Health inspection·January 10, 2025

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, staff interview and facility policy review, the facility failed to monitor Resident #97 for injuries after a fall. This affected one resident (#97) of three resident injuries reviewed. The facility census was 94. Residents Affected - Few Findings Include: Resident #97 was admitted to the facility on [DATE] with diagnoses including dementia, depression, insomnia, drug induced subacute dyskinesia, mixed hyperlipidemia, urinary incontinence, and constipation. Review of the Minimum Data Set (MDS) assessment, dated 12/08/24, revealed Resident #97 had severe cognitive impairment. Review of the progress notes, dated 12/05/24, revealed Resident #97 was found with her knees on the ground, legs out of her bed, and head/torso still lying on her bed. Staff documented that there was discoloration to Resident #97's knees and a small area to her right elbow. There was no other documentation to describe what the injuries/areas looked like. Review of Resident #97 medical records, including bath/shower records, skin assessments, progress notes, fall investigation documents, or other medical records, found no documentation of follow up to the discoloration to her knees and an area to her right elbow. The next documentation that was found was a bath/shower log on 12/08/24, which had no skin issues documented on it. Interview with the Director of Nursing (DON) on 01/10/25 at 1:45 P.M. and 2:20 P.M. revealed documentation supported that after staff found Resident #97 on the floor on 12/05/24, she had discoloration to her knees and an area to her right elbow. She confirmed she does not know the extent of the injuries or discoloration. She confirmed there was no documentation to support monitoring being done for these areas to determine if they were injuries or if they simply were marks on her body from falling out of bed. She confirmed when there were documented areas on a resident's body, routine monitoring should be completed until the area has been resolved. Review of the facility Basic Skin Management policy, dated 11/21/24, revealed upon admission, residents have a risk assessment completed. It is completed weekly for the first four weeks of admission, and then monthly after that. All residents have preventative measures in place that include pressure redistribution mattresses on all beds, wheelchair cushions, heel boots, or suspension if needed, frequent repositioning per Certified Nurse Aides (CNAs) and activity of daily living (ADL) care, incontinent care provided with skin cleansers/wipes, and barrier cream application if needed. It is the (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: 365048 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 365048 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/10/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Life Care Center of Westlake 26520 Center Ridge Rd Westlake, OH 44145 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)