Pinecrest Manor

During an interview on 1/30/25, at 9:09 a.m.

Registered Nurse Assessment Coordinator Employee E1 confirmed that a care plan had not been developed to address Resident R7's use of insulin. 28 Pa.

Code 201.14(a) Responsibility of licensee 28 Pa.

Code 211.12(d)(3)(5) Nursing services

395279 01/30/2026

Pinecrest Manor 763 Johnsonburg Rd St Marys, PA 15857

Based on review of facility policy and drug manufacturer instructions, observation, and staff

of four medication carts reviewed (C Hall Medication Cart).

Findings include: Review of facility policy dated 11/18/25, entitled Pharmaceutical Services and Medication Storage revealed the facility must adhere to all relevant state, federal, and local regulations, included those from the Department of Health, Food and Drug Administration, and Drug Enforcement Agency and State Boards of Pharmacy regarding the storage, handling, and administration of all medications.

Manufacturer's guidelines for Trelegy Ellipta (medication used to treat Chronic Obstructive Pulmonary Disease [COPD - a condition that prevents airflow to the lungs resulting in difficulty breathing] and Asthma [a long-term inflammatory disease of the airways that cause the airways to narrow and swell causing symptoms such as wheezing, coughing, chest tightness, and shortness of breath], indicated that Trelegy should be discarded six weeks after opening the foil tray or when the counter read 0, whichever comes first.

Manufacturer's guidelines for Fluticasone Salmeterol also known as Advair Diskus (maintenance medication used to prevent flare-ups or worsening COPD and prevent asthma attacks), indicated that Fluticasone Salmeterol should be safely thrown away in the trash one month after the foil pouch is opened or when the counter reads 0, whichever comes first.

Observation on 1/27/26, at 1:19 p.m. of C-Hall Medication Cart, revealed one Trelegy Ellipta Diskus with the foil container opened, diskus in use, and diskus lacking an open date and one Fluticasone Salmeterol Diskus out of the foil package, diskus in use, and diskus lacking an open date. At the time of observation, Licensed Practical Nurse Employee E3 confirmed the Trelegy Ellipta and Fluticasone Salmeterol were both opened, in use and lacked an open date. 28 Pa.

Code 201.14(a) Responsibility of licensee 28 Pa.

Code 201.18(b)(1) Management 28 Pa.

Code 211.9(a)(1) Pharmacy services 28 Pa.

Code 211.12(d)(1)(3)(5) Nursing services