Inspection·January 7, 2025

F 0690 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, resident and staff interviews, record review, and facility policy review, the facility failed to provided timely incontinence care to the residents. This affected two (Residents #10 and #74) of three residents reviewed for incontinence care. The facility census was 110. Findings include: 1. Record review for Resident #10 revealed an admission date of 11/06/23. Diagnoses included hemiplegia and hemiparesis following cerebral infarction affecting right dominant side, and muscle weakness. Review of the annual Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #10 was moderately cognitively impaired. Resident #10 had impairment on one side of the upper and lower extremities, was frequently incontinent of urine and always incontinent of bowel. Resident #10 required substantial/maximal assistance with toileting hygiene, personal hygiene, and was dependent on staff for transfers. Review of the care plan dated 12/23/24 revealed Resident #10 had bowel incontinence due to impaired mobility and physical limitations. Resident #10 also had bladder frequent incontinence due to impaired mobility and physical limitations. Interventions included to check resident, if she was continent, offer to assist with toileting. If she was incontinent, remove wet or soiled clothing, briefs; provide incontinent care; apply protective barrier after each incontinent episode; and maintain resident dignity during incontinent care. Observation and interview on 01/06/25 at 12:53 P.M. revealed Resident #10 was sitting up in her chair. Resident #10 stated she had been incontinent and asked the Certified Nursing Assistant (CNA) to change her since 10:00 A.M. Interview on 01/06/25 at 12:57 P.M. with CNA #335 confirmed she was Resident #10's CNA. CNA #335 stated she needed two people to transfer Resident #10 to her bed to change her so she would do it at 2:00 P.M. Interview on 01/06/24 at 2:22 P.M. with CNA #335 stated she was not ready yet to change Resident #10, she needed to wait for another staff member to assist her with the transfer. CNA #335 stated Resident #10 was a mechanical lift and required two persons to transfer her. The night shift placed her in the chair, unsure what time but it was before 7:00 A.M., and Resident #10 has not been laid back down or checked and changed since night shift got her up. CNA #335 stated she did not have enough (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 2 Event ID: 365033 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 365033 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Cedarwood Plaza 12504 Cedar Road Cleveland Heights, OH 44106 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)