Inspection·December 20, 2023

F 0625 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave. Based on review of clinical records and staff interviews, it was determined that the facility failed to ensure that the resident and/or responsible party was notified about the facility's bed-hold policy upon transfer to the hospital for one of 19 residents reviewed (Resident 3). Findings include: A nurse's note for Resident 3, dated August 16, 2023, at 4:01 p.m. revealed that the resident developed left facial drop and slurred speech and was transferred to the hospital. A nurse's note, dated August 17, 2023, at 6:41 a.m., revealed that the resident was admitted to the hospital. A nurse's note for Resident 3, dated September 24, 2023, at 8:32 a.m. revealed that the resident had a change in condition and had requested to be transferred to the hospital. A nurse's note, dated September 25, 2023, at 10:08 a.m., revealed that the resident was admitted to the hospital. There was no documented evidence that Resident 3 and/or the responsible party was notified about the facility's bed-hold policy at the time of the above transfers to the hospital. Interview with the Registered Nurse Assessment Coordinator on December 20, 2023, at 11:37 a.m. confirmed there was no documented evidence that a bed-hold notice was issued to Resident 3 or her responsible party at the time of the transfers to the hospital. 28 Pa. Code 201.29(a) Resident rights FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396035 If continuation sheet Page 2 of 18 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 396035 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Scottdale Healthcare & Rehabilitation Center 900 Porter Avenue Scottdale, PA 15683 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 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Based on review of clinical records, as well as staff interviews, it was determined that the facility failed to develop care plans for individualized resident care needs for four of 19 residents reviewed (Residents 6, 17, 18, 22). Findings include: An annual Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs) for Resident 6, dated October 10, 2023, indicated that the resident was cognitively intact, required assistance from staff for her daily care needs, was continent of bowel and urine, and had a significant weight gain. A review of Resident 6's clinical record revealed that the resident had a history of urinary tract infections. A physician's order for Resident 6, dated December 15, 2023, included an order for the resident to receive Cephalexin (an antibiotic) two times a day for a urinary tract infection until December 22, 2023. There was no documented evidence that a care plan was developed to address Resident 6's urinary tract infection with antibiotic treatment. An interview with the Registered Nurse Assessment Coordinator (RNAC) on December 20, 2023, at 11:22 a.m. confirmed there was no care plan in place to address Resident 6's urinary tract infection with antibiotic treatment and there should have been. An admission MDS assessment for Resident 17, dated November 16, 2023, indicated that the resident was cognitively intact, required assistance from staff with her daily care needs, was dependent on staff for transfers with use a mechanical lift, was incontinent of bowel and urine, had a Stage 2 pressure area (a shallow open wound), moisture-associated skin damage (inflammation of the skin caused by exposure to moisture), and had a diagnosis of morbid obesity. Physician's orders for Resident 17, dated November 12, 2023, included an order to cleanse bilateral posterior thighs with soap and water, pat dry, and apply Zinc cream topically every shift and as needed for incontinence. A physician's order, dated December 6, 2023, included an order to cleanse bilateral thigh and buttocks with normal saline cleanser, apply collagen, and cover with border gauze every shift daily and as needed. A physician's order, dated December 6, 2023, included an order to cleanse the open area to right posterior upper leg with wound cleanser, apply collagen, and secure with border gauze daily and as needed. There was no documented evidence that a care plan was developed to address Resident 17's skin impairments. Interview with the RNAC on December 19, 2023, at 1:55 p.m. confirmed that there was no care plan developed to address Resident 17's skin impairments and there should have been. A quarterly MDS assessment for Resident 18, dated September 4, 2023, indicated that the resident was cognitively intact, required assistance from staff for her daily care needs, and had a significant weight gain. Resident 18's diagnoses included end-stage renal disease (kidneys no longer work as (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396035 If continuation sheet Page 3 of 18 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 396035 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Scottdale Healthcare & Rehabilitation Center 900 Porter Avenue Scottdale, PA 15683 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 0656 they should). Level of Harm - Minimal harm or potential for actual harm Physician's orders for Resident 18, dated December 6, 2023, included an order for the resident to receive dialysis (treatment to remove excess fluids and waste for people whose kidneys are failing) at 9:30 a.m. on Tuesdays, Thursdays and Saturdays. Residents Affected - Few There was no documented evidence that a care plan was developed to address Resident 18's care related to renal disease and the need for dialysis. Interview with the RNAC on December 19, 2023, at 2:19 p.m. confirmed that there was no care plan developed to address Resident 18's renal disease and dialysis and there should have been. An admission MDS assessment for Resident 22, dated September 22, 2023, revealed that the resident was cognitively intact, required limited assistance with personal hygiene needs, and had diagnoses that included requiring surgical care after a surgery, anxiety and obesity. Nursing notes for Resident 22, dated October 15, 2023; November 8 and 24, 2023; and December 1 and 16, 2023, revealed that the resident had refused the showers offered to her. Interview with the Social Worker on December 18, 2023, at 10:50 a.m. revealed that the resident sometimes hides her clothes and refuses to let staff wash them. There was no documented evidence that a care plan was developed and implemented to address Resident 22's refusal of care. Interview with the Registered Nurse Assessment Coordinator on December 20, 2023, at 1:19 p.m. confirmed that a care plan for Resident 22's refusal of care was not developed and implemented and should have been. 28 Pa. Code 211.11(d) Resident care plan. 28 Pa. Code 211.12(d)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396035 If continuation sheet Page 4 of 18 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 396035 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Scottdale Healthcare & Rehabilitation Center 900 Porter Avenue Scottdale, PA 15683 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 0657 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. Based on review of clinical records and observations, as well as resident and staff interviews, it was determined that the facility failed to ensure that care plans were updated to reflect changes in care needs for four of 19 residents reviewed (Residents 6, 9, 22, 40). Findings include: An annual Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs) for Resident 6, dated October 10, 2023, indicated that the resident was cognitively intact, required assistance from staff for her daily care needs, was continent of bowel and urine, and had a significant weight gain. Observations of Resident 6 on December 18, 2023, at 11:15 a.m. revealed the resident was lying in bed. The resident stated she had not been out of bed for the last three to four weeks because staff had stated that the mechanical lift would not support her weight. Interview with the Registered Nurse Assessment Coordinator (RNAC) on December 19, 2023, at 2:00 p.m. revealed that Resident 6 was not able to get out of bed due to her weight exceeding the maximum weight limit of 450 pounds for the mechanical lift. Resident 6's weight on November 22, 2023, was 456 pounds. The RNAC stated that they purchased a transfer device so the resident could be transferred in case of an emergency and looked at purchasing a mechanical lift with a maximum weight limit of 600 pounds. Resident 6's care plan, last revised on November 10, 2023, revealed that she is transferred with a hoyer lift (a mechanical lift) with assist of two staff. Interview with the RNAC on December 19, 2023, at 2:21 p.m. confirmed that Resident 6's care plan was not revised to reflect her change in transfer status and it should have been. A quarterly MDS assessment for Resident 9, dated August 15, 2023, revealed that the resident was cognitively impaired, required extensive assist to total dependence with care needs, had a diagnosis of pneumonia (infection in the lungs), and had a feeding tube (a mechanical device that delivers food, fluids and medications to a person who is unable to eat or drink). A care plan for Resident 9, last revised on October 13, 2023, instructed to elevate the head of the bed 30 to 45 degrees during feeding administration. Physician's order for Resident 9, dated November 22, 2023, indicated to elevate the head of the bed at least 60 to 75 degrees during feeding and for one hour after. Physician's orders, dated October 19, 2023, indicated to check for residual every shift and hold feeding for one hour if above 90 cc. Interview with the RNAC on December 20, 2023, at 1:28 p.m. confirmed that Resident 9's care plan was not revised to reflect changes in positioning during tube feeding and checking for a residual and that it should have been. An admission MDS assessment for Resident 22, dated September 22, 2023, revealed the resident was cognitively intact, required limited assistance with personal hygiene needs, and had diagnoses that included requiring surgical care after a surgery, anxiety and obesity. A care plan for Resident 22, dated September 18, 2023, indicated that the resident