Pennsylvania Department of Health
WECARE AT MURRYSVILLE REHABILITATION AND NURSING CENTER
Patient Care Inspection Results

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WECARE AT MURRYSVILLE REHABILITATION AND NURSING CENTER
Inspection Results For:

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WECARE AT MURRYSVILLE REHABILITATION AND NURSING CENTER - Inspection Results Scope of Citation
Number of Residents Affected
By Deficient Practice
Initial comments:Based on an Abbreviated Survey in response to a complaint, and an incident completed on December 17, 2025, it was determined that WeCare at Murrysville Rehab and Nursing Center was not in compliance with the following requirements of 42 CFR Part 483, Subpart B, Requirements for Long Term Care Facilities and the 28 Pa. Code, Commonwealth of Pennsylvania Long Term Care Licensure Regulations.
 Plan of Correction:


483.12(c)(2)-(4) REQUIREMENT Investigate/Prevent/Correct Alleged Violation:This is a less serious (but not lowest level) deficiency and is isolated to the fewest number of residents, staff, or occurrences. This deficiency is one that results in minimal discomfort to the resident or has the potential (not yet realized) to negatively affect the resident's ability to achieve his/her highest functional status.
§483.12(c) In response to allegations of abuse, neglect, exploitation, or mistreatment, the facility must:

§483.12(c)(2) Have evidence that all alleged violations are thoroughly investigated.

§483.12(c)(3) Prevent further potential abuse, neglect, exploitation, or mistreatment while the investigation is in progress.

§483.12(c)(4) Report the results of all investigations to the administrator or his or her designated representative and to other officials in accordance with State law, including to the State Survey Agency, within 5 working days of the incident, and if the alleged violation is verified appropriate corrective action must be taken.
Observations: Based on review of facility documents, facility policy, clinical records, and staff interviews, it was determined that the facility failed to conduct a thorough investigation of an allegation of abuse for one of two residents (Resident R1). Findings include: Review of facility "Abuse, Neglect, Exploitation or Misappropriation-Reporting and Investigating" policy dated 5/30/25, indicated all reports of resident abuse, neglect, exploitation or theft/misappropriation of resident property are reported to local, state and federal agencies and thoroughly investigated by facility management. Findings of all investigations are documented and reported. Review of the clinical record indicated Resident R1 was admitted to the facility on 8/15/25. Review of Resident R1's Minimum Data Set (MDS - a periodic assessment of care needs) dated 12/8/25, indicated diagnoses of depression, chronic obstructive pulmonary disease (COPD, a group of progressive lung disorders characterized by increasing breathlessness), and heart failure (a progressive heart disease that affects pumping action of the heart muscles). Resident R1's MDS assessment section C0200 Brief Interview for Mental Status ("BIMS", a screening test that aides in detecting cognitive impairment). The BIMS total score suggests the following distributions: 13-15: cognitively intact, 8-12: moderately impaired, 0-7: severe impairment. Resident R1's BIMS score was "14" indicating Resident R1 was cognitively intact. Review of facility documentation submitted to the state survey office dated 12/3/25, at 9:00 a.m. indicated that Resident R1 alleged Nurse Aide (NA) Employee E1 grabbed her arm to force her to go to the dining room for lunch. Review of Resident R1's progress note dated 12/3/25, by Registered Nurse Employee E2 indicated Resident R1's family member called the facility claiming Resident R1 was mishandled by a nurse aide. Resident on her part reported her right arm was sore because NA Employee E1 grabbed her arm forcefully during lunch time. On assessment of the right arm, nothing was seen that was unusual, skin was dry and intact. An X-ray was ordered for the right arm. Review of Resident R1's statement obtained on 12/4/25, by Licensed Practical Nurse (LPN) Employee E3 stated the following, "They attempted to take me to therapy, but there was a long line, and I wanted to return to my room. I began to take myself back to my room from therapy and NA Employee E1 attempted to take me elsewhere (dining room), so I held onto the hand railing. He then grabbed my right arm, and it hurt. He should not be putting his hands on me no matter what. Two nurses then approached me, assisted me back to my room, and helped me into bed." During a review of witness statements, including NA Employee E1's, provided by the facility on 12/17/25, at 10:00 a.m. indicated that witness statements were completed and focused on care and treatment that was provided to Resident R1 while in her room. The witness' statements failed to include any information about an incident involving Resident R1's allegation of forcefully moving her hand off the handrail in the hallway. During an interview on 12/17/25, at 11:22 a.m. with NA Employee E1 indicated that nursing supervisor asked him to write a statement concerning providing care to Resident R1 on 12/3/25. "She told me that I was being investigated and to write a statement about the care I provided. I wrote about helping resident out of bed with others in the room. Nobody asked me about the resident grabbing the handrail. We took her to the dining room, where trays were ready to be passed to all the residents. Resident R1 was going back to her room, and I asked that she not transfer back to bed without assistance because she may fall. Resident R1 stated she didn't care and that she was getting back into bed. She started to self-propel towards her room. I approached her and turned her wheelchair back towards the dining room so she wouldn't self-transfer and fall. She grabbed the handrail. I lifted her arm that she had a hold of the railing with so I could take her back to the dining room. I lifted her arm easily. Resident R1 never complained about me or the incident the rest of the day." During an interview on 12/17/25, at 1:13 p.m. Director of Nursing stated that the facility failed to fully investigate Resident R1's allegation of abuse and that five out of six witness statements failed to reveal information about the actual allegation of NA Employee E1 forcefully grabbing Resident R1's arm which was reported by resident and reported to the state survey office. During an interview on 12/17/25, at 2:00 p.m. the Nursing Home Administrator and Director of Nursing confirmed that the facility failed to conduct a thorough investigation of an allegation of abuse for one of two residents (Resident R1). 28 Pa Code: 201.18 (e)(1)(2) Management. 28 Pa Code: 201.29 (a)(c) Resident Rights. 28 Pa Code: 211.12 (c)(d)(1)(3)(5) Nursing services.
 Plan of Correction - To be completed: 01/26/2026

1. The facility is unable to retroactively correct cited deficiency pertaining to this event. The facility will provide instructions to staff upon obtaining witness statements to ensure vital information is gathered during an event investigation to ensure a thorough investigation.

2. DON/designee will complete a review of all current investigations to ensure that information gathered is sufficient to conduct a full investigation and ensure full investigation is completed.

3. DON/designee to educate nursing staff on abuse/neglect and requirements of a thorough investigation.

4. The DON/Designee will audit all Incident Reports to ensure a thorough investigation 2x/week for 3 weeks, then weekly x 3 weeks.

5. Results to be submitted to QAPI for review and approval.


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