Health inspection·September 5, 2025

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. **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 adequate supervision to avoid injuries for one of three residents (Resident R1). Findings include:Review of the clinical record indicated Resident R1 was admitted to the facility on [DATE]. Review of the Minimum Data Set (MDS - periodic assessment of resident care needs) dated 7/16/25, included diagnoses of COPD, muscle weakness, and the need for aftercare following joint replacement surgery. Review of Section G: Functional Status indicated that Resident R1 required supervision for eating. Review of Resident R1's plan of care for ADL (activities of daily living)/mobility dated 7/11/25, indicated for staff to monitor for changes or decline in ability to participate in ADLs, decreased strength, increased weakness, or changes in cognition. Further review of the care plan failed to reveal documentation of the needed assistance level during meals. Review of a progress note dated 8/18/25, at 10:00 a.m. indicated, Resident lying in bed, very lethargic, slow to respond, not responding appropriately, or follow direction. not engaging in conversation, poor eye contact. alert to name and place, not alert to date. not able to recall this nurse. Resident appeared flushed, with slight body tremors, 95/46 (blood pressure)-99.2 (temperature)-72 (heart rate)-16 (respiration rate). 77% on room air, o2 (oxygen) applied at 2L (two liters) with gradual response to 90%, o2 increased to 3L with pox of 96%.Review of a nurse practitioner's note dated 8/18/25, at 11:33 a.m. indicated, Pt (patient) evaluated per request of nursing for acute hypoxia (low level of oxygen in the body tissues). Per nursing, pt was found to be sating (slang to refer to a patient's oxygen saturation level) at 77%, unsure for how long. Nurse further stated pt was confused from baseline.Review of a progress note dated 8/18/25, at 2:35 p.m. indicated that Resident R1 had slurred speech and notable hand tremors. Review of a progress note dated 8/18/25, at 3:05 p.m. indicated Resident R1 had a change in condition, shortness of breath, tired, weak, confused, or drowsy.Review of a progress note dated 8/19/25, at 1:11 p.m. indicated, This nurse was called by CNA (nurse aide) to look at pt's right front thigh that appeared to be pink in color circular shaped 15 cm x 15 cm x 0 cm: intact skin. Pt stated she spilled entire lunch tray with hot soup onto her lap.Review of a grievance filed on 8/19/25, indicated, Resident was passed her lunch tray, it was set up for her by the CNA. While eating chicken noodle soup, [Resident R1] spilled the hot soup on herself and reported to the nursing staff that she spilled the soup and burned herself. The resolution to this grievance included:-Pt cleaned up by nursing staff.-Sensitive area to inner thighs assessed by RN (registered nurse) and CRNP (certified registered nurse practitioner). CRNP ordered to keep OTA (open to air) and monitor for pain/complications.-Tremors seem to be newer onset, NP/MD (doctor of medicine) evaluating for potential cause. In the meantime, hot soups will be removed from the resident's meal trays for safety measures.-Investigation of food temps (temperatures) by [Dietary Manager]. - [Resident R1] agreeable to resolution.Review of facility-submitted information dated 9/5/25, indicated On 8/19/2025 the patient was provided her (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 2 Event ID: 396066 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 396066 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/05/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whitehall Borough Post Acute 505 Weyman Road Pittsburgh, PA 15236 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)