has a surgical (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396035 If continuation sheet Page 5 of 18 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 396035 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Scottdale Healthcare & Rehabilitation Center 900 Porter Avenue Scottdale, PA 15683 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 0657 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few wound site from a hiatal hernia (when the upper part of the stomach bulges through the large muscle that separates the abdomen and the chest) repair and that treatments were to be provided per physician's orders. Nurse's note for Resident 22, dated October 10, 2023, revealed that staff was to discontinue treatment to her abdominal incision because it had healed. Interview with the Registered Nurse Assessment Coordinator on December 20, 2023, at 1:19 p.m. confirmed that Resident 22's care plan should have been revised when her surgical incision had healed but it was not. Review of admission records for Resident 40, dated December 5, 2023, revealed that the resident had diagnosis that included spinal stenosis (narrowing of the spinal column) and diabetes and had a Stage 4 (tissue loss with exposed bone, tendon, or muscle) Sacrococcygeal (area that includes the base of the spine and the tailbone) pressure ulcer (injuries to skin resulting from prolonged pressure). Observations of Resident 40 on December 18, 2023, at 11:20 a.m. revealed that the resident's bed was equipped with an air mattress. A care plan for Resident 40, dated December 6, 2023, revealed that the resident had skin breakdown that included a Stage 4 Sacrococcygeal pressure ulcer. There was no documented evidence in the resident's care plan to indicate that she was to have an air mattress. Interview with the Registered Nurse Assessment Coordinator on December 20, 2023, at 11:37 a.m. revealed that it was determined that an air mattress would benefit Resident 40 and was attached to her bed; however, the resident's care plan was never revised to include the air mattress. 28 Pa. Code 211.11(d) Resident care plan. 28 Pa. Code 211.12(d)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396035 If continuation sheet Page 6 of 18 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 396035 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Scottdale Healthcare & Rehabilitation Center 900 Porter Avenue Scottdale, PA 15683 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 Based on clinical record reviews, observations, and staff interviews, it was determined that the facility failed to complete weekly wound assessments for one of 19 residents reviewed (Resident 8) and failed to notify the physician about a medication allergy for one of 19 residents reviewed (Resident 40). Residents Affected - Few Findings include: An annual Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs) for Resident 8, dated November 5, 2023, revealed that the resident was cognitively intact, required supervision with care needs, was at risk for developing pressure ulcers, had venous ulcers (ulcers caused by poor blood flow in leg veins), and had a diagnosis of peripheral vascular disease (a disease causing poor blood circulation to lower limbs). A care plan for Resident 8, revised on November 30, 2023, revealed that the resident had skin breakdown related to venous stasis ulcers of right ankle, right medial foot, right dorsal foot, and left dorsal foot. Interventions included to report evidence of infection such as purulent drainage, swelling, localized heat, increased pain, and to notify physician as needed. Physician's orders for Resident 8, dated December 5, 2023, included an order to cleanse her right medial foot and ankle with wound cleanser, apply 500 milligrams (mg) of crushed Flagyl (an antibiotic), cover with silver alginate (a wound dressing that contain silver ions, which have antimicrobial properties and can help prevent infections) abdominal dressing and rolled gauze daily and as needed. Physician's orders for Resident 8, dated December 19, 2023, included orders to cleanse her right dorsal foot, ankle and leg with wound cleanser; apply oil emulsion cover (non-adherent wound product); cover with silver alginate; wrap with rolled gauze daily and as needed; and to cleanse her left foot with soap and water daily, pat dry, apply gauze and Kling, and wrap daily and as needed. Review of Resident 8's clinical record revealed no documented evidence of weekly wound assessments by the facility's medical staff between May 25, 2023, and August 2, 2023. Interview with Licensed Practical Nurse 3 on December 20, 2023, at 12:42 p.m. confirmed that Resident 8's wounds were not assessed weekly between May 25, 2023, and August 2, 2023. Interview with the Nursing Home Administrator on December 20, 2023, at 3:05 p.m. confirmed that there was no documented evidence that Resident 8's wounds were assessed weekly from May 25, 2023, until August 2, 2023, and they should have been. Review of admission records for Resident 40, dated December 5, 2023, revealed that the resident had diagnoses that included spinal