Inspection·November 25, 2025

F 0693 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of facility policy, clinical record review, observation, and staff interview, it was determined that the facility failed to ensure that residents with an enteral feeding tube (a tube inserted in the stomach through the abdomen) received appropriate treatment and services to prevent potential complications for one of three residents (Resident R30).Findings include: Review of facility policy Tube Feeding via Enteral Feeding Pump last reviewed 9/25/25, indicated to deliver a liquid feeding formula directly to the stomach. Enteral feeding and tubing are changed every 24 hours or when a new bottle is hung. Label feeding bag/bottle with date and time hung. Review of the clinical record indicated Resident R30 was admitted to the facility on [DATE], with diagnosis of breast cancer, hypotension (low blood pressure) and abdominal discomfort. Review of a nutrition communication note dated 11/21/25, indicated Resident R30's recommended tube feeding formula is [NAME] Farm 1.5 calorie with goal rate of 50 milliliters (ml) per hour with water flush of 150 ml every four hours. Review of Resident R30's nursing notes dated 11/24/25, indicated tube feeding method continuous with rate of 50ml/hour tolerating without feeling of fullness. During an observation on 11/24/25, at 9:11 a.m. Resident R30's enteral feeding formula and water bag were noted in room infusing via pump. The formula and water bag failed to be labeled with a date or time hung. During an interview on 11/24/25, at 9:15 a.m. Registered Nurse Employee E2 stated I know she just hung it last night. During an interview on 11/24/25, at 9:15 a.m. RN Employee E2 confirmed that the facility failed to ensure that residents with an enteral feeding tube received appropriate treatment and services to prevent potential complications for one of three residents (Resident R30). 28 Pa. Code: 201.18(b)(1) Management. 28 Pa. Code: 211.10(c) Resident care policies.28 Pa. Code: 211.12(d)(1)(5) Nursing services. Event ID: Facility ID: 396098 If continuation sheet Page 2 of 6 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 396098 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/25/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE UPMC Magee-Womens Hospital Tcu 300 Halket Street Pittsburgh, PA 15213 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 0694 Provide for the safe, appropriate administration of IV fluids for a resident when needed. Level of Harm - Minimal harm or potential for actual harm Based on review of facility policy, observations, and staff interviews, it was determined that the facility failed to provide adequate treatment and care for a peripherally inserted catheter (a thin plastic tube inserted into a vein using a needle) in accordance with professional standards of practice for one of two residents (Resident R33). Findings include: Review of the facility policy Intravenous (IV) Therapy: Peripheral, Including Midlines last reviewed 9/25/25, indicates to maintain venous access, administer continuous/intermittent intravenous fluids, nutrition, medications, and blood products over a specific time frame. All registered Nurses and Licensed Practical Nurses that complete the IV therapy program are responsible for including but not inclusive to:. IV site inspection a minimum of every shift Maintain a clean, dry and intact dressing over insertion site Document date and time. Review of Resident R33's clinical record indicates an admission date of 11/12/25, with the diagnosis of hernia (when an organ or fatty tissue squeezes through a weak spot in muscle or connective tissue) repair, muscular deconditioning (wasting or thinning of muscle mass) and obesity. Review of Resident R33's clinical documentation indicated a size 22-gauge peripheral catheter was inserted to the left wrist on 11/23/25. During an observation on 11/24/25, at 9:32 a.m. Resident R33 was sitting in her wheelchair, a peripheral IV access site was noted to her left wrist. The IV site was noted not to have been labeled with a date or time of insertion. During an interview on 11/24/25, at 9:34 a.m. Licensed Practical Nurse Employee E3 confirmed the IV access site dressing did not contain a date or time of insertion and that the facility failed to provide adequate treatment and care for a peripherally inserted catheter in accordance with professional standards of practice for one of two residents (Resident R33). 28 Pa. Code: 211.12 (d)(1)(2)(3)(5) Nursing Services.28 Pa. Code: 201.14(a) Responsibility of licensee Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396098 If continuation sheet Page 3 of 6 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 396098 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/25/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE UPMC Magee-Womens Hospital Tcu 300 Halket Street Pittsburgh, PA 15213 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 - Potential for minimal harm Residents Affected - Many FORM CMS-2567 (02/99) Previous Versions Obsolete Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on a review of policy, observation and staff interview, it was determined that the facility failed to maintain the cleanliness and sanitation of equipment to prevent the potential for cross-contamination or foodborne illness in the Transition Care Unit (TCU) Dining Room (3rd floor, 3100 unit).Findings include: Review of facility policy SRC-Food and Nutrition - Sanitation-AB dated 9/30/25, indicated all employees are responsible for keeping equipment and the department clean. All kitchen equipment will be cleaned and sanitized following each use. During an observation on 11/24/25, at 10:45 a.m., of the dining room on the TCU, which included the Resident Pantry area, revealed the microwave oven's (kitchen appliance used to reheat foods) interior cooking surfaces were covered with dried food particles and splatters of dried food debris. During an interview on 11/24/25, at 11:02 a.m., the Nursing Home Administrator (NHA) confirmed the unit's microwave oven needed cleaned and sanitized and that the facility failed to maintain the cleanliness and sanitation of equipment to prevent the potential for cross-contamination or foodborne illness in the Transition Care Unit (TCU) Dining Room (3rd floor, 3100 unit). 