Inspection·October 27, 2023

F 0656 Level of Harm - Minimal harm or potential for actual harm Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Based on observation, a review of clinical records and staff interview, it was determined that the facility failed to develop a comprehensive care plan for one of 28 residents reviewed (Resident 23). Residents Affected - Few Findings include: Observation on October 26, 2023 at 9:05 a.m. revealed resident lying in bed with oxygen on at 2L(liters)/min via nasal cannula (medical device to provide supplemental oxygen therapy). Review of physician's orders included an order for oxygen at 2L/min via nasal cannula continuous every shift related to pneumonia (an infection of the air sacs in one or both the lungs), titrate (adjust) to maintain saturation (measure of how much oxygen is traveling through the body) at 92% or above. Further review of the clinical record revealed no care plan regarding the use of oxygen. Interview with the Nursing Home Administrator(NHA) on October 27, 2023, at 1:30 p.m. revealed the Pneumonia had resolved and the oxygen was used on an as needed basis. The NHA confirmed that there was no care plan in place to address the use of oxygen. 483.21 Comprehensive Resident Centered Care Plan Previously cited 12/30/22 28 Pa. Code 211.5(f) Clinical records Previously cited 12/30/22 28 Pa. Code 211.11(a) Resident care plan 28 Pa. Code 211.11(d) Resident care plan 28 Pa. Code 211.12(d)(1)(5) Nursing services Previously cited 12/30/22 FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396083 If continuation sheet Page 2 of 9 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 396083 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Sterling Health Care and Rehab Center 318 South Orange Street Media, PA 19063 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 upon review of staffing records and performance reviews it was determined the facility failed to ensure performance reviews were completed for five of five staffing records reviewed. Residents Affected - Some Findings include: Review of staffing records and performance reviews revealed five staff members did not have annual performance reviews performed. Interview with the Nursing Home Administrator on October 27, 2023 at 1:00 p.m. confirmed staff performance reviews were not completed. 28 Pa. Code 201.20(a)(c) Staff Development FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396083 If continuation sheet Page 3 of 9 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 396083 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Sterling Health Care and Rehab Center 318 South Orange Street Media, PA 19063 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. Based on clinical records review and staff interviews, it was determined that the facility failed to follow a recommendation from a consulting psychiatry provider for a resident exhibiting a behavioral symptom for one of 28 residents reviewed (Resident 65). Findings include: Review of Resident 65's diagnosis list includes Schizoaffective disorder (mental disorder characterized by abnormal thought processes and an unstable mood), Major Depressive Disorder (mood disorder that causes a persistent feeling of sadness and a loss of interest), Vascular Dementia (decline in thinking skills caused by conditions that block or reduce blood flow to various regions of the brain), and Anxiety Disorder (mental health disorder characterized by feeling of worry, anxiety, or fear that are strong enough to interfere with one's daily activities). Review of Resident 65's current behavioral care plan of care initiated on December 19, 2022, revealed the resident had a history of aggressive and combative behaviors, including throwing a rolling walker at the staff. Interventions were put in place. Review of Resident 65's progress notes dated August 27, 2023, at 10:23 p.m., revealed that at 6:20 p.m., the resident approached the staff and asked to be taken out to smoke. The resident became upset when staff informed him/her to wait until dinner trays were collected and that smoking time is not until 6:30 p.m., this resulted in the resident using profanities, walking through the resident's dining area, and breaking one of the windows in the back entrance with a walker. The physician was notified and ordered to notify the psyche provider. While awaiting a callback, a housekeeping staff came into the dining room to clean the area, the resident picked up the walker and attempted to throw it at the employee, 911 was called, two police officers came out, the physician was notified, and ordered to transfer the resident to the emergency room, but resident refused to be transported when the emergency transport arrived, the physician was notified. The resident was closely monitored. Review of the behavior notes dated August 28, 2023, at 8:00 a.m., revealed that Resident 65 was seen by the psychiatric provider. The resident's anti-psychotic medication dose was adjusted and a recommendation for an outpatient psychiatry transfer. Review of Resident 65's clinical records review revealed the resident's behavior was monitored. Review of the social service note dated August 28, 2023, at 9:04 a.m., revealed resident's information was faxed over to an in-patient psychiatric facility for resident transfer. Review of Resident 65's clinical records failed to reveal follow-up documentation regarding the resident's transfer to an in-patient psychiatric facility which was recommended by the consulting psychiatric provider. Interview conducted with the Social Worker, Employee E3 dated October 27, 2023, at 11:00 a.m., revealed the social worker sent Resident 65's information for transfer to two in-patient psychiatric facilities but was turned down. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396083 If continuation sheet Page 4 of 9 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 396083 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Sterling Health Care and Rehab Center 318 South Orange Street Media, PA 19063 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 The clinical records review failed to reveal any documentation regarding coordination that occurred between the facility and the in-patient psyche facility regarding the resident's transfer. The clinical records also failed to reveal that the consulting psyche provider and the attending physician were notified that the recommendation to transfer Resident 65 to an in-house psyche facility was followed. Residents Affected - Few The above information was reviewed with the Director of Nursing on October 27, 2023, at 1:00 p.m. The facility failed to ensure the recommendation of the psychiatric provider to transfer Resident 65 who was showing behavioral symptom to an in-house psychiatric facility was followed. 