stenosis (narrowing of the spinal column) diabetes and a Stage 4 (tissue loss with exposed bone, tendon, or muscle) Sacrococcygeal (area that includes the base of the spine and the tailbone) pressure ulcer (injuries to skin resulting from prolonged pressure). Physician's orders for Resident 40, dated December 6, 2023, at 2:15 p.m. included an order for the resident to receive two 325 milligrams (mg) tablets of Tylenol every four hours as needed for pain. A nurse's note for Resident 40, dated December 5, 2023, at 9:59 p.m. revealed that the resident was admitted to the facility from a hospital, had periods of confusion, had an allergy to acetaminophen (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396035 If continuation sheet Page 7 of 18 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 396035 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Scottdale Healthcare & Rehabilitation Center 900 Porter Avenue Scottdale, PA 15683 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 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few (generic form of Tylenol), and that the Tylenol protocol was not to be given. There was no documented evidence in the clinical record to indicate that the physician was made aware of Resident 40's Tylenol allergy. Review of Resident 40's Medication Administration Record (MAR) for December 2023 revealed that the resident received two 325 mg tablets of Tylenol for pain on December 9 at 7:17 p.m., December 14 at 9:57 a.m., December 17 at 1:27 a.m., and December 19 at 8:15 a.m. Interview with the Registered Nurse Assessment Coordinator on December 20, 2023, at 11:37 a.m. confirmed that there was no documented evidence that the physician was made aware of Resident 40's allergy to Tylenol when it was ordered. 28 Pa. Code 211.12(d)(1)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396035 If continuation sheet Page 8 of 18 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 396035 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Scottdale Healthcare & Rehabilitation Center 900 Porter Avenue Scottdale, PA 15683 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 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Based on review of clinical records and facility assessment reports, as well as staff interviews, it was determined that the facility failed to complete safety assessments for three of 19 residents reviewed (Residents 9, 17, 40) who used an air mattress. Findings include: A quarterly Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs) for Resident 9, dated August 15, 2023, revealed that the resident was cognitively impaired, required extensive assist to total dependence with care needs, and was at risk for developing pressure ulcers. Observations on December 18, 2023, at 10:35 a.m. revealed that Resident 9 was lying in bed and the bed was equipped with an air mattress; however, there was no documented evidence that the use of an air mattress was assessed for potential safety hazards prior to being placed on the resident's bed. Interview with the Registered Nurse Assessment Coordinator (RNAC) on December 20, 2023, at 11:21 a.m. confirmed that there was no assessment for potential safety hazards prior to the air mattress being placed on the Resident 9's bed and there should have been. An admission MDS assessment for Resident 17, dated November 16, 2023, indicated that the resident was cognitively intact, required assistance from staff with her daily care needs, was dependent on staff for transfers with use of a mechanical lift, was incontinent of bowel and urine, had a Stage 2 pressure area (a shallow open wound), moisture-associated skin damage (inflammation of the skin caused by exposure to moisture), and had a diagnosis of morbid obesity. Physician's orders, dated November 16, 2023, included an order for the resident's bed to be equipped with an air mattress. Observations on December 18, 2023, at 11:00 a.m. revealed that Resident 17 was lying in bed and the bed was equipped with an air mattress; however, there was no documented evidence that the use of an air mattress was assessed for potential safety hazards prior to being placed on the resident's bed. Interview with the Registered Nurse Assessment Coordinator (RNAC) on December 19, 2023, at 2:27 p.m. confirmed that there was no assessment for potential safety hazards prior to the air mattress being placed on the Resident 17's bed and there should have been. Review of admission records for Resident 40, dated December 5, 2023, revealed the resident had diagnoses that included spinal stenosis (narrowing of the spinal column), diabetes, and a Stage 4 (tissue loss with exposed bone, tendon, or muscle) Sacrococcygeal (area that includes the base of the spine and the tailbone) pressure ulcer (injuries to skin resulting from prolonged pressure). Observations of Resident 40 on December 18, 2023, at 11:20 a.m. revealed the resident's bed was equipped with an air mattress; however, there was no documented evidence that the use of an air mattress was assessed for potential safety hazards prior to being placed on the resident's bed. Interview with the registered Nurse Assessment Coordinator on December 20, 2023, 11:37 a.m. confirmed there was no assessment for potential safety hazards prior to an air mattress being placed on Resident 40's bed. