Health inspection·March 26, 2025

F 0573 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Let each resident or the resident's legal representative access or purchase copies of all the resident's records. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on facility policy and staff interview it was determined that the facility failed to provide medical record access for one of four residents (Resident R1). Findings include: Review of Release of Medical Records dated 1/1/25, indicated medical records will be released with a valid request and in accordance with state and federal laws. Requests for records should be referred to the Director of Nursing or Administrator, or another staff member previously designated by the facility. The facility should request copies of any legal papers necessary to authenticate authority. The legal papers should be attached to the request for records. The corporate office/risk manager should be notified of the request for records. Upon receipt of a request for medical record copies, the facility should notify the requesting party, in writing of the cost for obtaining records and that records are available two days after the receipt of payment for the copies. Records should be assembled in chronological order. When documents are missing, the person assembling the record should make a notation of the items missing. Facility documentation indicated Resident R1 was admitted on [DATE]. Review of Resident R1's MDS (minimum data set a periodic assessment of basic needs) dated 1/24/24, revealed 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 disorder, and Alzheimer's disease (a brain condition that slowly damages your memory, thinking, learning and organizing skills. It's the most common cause of dementia.) Review of Resident R1's MDS assessment dated [DATE], indicated the resident was discharged from the facility on 2/28/24. The resident ceased to breathe. During an interview on 3/26/25, at 9:15 a.m. the Nursing Home Administrator stated once the facility receives a medical request in writing, the facility informs the recipient of the cost associated. It was indicated a hard copy or flash drive can be provided for medical records as long as it is a legal request. If the medical request is from a law firm, the facility will obtain the necessary medical records and send it. The NHA stated the facility cannot send Resident R1's medical records because of how thick it is and the facility's copier is broken. The NHA stated the facility has another scanner that can be used off-site to send the records. During an interview on 3/26/25, at 9:25 a.m. the NHA indicated a law firm has been requesting Page 1 of 4 396056 396056 03/26/2025 William Penn Care Center 2020 Ader Road Jeannette, PA 15644

F 0573 Resident R1's medical records. Level of Harm - Minimal harm or potential for actual harm During an interview on 3/26/25, at 9:40 a.m. the NHA confirmed it has been a few months since the facility received the initial request for Resident R1's medical records. The NHA confirmed the facility failed to provide medical record access for one of seven residents (Resident R1). Residents Affected - Few 28 Pa. Code 201.29(a)Resident rights. 396056 Page 2 of 4 396056 03/26/2025 William Penn Care Center 2020 Ader Road Jeannette, PA 15644

F 0660 Plan the resident's discharge to meet the resident's goals and needs. 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 record review, and staff interview, it was determined that the facility failed to implement an effective discharge planning process that focuses on the resident's discharge goals and effectively transition them to post-discharge care for one of three residents (Resident R2). Residents Affected - Few 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 2/14/25, indicated diagnoses of encounter for surgical aftercare following surgery on the digestive system, colostomy (a surgical procedure that changes the way stool exits your body), and high blood pressure. Review of Resident R2's care plan dated 2/12/25, indicated to assist the resident with obtaining durable medical equipment (DME) and medical supplies prior to discharge. Review of a physician order dated 2/12/25, indicated to administer oxygen at two liter per minute (LPM) continuously. Review of a physician order dated 2/13/25, indicated to wean oxygen as tolerated. Review of a physician order dated 2/15/25, indicated to administer oxygen at two LPM, as needed via nasal cannula to maintain oxygen above 92%. Review of a progress note dated 2/22/25, revealed Resident R2 had increased respiratory effort observed on exertion. The resident has a dry cough and complaints of shortness of breath upon exertion. The resident's oxygen saturation was 90% on room air. Review of Resident R2's progress note dated 2/22/25, indicated the resident was positive for influenza A. Review of a progress note dated 2/23/25, revealed the physician was notified and orders were obtained for discharge on [DATE], at 9:00 a.m. The resident was ordered home health services and a wheeled walker. Resident R2's family member picked the resident up for discharge. Discharge instructions were provided to the resident and resident's family member. The facility sent all medications with the resident. The facility failed to order the resident oxygen. During an interview on 3/18/25, at 1:57 p.m. the Director of Nursing stated Resident R2's family member called the facility after Resident R2 discharged and confirmed the facility failed to ensure Resident R2 was ordered oxygen. During an interview on 3/18/25, at 2:24 p.m. the DON and Nursing Home Administrator confirmed the facility failed to implement an effective discharge planning process that focuses on the resident's discharge goals and effectively transition them to post-discharge care for one of three residents (Resident R2). 396056 Page 3 of 4 396056 03/26/2025 William Penn Care Center 2020 Ader Road Jeannette, PA 15644

F 0660 28 Pa. Code 201.18 (b)(1) Management. Level of Harm - Minimal harm or potential for actual harm 28 Pa. Code 211.12 (c)(d)(3)(5) Nursing services. Residents Affected - Few 396056 Page 4 of 4