28 Pa. Code 211.12(d)(1)(3)(5) Nursing services Previously cited 12/30/22 FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396083 If continuation sheet Page 5 of 9 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 396083 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Sterling Health Care and Rehab Center 318 South Orange Street Media, PA 19063 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 Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. Based upon clinical record review, it was determined that the facility failed to ensure that medication irregularities were acted upon by a physician for one of three residents reviewed (Resident 58). Residents Affected - Few Findings include: Review of Resident 58's clinical record revealed that a MRR (Medication Record Review) was completed on January 5, 2023, with a recommendation, the current diagnosis of anxiety for Risperidone (antipsychotic medication) use may not be approved at the time of [Department of Health] survey. The pharmacist informed that a diagnosis of Autism, Bipolar, Mania or Schizophrenia are considered FDA approved diagnoses for the use of Risperidone. Further review of Resident 58's clinical record revealed that a MRR (Medication Record Review) was completed on February 4, 2023, with the same recommendation, the current diagnosis of anxiety for Risperidone (antipsychotic medication) use may not be approved at the time of survey. The pharmacist again informed that a diagnosis of Autism, Bipolar, Mania or Schizophrenia are considered FDA approved diagnoses for the use of Risperidone. Review of Resident 58's physician orders revealed an order dated June 2, 2023, for Risperdal oral tablet 1 mg, give by mouth at bedtime for restlessness, agitation, related to unspecified dementia, unspecified severity, with other behavioral disturbance. Further review of Resident 58's physician orders revealed an order dated June 7, 2023, for Risperdal oral tablet 0.25 mg by mouth one time a day for anxiety. Further review of the clinical record failed to reveal that the pharmacist recommendations were addressed by the attending physician. The above findings were addressed with presented to the Director of Nursing and Nursing Home Administrator during an exit meeting on October 27, 2023, at 2:30 p.m. 483.45 Drug Regimen Review, Report Irregular, Act on Previously cited 11/1/21, 12/30/22, 3/24/23 28 Pa. Code 211.5(f) Clinical records Previously cited 11/1/21, 12/30/22, 3/24/23 28 Pa. Code 211.12(c) Nursing services Previously cited 11/1/21, 12/30/22, 3/24/23 28 Pa. Code 211.12(d)(3) Nursing services Previously cited 11/1/21, 12/30/22, 3/24/23 (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396083 If continuation sheet Page 6 of 9 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 396083 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Sterling Health Care and Rehab Center 318 South Orange Street Media, PA 19063 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 28 Pa. Code 211.12(d)(1)(5) Nursing services Level of Harm - Minimal harm or potential for actual harm Previously cited 11/1/21, 12/30/22, 3/24/23 Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396083 If continuation sheet Page 7 of 9 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 396083 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Sterling Health Care and Rehab Center 318 South Orange Street Media, PA 19063 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 observation and interviews with staff it was determined that the facility failed to ensure infection control and prevention was implemented during medication administration for three of the three residents observed (Residents 44, 61, and Resident 7) Residents Affected - Some Findings include: Observation conducted of medication administration for Resident 44 with licensed nurse, Employee E4 on October 25, 2023, at 9:00 a.m. The observation revealed Employee E4 opened the medications Celexa (anti-depressive medication) and Olanzapine (anti-psychotic medication) from a blister card with her/his bare hand and placed it into the medicine cup then administered the medication to Resident 44. Employee E4 then proceeded back to the medication cart to document in the computer. Without performing hand hygiene, Employee E4 proceeded to prepare the medication for Resident 61 at 9:07 a.m. Further observation revealed Employee E4 popped medications Benztropine (medication to treat Parkinson's), Furosemide (water pill), Fluoxetine (anti-depressive medication), and Perphenazine (anti-psychotic medication) from a blister card from her/his bare hands and placed it into the medicine cup then administered the medication to Resident 61. Observation conducted of the medication administration for Resident 7 was conducted with licensed nurse Employee E5 on October 26, 2023, at 8:50 a.m. The observation revealed Employee E5 put on a clean glove, checked the resident ' s blood sugar the proceeded to administer insulin. Without changing gloves and performing hand hygiene, Employee E5 applied an eye drop to the resident ' s eyes. Interview conducted with Employee E5 on October 26, 2023, at 8:55 a.m., confirmed that he/ she should have changed gloves and performed hand hygiene before administering eye drops to Resident 7. The above information was conveyed to the Director of Nursing on October 27, 2023, at 11:00 a.m. The facility failed to ensure infection control and prevention was practiced while administering medications to Residents 44, 61, and Resident 7. 28 Pa. Code 201.18 (b)(1) Management 28 Pa. Code 211.12(d)(1)(3)(5) Nursing services FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396083 If continuation sheet Page 8 of 9 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 396083 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Sterling Health Care and Rehab Center 318 South Orange Street Media, PA 19063 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 Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention. Based upon review of staffing records and inservice documentation, it was determined the facility failed to ensure nurse aides received required 12 hour annual re-training for five of five records reviewed. Residents Affected - Some Findings Include: Review of five staffing records and inservice documentation revealed one nurse aide received the required 12 hour annual retraining. Further review of the staffing records and inservice documentation revealed four of the five records reviewed failed to reveal evidence of retraining. Interview with the Nursing Home Administrator on October 27, 2023 at 1:00 p.m. confirmed that the nurse aides did not received the required in-service retraining. 28 Pa. Code 201.20(a)(c) Staff Development FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396083 If continuation sheet Page 9 of 9