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396035 If continuation sheet Page 9 of 18 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 396035 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Scottdale Healthcare & Rehabilitation Center 900 Porter Avenue Scottdale, PA 15683 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 28 Pa. Code 201.14(a) Responsibility of licensee. Level of Harm - Minimal harm or potential for actual harm 28 Pa. Code 201.18(b)(1)(e)(1) Management. 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: 396035 If continuation sheet Page 10 of 18 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 396035 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Scottdale Healthcare & Rehabilitation Center 900 Porter Avenue Scottdale, PA 15683 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Based on review of policies and clinical records, as well as staff interviews, it was determined that the facility failed to maintain accountability for controlled medications (drugs with the potential to be abused) for three of 19 residents reviewed (Resident 11, 15, 17). Findings include: The facility's policy regarding the administration of oral medications, dated December 7, 2023, indicated that the nurse will document on the Medication Administration Record (MAR) with their initials, at the appropriate date and time for the medication administered, after witnessing the ingestion of the medication. An admission Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs) for Resident 11, dated November 16, 2023, revealed that the resident was cognitively intact, required assistance from staff for daily care needs, and had diagnoses that included arthritis, high blood pressure, and chronic pain syndrome. Physician's orders for Resident 11, dated November 10, 2023, included an order for the resident to receive 10-325 milligrams (mg) of Hydrocodone (a controlled pain medication) every eight hours as needed for moderate to severe pain. A review of the controlled drug record (a form that accounts for each tablet/pill/dose of a controlled drug) for Resident 11 for November 2023 indicated that a dose of 10-325 mg of Hydrocodone was signed out on November 21, 2023, and on November 27, 2023. However, the resident's clinical record contained no documented evidence that the signed-out tablet of Hydrocodone was administered to the resident on the dates that were mentioned. A quarterly MDS assessment for Resident 15, dated November 10, 2023, revealed that the resident was cognitively intact, required assistance from staff for daily care needs, and had diagnoses that included high blood pressure and fibromyalgia (disorder that affects muscle causing pain). Physician's orders for Resident 15, dated July 3, 2023, included an order for the resident to receive 5-325 milligrams (mg) of Hydrocodone (a controlled pain medication) every six hours as needed for moderate to severe pain. A review of the controlled drug record for Resident 15, for October, November and December 2023 indicated that one 5-325 mg tablet of Hydrocodone was signed out on October 27, October 30, November 19, and December 2, 2023, for administration to the resident. However, the resident's clinical record, including the MAR and nursing notes, contained no documented evidence that the signed-out tablet of Hydrocodone was administered to the resident on the dates that were mentioned. An interview with the Registered Nurse Assessment Coordinator on December 20, 2023, at 11:21 a.m. confirmed that there was no documented evidence that staff administered the controlled drugs to Residents 11 and 15 on the dates mentioned above. An admission MDS assessment for Resident 17, dated November 16, 2023, indicated that the resident was cognitively intact, required assistance from staff with her daily care needs, had a Stage 2 (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396035 If continuation sheet Page 11 of 18 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 396035 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Scottdale Healthcare & Rehabilitation Center 900 Porter Avenue Scottdale, PA 15683 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0755 pressure area (a shallow open wound), occasional pain, and a diagnosis of anxiety. Level of Harm - Minimal harm or potential for actual harm Physician's orders for Resident 17, dated December 4, 2023, included an order for the resident to receive 50 milligrams (mg) of Tramadol HCL (a controlled pain medication) every eight hours as needed for severe pain. Physician's orders for Resident 17, dated November 29, 2023, included an order for the resident to receive 0.5 mg of Lorazepam (a controlled anxiety medication) every eight hours as needed for anxiety or restlessness. Residents Affected - Few A review of the controlled drug record (a form that accounts for each tablet/pill/dose of a controlled drug) for Resident 