 of 36
Reading this as a family member? Your long-term care ombudsman is a free advocate for residents and families.
Back to topCitations
39 citations recorded*CMS
What do CMS severity letters mean?
Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.
General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.
Each letter combines severity with scope: how many residents the deficiency affected.
F554 - The right to self-administer medications if the interdisciplinary team, as
Allow residents to self-administer drugs if determined clinically appropriate.
F568 - Accounting and Records
Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.
F569 - Notice of certain balances
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
F580 - Notification of Changes
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
F602 - The resident has the right to be free from abuse, neglect, misappropriation of re
Protect each resident from the wrongful use of the resident's belongings or money.
F605 - Respect and Dignity
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
F607 - The facility must develop and implement written policies and procedures that:
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
F609 - The facility must develop and implement written policies and procedures that:
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
F628 - Documentation
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
F684 - Quality of care
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
F688 - Mobility
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
F689 - Accidents
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
F695 - Respiratory care, including tracheostomy care and tracheal suctioning
Provide safe and appropriate respiratory care for a resident when needed.
F698 - Dialysis
Provide safe, appropriate dialysis care/services for a resident who requires such services.
F725 - Nursing Services
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
F730 - Regular in-service education
Observe each nurse aide's job performance and give regular training.
F732 - Nurse Staffing Information
Post nurse staffing information every day.
F740 - Behavioral health services
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
F745 - The facility must provide medically-related social services to attain or
Provide medically-related social services to help each resident achieve the highest possible quality of life.
F756 - Drug Regimen Review
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
F757 - Unnecessary Drugs—General
Ensure each resident’s drug regimen must be free from unnecessary drugs.
F760 - Residents are free of any significant medication errors
Ensure that residents are free from significant medication errors.
F842 - Resident-identifiable information
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
F868 - Quality assessment and assurance
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
F908 - Maintain all mechanical, electrical, and patient care equipment in safe
Keep all essential equipment working safely.
F940 - Training Requirements
Develop, implement, and/or maintain an effective training program for all new and existing staff members.
F947 - Training Requirements
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
F887 - Infection control
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
F880 - Infection Control
Provide and implement an infection prevention and control program.
- 0006GeneralS&S Cno actual harm
Conduct risk assessment and an All-Hazards approach.
- 0020GeneralS&S Cno actual harm
Establish policies and procedures including evacuation.
- 0036GeneralS&S Cno actual harm
Establish emergency prep training and testing.
- 0100GeneralS&S Cno actual harm
Meet other general requirements.
- 0324GeneralS&S Epotential for harm
Provide properly protected cooking facilities.
- 0353GeneralS&S Epotential for harm
Inspect, test, and maintain automatic sprinkler systems.
- 0372GeneralS&S Fpotential for harm
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
F911 - Accommodate no more than four residents
Meet requirements for the installation and maintenance of electrical systems.
F918 - Bathroom Facilities
Have generator or other power source capable of supplying service within 10 seconds.
F920 - Dining and Resident Activities
Ensure proper usage of power strips and extension cords.
FAQ · About this visit
Common questions about this visit
What happened during the January 9, 2026 survey of KITTANNING HEALTH & REHAB CENTER?
This was a inspection survey of KITTANNING HEALTH & REHAB CENTER on January 9, 2026. The surveyor cited 39 deficiencies, recorded on the federal Form 2567 statement of deficiencies.
Were any deficiencies cited at KITTANNING HEALTH & REHAB CENTER on January 9, 2026?
Yes, 39 deficiencies were cited, each with a CMS Scope and Severity grade. The first was: "Allow residents to self-administer drugs if determined clinically appropriate."
What type of survey was this?
This was a inspection survey conducted by state surveyors under federal Centers for Medicare & Medicaid Services (CMS) oversight. Findings are published on CMS Care Compare.
SourceView on CMS Care Compare
Next steps
Concerned about a resident’s care?Find your local ombudsman through the Eldercare Locatoror file a complaint with your state survey agency.
Researching this visit professionally?Book a 15-minute calland we will walk through what we have on file.
Data from CMS Care Compare public records. Dataset last refreshed . If you believe any information is inaccurate, report it here.