Health inspection·September 20, 2023

F 0553 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Allow resident to participate in the development and implementation of his or her person-centered plan of care. Based on a review of clinical records and select facility policy and staff interviews, it was determined that the facility failed to demonstrate the inclusion of the resident and/or their interested representative in the development of the plan of care as evidenced by the facility's failure to invite a resident and/or their representative to attend care plan meetings for three of 10 sampled residents (Residents 1, 2, and 6). Findings include: A review of facility policy entitled Comprehensive Care Planning Policy, last revised July 19, 2019, indicated that an interdisciplinary plan of care will be established for every resident and updated in accordance with state and federal regulatory requirements and on an as needed basis. In states where pre-admission screening applies, this will be coordinated with the facility assessment. The interdisciplinary Care Plan team may consist of the resident, the resident's family and/ or the resident's legal guardian. A review of MDS/ Care Plan schedule for the month of July 2023, revealed that Resident 6 was scheduled for a care plan meeting on July 9, 2023. Review of the clinical record revealed no evidence that Resident 6 and/or the resident's interested representative was invited to the care plan meeting and afforded the opportunity to participate in the resident's care plan development A review of MDS/ Care Plan schedule for the month of August 2023, revealed that Resident 2 was scheduled for a care plan meeting on August 10, 2023. Review of the clinical record revealed no evidence that Resident 2 and/or the resident's interested representative was invited to the care plan meeting and afforded the opportunity to participate in the resident's care plan development A review of MDS/ Care Plan schedule for the month of September 2023, revealed that Resident 1 was scheduled for a care plan meeting on September 7, 2023. Review of the clinical record revealed no evidence that Resident 1 and/or the resident's interested representative was invited to the care plan meeting and afforded the opportunity to participate in the resident's care plan development An interview with the Nursing Home Administrator and Director of Nursing on September 20, 2023, at Page 1 of 6 396095 396095 09/20/2023 Scranton Health Care Center 2933 McCarthy Street Scranton, PA 18505

F 0553 Level of Harm - Minimal harm or potential for actual harm 1:00 PM confirmed that there was no evidence that the facility had invited the resident and/or interested representative to attend the care plan meetings and participate in the development of the residents' plan of care. 28 Pa. Code 201.29 (a) Resident rights Residents Affected - Some 396095 Page 2 of 6 396095 09/20/2023 Scranton Health Care Center 2933 McCarthy Street Scranton, PA 18505

F 0644 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review and staff interview, it was determined that the facility failed to incorporate the recommendations from the Pre-admission Screening and Resident Review (PASARR) level II determination and the PASRR evaluation report into a resident's assessment, care planning, and transitions of care for one of 10 residents reviewed (Resident 5) Findings include: Clinical record review revealed that Resident 5 was admitted to the facility on [DATE], with diagnoses that included cerebral palsy. A review of Resident 5's clinical revealed that on August 10, 2023, a Pennsylvania Preadmission Screening Resident Review (PASRR) identified that the resident had a positive screen for serious mental illness, intellectual disability/developmental disability, and/or other related condition; he/she requires a further PASRR Level II evaluation. You must notify the individual that a further evaluation needs to be done. Have the individual or his/her legal representative sign that they have been notified of the need to have a PASRR Level II evaluation done. A determination letter dated August 31, 2023, indicated that Resident 5 qualified for additional services. There was no evidence that additional services were obtained, coordinated or provided based on the resident's positive Level II screen. The resident's current care plan failed to identify the individual and specific referrals made or services recommended and provided to the resident as the result of the resident's other related condition (Cerebral Palsy), and PASARR II. For a resident with a Level II determination and recommendations, the facility failed to incorporate the recommended services into the resident's care plan (Specialized services provided or arranged by the State may be provided in the NF or through off-site visits arranged by the NF, while the resident lives in the facility). Resident 5's clinical record revealed no documented evidence at the time of the survey ending April 28, 2023, that Resident 45's Level II PASARR for other related condition (Cerebral Palsy) had been coordinated with the Office of Long-Term Living to ensure that the resident received the eligible services. The facility failed to demonstrate that they had arranged for the residents to receive specialized services through off-site visits, if appropriate, to meet Resident 5's needs as identified in the residents' PASARR Level II recommendations. An interview with the Nursing Home Administrator and Director of Nursing on September 20, 2023, at 1:00 p.m. confirmed that the PA-PASARR-ID II form completed had identified Resident 5 as a target and were unable to provide evidence of coordination of services including care planning. 28 Pa. Code 201.29 (a) Resident rights 396095 Page 3 of 6 396095 09/20/2023 Scranton Health Care Center 2933 McCarthy Street Scranton, PA 18505

F 0644 28 Pa. Code 201.14 (a) Responsibility of Licensee Level of Harm - Minimal harm or potential for actual harm 28 Pa. Code 211.12 (d)(3)(5) Nursing services Residents Affected - Few 396095 Page 4 of 6 396095 09/20/2023 Scranton Health Care Center 2933 McCarthy Street Scranton, PA 18505

F 0645 PASARR screening for Mental disorders or Intellectual Disabilities Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review and staff interviews it was determined that the facility failed to ensure each resident was screened for a mental disorder (MD) or intellectual disability (ID) prior to admission and that individuals identified with MD or ID are evaluated and receive care and services in the most integrated setting appropriate to their needs by failing to conduct Pennsylvania Preadmission Screening Resident Review (PASRR) Level I identification form (PASRR Level I) for two of 10 residents reviewed (Residents 9 and 10). Residents Affected - Few Findings included: Clinical record review revealed that Resident 9 was admitted to the facility on [DATE], with diagnoses, which included Bipolar disorder. A review of Resident 9's clinical record revealed that as of survey ending on September 20, 2023, a PASRR screening had not been completed. Clinical record review revealed that resident 10 was admitted to the facility on [DATE], with diagnoses which included Parkinson's disease. A review of Resident 10's clinical record revealed that as of survey ending on September 20, 2023, a PASRR screening had not been completed. Interview with the Nursing Home Administrator and Director of Nursing (DON) on September 20, 2023, at approximately 1:30 PM, confirmed that there was no evidence that a PASRR screening was completed prior to admission for Residents 9 and 10. 28 Pa. Code 201.14 (a) Responsibility of Licensee 28 Pa. Code 201.28 (c) admission policy 396095 Page 5 of 6 396095 09/20/2023 Scranton Health Care Center 2933 McCarthy Street Scranton, PA 18505

F 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Based on observations and staff interviews it was determined that the facility failed to maintain systematically organized, readily accessible and secured resident medical records and failed to safeguard medical record information against loss, destruction, or unauthorized use. Findings included: Observations on September 20, 2023, at approximately 10:00 AM of a garage, on the facility grounds, adjacent to the building, that is utilized for storage of resident equipment, maintenance supplies, and maintenance tools revealed that multiple boxes of resident medical records were stored in this garage. The records were not secured and being stored in a location to prevent unauthorized access to confidential medical records and to prevent destruction and loss of the health records. An interview with the Nursing Home Administrator on September 20, 2023, at approximately 2:00 PM confirmed that the facility failed to secure resident medical records and private health information to prevent loss, unauthorized access and destruction. 28 Pa. Code 201.18 (e)(1)(2.1) Management 396095 Page 6 of 6