17, dated November 15, 2023, and December 4, 2023, indicated that one 50 mg tablet of Tramadol HCL was signed-out for administration to the resident. However, the resident's clinical record, including the MAR and nursing notes, contained no documented evidence that the signed-out tablet of Tramadol HCL was administered to the resident on these dates. A review of the controlled drug record for Resident 17 revealed that one 0.5 mg tablet of Lorazepam was signed out on December 5, 2023, for administration to the resident. However, the resident's clinical record, including the MAR and nursing notes, contained no documented evidence that the signed-out tablet of Lorazepam was administered to the resident on this date. An interview with the Regional Director on December 20, 2023, at 2:15 p.m. confirmed that there was no documented evidence that staff administered the Lorazepam to Resident 17 on the date mentioned above. 28 Pa. Code 211.9(h) Pharmacy services. 28 Pa. Code 211.12(d)(1)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396035 If continuation sheet Page 12 of 18 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 396035 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Scottdale Healthcare & Rehabilitation Center 900 Porter Avenue Scottdale, PA 15683 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Based on review of policies, clinical records, and manufacturer's instructions, as well as observations and staff interviews, it was determined that the facility failed to properly secure and store medications in the medication carts and failed to properly label medications in the medication room. Findings include: The facility's policy regarding administering medications, dated December 7, 2023, indicated that the medication cart was to be kept closed and locked when out of site of the medication nurse, no medications were to be kept on top of the cart, and when opening a multi-dose container, the date opened was to be recorded on the container. Observations of a medication pass on December 19, 2023, at 7:40 a.m. revealed that Licensed Practical Nurse 4 left a card of Naproxen 500 milligram (mg) tablets and a card of Allopurinol 100 mg tablets on top of the medication cart unsupervised while he entered a resident's room to administer medication. Interview with Licensed Practical Nurse 4 at that time confirmed that he should not have left the medication on top of the cart unsupervised. Manufacturer's Instructions for Tubersol, dated November 1, 2021, indicated that a multi-dose vial of Tubersol solution should be discarded 30 days after it is opened. Observations of the facility's medication room on December 20, 2023, at 11:13 a.m. revealed that the door to the medication room was open, unlocked, and unsupervised. Observation of the medication room refrigerator at that time revealed one opened and undated bottle of Tubersol Tuberculin injection for Mantoux TB skin test (to test for tuberculosis). Interview with Registered Nurse 5 on December 20, 2023, at 11:13 a.m. confirmed that the bottle of Tubersol was not dated when it was opened and that it should have been, and the door to the medication room should have been closed and locked. Interview with the Nursing Home Administrator on December 19, 2023, at 9:26 a.m. confirmed that medications should not have been left unsupervised on top of the medication cart and should have been secured in the medication cart when the nurse walked away from the cart. Interview with the Registered Nurse Assessment Coordinator on December 20, 2023, at 3:56 p.m. confirmed that the door to the medication room was to be kept shut and locked when not in use and that the Tubersol should have been dated when opened. 28 Pa. Code 211.9(a)(1) Pharmacy services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396035 If continuation sheet Page 13 of 18 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 396035 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Scottdale Healthcare & Rehabilitation Center 900 Porter Avenue Scottdale, PA 15683 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 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on review of facility policies, as well as observations and staff interviews, it was determined that the facility failed to store and prepare food in accordance with professional standards for food service safety by not dating opened food items and not storing food under sanitary conditions. Findings include: The facility's policy regarding food storage, dated December 7, 2023, revealed that leftover food was to be stored in covered containers or wrapped carefully and securely. Each item was to be clearly labeled and dated before being refrigerated or frozen. All stock must be rotated with each new order received; new items were to be placed behind the supply in stock so that the oldest stock is always used first. Observations in the kitchen refrigerator on December 18, 2023, at 9:43 a.m. revealed an opened and undated package of lunch meat. Observations in the kitchen's walk-in refrigerator at 9:46 a.m. revealed a block of opened swiss cheese that was dated November 24, 2023, and three unopened containers of orange juice with a best by date of October 19, 2023. Interview with the Dietary Manager at the time of observations confirmed that the opened package of lunch meat should have been dated when opened, the block of cheese should have been discarded, and the orange juice was outdated and should have been discarded. 