28 Pa. Code: 201.14(a) Responsibility of licensee.28 Pa. Code: 201.18(b)(1) Management. Event ID: Facility ID: 396098 If continuation sheet Page 4 of 6 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 396098 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/25/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE UPMC Magee-Womens Hospital Tcu 300 Halket Street Pittsburgh, PA 15213 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 0887 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on facility policy, clinical record review and staff interview, it was determined that the facility failed to provide accurate and timely documentation related to the COVID-19 (a respiratory disease) vaccine for five out of five residents (Resident R6, R9, R27, R28, and R36). Findings include: Review of facility policy Infection Control - Immunizations dated 9/25/25, indicated Pneumococcal, Covid, and Influenza immunizations will be offered to residents. Other immunizations will be offered as indicated. The purpose is to prevent transmission of agents. Upon admission, establish immunization status with resident or resident representative. Review of Resident R6's clinical record indicated the resident was admitted to the facility on [DATE]. Review of Resident R6's Minimum Data Set (MDS - a periodic assessment of care needs) dated 10/22/25, indicated diagnoses of hypertension, diabetes (a metabolic disorder in which the body has high sugar levels for prolonged periods of time), and anemia (too little iron in the body causing fatigue). MDS Section O- Special treatment, Procedures, and Programs O0350 indicated COVID-19 vaccine was coded a 0- resident not up to date. Review of clinical records indicated that Resident R6's last received a COVID-19 vaccination on 2/9/2022.During a review of Resident R6's clinical record on 11/24/25, at 12:35 p.m. failed to include documentation that a Covid-19 booster vaccine was offered. Review of Resident R9's clinical record indicated the resident was admitted to the facility on [DATE]. Review of Resident R9's MDS dated [DATE], indicated diagnoses of hypertension, diabetes, and deep vein thrombosis (blood clot forms in a deep vein). Review of clinical records indicated that Resident R9's last received a COVID-19 vaccination on 12/2/21. During a review of Resident R9's clinical record on 11/24/25, at 12:37 p.m. failed to include documentation that a Covid-19 booster vaccine was offered. Review of Resident R27's clinical record indicated the resident was admitted to the facility on [DATE]. Review of Resident R27's MDS's dated 11/14/25, indicated diagnoses of heart failure (a progressive heart disease that affects pumping action of the heart muscles), edema, and osteoporosis (condition when the bones become brittle and fragile). MDS Section O- Special treatment, Procedures, and Programs O0350 indicated COVID-19 vaccine was coded a 0- resident not up to date. Review of clinical records indicated that Resident R27's last received a COVID-19 vaccination on 4/14/21. During a review of Resident R27's clinical record on 11/24/25, at 12:39 p.m. failed to include documentation that a Covid-19 booster vaccine was offered. Review of Resident R28's clinical record indicated the resident was admitted to the facility on [DATE]. Review of Resident R28's MDS's dated 11/19/25, indicated diagnoses of osteoporosis, chronic pain, and epilepsy (disorder of the brain characterized by repeated seizures). Review of clinical records indicated that Resident R28's last received a COVID-19 vaccination on 11/11/21. During a review of Resident R28's clinical record on 11/24/25, at 12:43 p.m. failed to include documentation that a Covid-19 booster vaccine was offered. Review of Resident R36's clinical record indicated the resident was admitted to the facility on [DATE]. Review of Resident R36's MDS's dated 11/24/25, indicated diagnoses of high blood pressure, cellulitis (bacterial skin infection), and gastroesophageal reflux disease (GERD- chronic digestive disorder where stomach acid flows back into throat). MDS Section O- Special treatment, Procedures, and Programs O0350 indicated COVID-19 vaccine was coded a 0- resident not up to date. Review of clinical records indicated that Resident R36's last received a COVID-19 vaccination on 7/7/22. During a review of Resident R36's clinical record on 11/24/25, at 12:47 p.m. failed to include documentation that a Covid-19 booster vaccine was offered. During an interview on 11/24/25, at 1:17 p.m. Registered Nurse Assessment Coordinator Employee E1 stated the facility does not offer Covid vaccines (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396098 If continuation sheet Page 5 of 6 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 396098 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/25/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE UPMC Magee-Womens Hospital Tcu 300 Halket Street Pittsburgh, PA 15213 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 0887 Level of Harm - Minimal harm or potential for actual harm to residents and confirmed that the facility failed to provide accurate and timely documentation related to the COVID-19 (a respiratory disease) vaccine for five out of five residents (Resident R6, R9, R27, R28, and R36). 28 Pa. Code 211.5(f)(i)-(xi) Clinical records Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 396098 If continuation sheet Page 6 of 6