Hidden Meadows On the Ridge the Laurels.

“The facility failed to report an incident of abuse to the Department within 24 hours. Staff person A witnessed staff person B kick a resident in the heels, but the home did not report this incident to the Department's personal care home regional office or complaint hotline.”

“A resident was physically abused by staff person B during care. The staff member was aggressive, forceful when pulling down the resident's clothing, yelled repeatedly at the resident, and kicked the resident's heels multiple times to force the resident to move their feet to align with the toilet.”

“A resident was not treated with dignity and respect. Staff person B prevented the resident from greeting a friend by putting up a hand in a stopping motion, which caused the resident distress and resulted in the resident refusing to eat breakfast until later in the morning.”

“Resident diet book was unlocked and unattended in a laundry basket in the dining area. Resident diet postings were found unlocked in pantry kitchens, and completed resident shower/skin assessment sheets were unlocked and accessible in upper cabinets.”

“Training record for direct care staff training conducted on 4/5/2025 did not include the source or length of training as required.”

“Resident had a bed side mobility device (enabler) attached to bed with a single strap around the box spring that was not tightened and had no tension, creating approximately 1 foot entrapment zone between side rails and mattress.”

“Multiple cans of labeled and unlabeled paint, including Valspar high-hiding primer/sealer, were stored on a wire rack in the same location as the home's emergency water supply.”

“Envirex fresh concentrate 118 sanitizer and Virucide cleaner were unlocked, unattended, and accessible under the sink in the Cedar kitchen. Crest 3D White toothpaste was unlocked, unattended, and accessible in a resident room. Not all residents were assessed as capable of safely recognizing and using poisons. This is a repeat violation from 04/04/2024.”

“Orange liquid was spilled on three shelves in the Dogwood pantry kitchen refrigerator.”

“Resident in secured dementia care unit eloped and walked approximately 0.4 miles to Grandview Hospital unaccounted for during shift change. Third-party hospice staff member propped open the magnetically locked main entrance without ensuring no residents were following. Resident was not evaluated by hospital or home upon return. Additionally, scheduled 30-minute checks were missed on two separate dates (12:30pm-2:30pm and 12:00am-7:00am).”

“Third-party contracted hospice staff member did not receive required first-day fire safety orientation including evacuation procedures, staff duties during fire drills, designated meeting places, smoking safety procedures, fire extinguisher location and use, smoke detectors and fire alarms, and telephone/emergency services notification.”

“Third-party contracted hospice staff member did not complete required 40-hour orientation training in resident rights, emergency medical plan, mandatory reporting of abuse and neglect under the Older Adult Protective Services Act, and reporting of reportable incidents and conditions.”

“Resident's most recent medical evaluation was not completed within the required annual timeframe, with a gap between the previous evaluation and the inspection date.”

“The narcotic book was found at the C hall medication cart on 03/06/25 at 3:15pm; it was unlocked, unattended, and accessible to any non-medical personnel, violating confidentiality requirements.”

“Two resident-home contracts were not signed by the residents; one resident refused to sign and one resident refused to sign due to lack of understanding.”

“Direct care staff person A does not have a high school diploma, GED, or active registry status on the Pennsylvania nurse aide registry.”

“On 03/01/25, there were 42 residents requiring a minimum of 84 hours of direct care service, but only 77 hours of direct care staffing was provided.”

“On 03/01/25, only 58 of the required 84 hours of direct care (69 percent) were provided during waking hours, failing to meet the 75% requirement.”

“Staff person B did not receive training in falls and accident prevention during the training year January 2024 to December 2024.”

“Wheelchairs, walkers, prosthetic devices and other apparatus used by residents must be clean, in good repair and free of hazards.”

“Cabinet under bathroom sink in resident room #C5 was unlocked and contained toothpaste with poison warning label. Not all residents assessed as capable of safely using poisonous materials.”

“Home served 39 residents requiring 117 gallons of emergency drinking water but had only 84 gallons. No contract with local bottled water supplier.”

“Metal frame of space heater in secured dementia care unit was hot to touch. No physical barrier present to restrict access to at-risk individuals, as recommended by manufacturer.”

“Resident #1's medical evaluation form did not include item (8) Body positioning/Movement; this section was left blank.”

“Resident #2's most recent medical evaluation was not completed at least annually.”

“Resident #3 prescribed Trulicity 0.5 ml injection subcutaneously every Tuesday was administered by unqualified medication technicians on 03/05, 03/12, 03/19, and 03/26/2024. Technicians lacked required waiver for GLP-1 medications.”

“Staff A documented resident #4's medication administration on MAR as administered before the resident actually ingested the pills. Repeat violation from 03/15/2023.”