28 Pa. Code 211.6(f) Dietary services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396035 If continuation sheet Page 14 of 18 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 396035 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Scottdale Healthcare & Rehabilitation Center 900 Porter Avenue Scottdale, PA 15683 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0849 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. Based on review of hospice contracts and clinical records, as well as staff interviews, it was determined that the facility failed to ensure that the designated interdisciplinary team member obtained the required information from the contracted hospice provider for one of one hospice residents reviewed (Resident 19). Findings include: An agreement between the facility and a hospice provider (provider of end-of-life services) indicated that the hospice provider would provide information to the facility to facilitate coordination of care that included the most recent hospice plan of care specific to each patient and a hospice benefit of elections form (a form signed to indicate that the individual waives all rights to traditional Medicare Part A payments for treatment related to the terminal illness). Physician's orders for Resident 19, dated August 31, 2023, revealed that the resident was to receive hospice services from the facility's contracted hospice provider. As of December 20, 2023, there was no documented evidence in the resident's clinical record, or in the hospice provider's clinical record, that the facility obtained the hospice benefit of elections form from the hospice provider. Interview with the Registered Nurse Assessment Coordinator on December 20, 2023, at 11:30 a.m. confirmed that there was no evidence that the election of benefits was on Resident 19's hospice chart. 28 Pa. Code 211.12(d)(3)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396035 If continuation sheet Page 15 of 18 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 396035 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Scottdale Healthcare & Rehabilitation Center 900 Porter Avenue Scottdale, PA 15683 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 0867 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. Based on review of the facility's plans of correction for previous surveys, and the results of the current survey, it was determined that the facility's Quality Assurance Performance Improvement (QAPI) committee failed to correct quality deficiencies and ensure that plans to improve the delivery of care and services effectively addressed recurring deficiencies. Findings include: The facility's deficiencies and plans of corrections for a State Survey and Certification (Department of Health) survey ending February 1, 2023; complaint investigation surveys ending June 13, 2023, and September 20, 2023; and revisit surveys ending July 24, 2023, and October 30, 2023, revealed that the facility developed plans of correction that included quality assurance systems to ensure that the facility maintained compliance with cited nursing home regulations. The results of the current survey, ending December 20, 2023, identified repeated deficiencies related to care plan timing and revision, the failure to provide quality of care, safe environment free from accident hazards, storage and labeling of medications, and infection control. The facility's plan of correction for a deficiency regarding care plan timing and revision, cited during the surveys ending June 13, 2023; July 24, 2023; September 20, 2023; and October 20, 2023, revealed that the facility would complete audits and report the results of the audits to the QAPI committee for review. The results of the current survey, cited under F657, revealed that the facility's QAPI committee failed to successfully implement their plan to ensure ongoing compliance with regulations regarding care plan timing and revision. The facility's plan of correction for a deficiency regarding quality of care, cited during the surveys ending February 1, 2023, and September 20, 2023, revealed that the facility would complete audits and report the results of the audits to the QAPI committee for review. The results of the current survey, cited under F684, revealed that the facility's QAPI committee failed to successfully implement their plan to ensure ongoing compliance with regulations regarding quality of care. The facility's plans of correction for deficiencies regarding a safe environment that is free of accident hazards, cited during the surveys ending September 20, 2023, and October 30, 2023, revealed that the facility developed plans of correction that included completing audits and reporting the results of the audits to the QAPI