Ruston Residence.

“A memory care resident's contract was not signed by the resident and there was no notation indicating the resident had been asked to sign or was unable to sign the contract.”

“A resident record did not contain a statement signed by the resident acknowledging receipt of a copy of the resident rights and complaint procedures.”

“A resident reported that an evening shift staff member made the resident feel embarrassed when requesting assistance with toileting, asking 'do you really have to go to the bathroom,' violating the resident's right to be treated with dignity and respect.”

“A bottle of Softsoap with a poison control label was left unlocked, unattended, and accessible to residents in the special care unit kitchen. Not all residents were assessed as capable of safely recognizing and using poisons. This was a repeat violation.”

“The ice maker had a pink and brown substance present inside the machine where ice falls into the bin, failing to maintain sanitary conditions.”

“Directions for operating the residence's locking mechanism were not conspicuously posted near the exit door leading to the patio in the special care unit.”

“Two bottles of GelRite hand sanitizer and two containers of Sani-Cloth disposable wipes with warnings to keep out of reach of children were left unlocked, unattended, and accessible to residents in the Memory Care Unit on top of a medication cart. Not all residents have been assessed as capable of safely recognizing and using poisonous materials.”

“A resident admitted to the special care unit did not have an initial support plan completed within 72 hours of admission as required.”

“The thermometer in the freezer in the Laurel Way Activity Room was not in working order. Food requiring refrigeration must be stored at or below 40°F and frozen food at or below 0°F, with thermometers required in refrigerators and freezers.”

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

“Direct care staff person A did not receive training in medication self-administration training during the training year 2024. Direct care staff person B did not receive training in instruction on meeting the needs of the residents as described in the preadmission screening form, assessment tool, medical evaluation and support plan, and medication self-administration training during the training year 2024. Direct care staff person C did not receive training in instruction on meeting the needs of the residents as described in the preadmission screening form, assessment tool, medical evaluation and support plan, and medication self-administration training during the training year 2024.”

“Staff person B did not receive training in Falls and accident prevention, emergency preparedness procedures and recognition and response to crises and emergency situations, and fire safety completed by a fire safety expert or by a staff person trained by a fire safety expert during training year 2024. Staff person C did not receive training in fire safety completed by a fire safety expert or by a staff person trained by a fire safety expert during training year 2024.”

“The residence's staff training plan for training year 2025 does not include name, position, and duties of each direct care staff person, training courses for each staff person, and the dates, times and locations of the scheduled training for each staff person.”

“On 3/3/2025, the carpet in sunflower hall had stains on the floor carpet near the exit, indicating unsanitary conditions were not maintained.”

“On 3/3/2025, at 9:51 am, a garden bin blocked egress from the residence's dining room, obstructing required egress routes.”

“The Memory Care Unit had 13 residents on the inspection date, exceeding the licensed capacity of 12 residents.”

“A resident passed away and personal belongings were removed from the room, but the residence did not refund the remainder of previously paid charges to the resident's estate within 30 days as required.”

“A resident was discharged and personal belongings were removed, but a refund was not issued within 30 days of discharge as required.”

“A prescribed medication (pill #21 from a blister pack) was stored in the narcotics locked box with a torn and taped foil backing, not meeting proper storage conditions as required by manufacturer's instructions.”

“A resident's medication administration record did not include the diagnosis or purpose for prescribed medications as required by regulation.”

“A resident admitted on an unspecified date did not have an initial assessment documented on the Department's assessment form that included completion dates, as required within 30 days prior to admission.”

“Three direct care staff persons working in the special care unit for dementia residents completed insufficient initial dementia training within the first 30 days of hire: Staff A completed 2 hours (required 8 hours), Staff B completed 2 hours (required 8 hours), and Staff C completed 4 hours (required 8 hours).”

“The facility failed to maintain a current and valid Certificate of Occupancy. The certificate was not posted in a conspicuous place as required.”

“The facility failed to maintain a current and valid Certificate of Occupancy. The certificate was not posted in a conspicuous place as required.”

“A resident's support plan had not been reviewed on a quarterly basis; the last review was completed on the date of annual assessment completion, which did not meet the requirement for quarterly reviews.”

“A discontinued prescription medication was found in the residence's medication cart and had not been properly destroyed according to Department of Environmental Protection and Federal and State regulations.”

“A resident was prescribed an inhaler for asthma but the residence had an Albuterol Sulfate Solution for use with a nebulizer instead of the prescribed inhaler. This is a repeat violation from 12/28/22.”

“A resident's medication administration times were over an hour after the prescribed administration times. This is a repeat violation from 11/02/22.”

“Nine staff members completed medication administration training in September 2023, but their training documentation was deficient. The "Observation Checklist" documented only one observation completed, contradicting the "Summary and Qualification Form" which claimed six medication passes were completed. Staff interviews confirmed six observations were not actually completed, and at least five forms had incomplete or blank required areas.”

“A resident reported emotionally distressing treatment by staff person A in a rough and rude manner. Although the incident was reported to other staff members, it was not reported to the local Area Agency on Aging as required by the Older Adult Protective Services Act and regulations.”

“During the inspection on 6/5/23, the residence's administrator was unavailable. The designee present, staff person D, did not meet the qualifications required of an administrator, including passing the Department-approved competency-based administrator training test.”

“The residence failed to report multiple incidents to the Department within 24 hours as required, including resident falls requiring trauma center care, emergency room visits, resident deaths, and incidents of inadequate incontinence care. Reports were submitted late to the Department.”

“Resident 1 and Residents 2-5 did not receive required assistance with incontinence care as indicated in their assessment and support plans.”

“Resident 1 and Residents 2-5 did not receive required assistance with personal hygiene as indicated in their assessment and support plans.”