committee for review. The results of the current survey, cited under F689, revealed that the facility's QAPI committee failed to maintain compliance with the regulation regarding a safe environment that is free of accident hazards. The facility's plans of correction for deficiencies regarding storage and labeling of medications, cited during the survey ending February 1, 2023, revealed that the facility developed plans of correction that included completing audits and reporting the results of the audits to the QAPI committee for review. The results of the current survey, cited under F761, revealed that the facility's QAPI committee failed to maintain compliance with the regulation regarding storage and labeling of medications. The facility's plans of correction for deficiencies regarding infection control, cited during the surveys ending September 20, 2023, and October 30, 2023, revealed that the facility developed plans of correction that included completing audits and reporting the results of the audits to the QAPI (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396035 If continuation sheet Page 16 of 18 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 396035 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Scottdale Healthcare & Rehabilitation Center 900 Porter Avenue Scottdale, PA 15683 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 0867 committee for review. The results of the current survey, cited under F880, revealed that the facility's QAPI committee failed to maintain compliance with the regulation regarding infection control. Level of Harm - Minimal harm or potential for actual harm Refer to F657, F684, F689, F761, F880. Residents Affected - Few 28 Pa. Code 201.14(a) Responsibility of licensee. 28 Pa. Code 201.18(e)(1) Management. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396035 If continuation sheet Page 17 of 18 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 396035 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Scottdale Healthcare & Rehabilitation Center 900 Porter Avenue Scottdale, PA 15683 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 Based on review of facility policies and clinical record reviews, as well as observations and staff interviews, it was determined that the facility failed to follow CDC guidelines to reduce the spread of infections and prevent cross-contamination related to an Extended Spectrum Beta-Lactamase (ESBL- Beta-lactamases are enzymes produced by some bacteria that may make them resistant to some antibiotics) infection in the urine for one of 19 residents reviewed (Resident 15). Residents Affected - Few Findings include: The facility's Infection Prevention and Control policy, dated December 7, 2023, revealed that contact precautions are intended to prevent the transmission of infectious agents which are spread through direct or indirect contact with the patient or the patient's environment. Contact precautions also apply where the presence of excessive wound drainage, urine or fecal incontinence, or other discharges from the body suggest an increased potential for environmental contamination and risk of transmission. Enhanced barrier protections are intended to prevent transmission of multi-drug resistant organisms (MDRO's-bacteria that have become resistant to certain antibiotics) via contaminated hands and clothing of healthcare workers to high-risk residents. A quarterly Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs) for Resident 15, dated November 10, 2023, revealed that the resident was cognitively intact, required assistance with staff for daily care needs, was incontinent of urine, and had diagnoses that included high blood pressure and fibromyalgia (a disorder that affects muscles, causing pain). A nursing note for Resident 15, dated December 6, 2023, at 4:56 p.m. revealed that the resident was at the hospital and was diagnosed with a urinary tract infection containing ESBL and Escherichia coli. Physician's orders for Resident 15, dated December 9, 2023, included an order for the resident to receive 1 gram of Ertapenem Sodium Intravenous (an antibiotic used to treat multi-drug resistance and ESBL) daily. A review of the clinical record, including physician orders, nurse's notes and care plans, for Resident 15, dated December 2023, revealed that as of December 20, 2023, there was no documented evidence that transmission-based precautions were ordered or implemented related to Resident 15's ESBL infection. Observations of Resident 15 on December 18, 19, and 20, 2023, revealed that there was no signage to alert staff and visitors of contact precautions for the resident and no observations that contact precautions were being implemented when providing care to the resident. Interview with the Director of Nursing on December 20, 2023, at 3:01 p.m. confirmed that contact isolation precautions were never initiated after Resident 15's return from the hospital with a positive ESBL infection and should have been. 28 Pa. Code 211.12(d)(1)(5) Nursing services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396035 If continuation sheet Page 18 of 18