Health inspection·August 10, 2023

F 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Based on record review, observation and interview, the facility did not ensure Resident #19's room was free from safety hazards that could potentiate fall risk. This affected one resident (#19) of four residents reviewed for accident hazards. The facility census was 27. Findings include: Medical record review was conducted for Resident #19 revealing a diagnosis of pain, malnutrition, and debility. Resident #19 had altered visual depth perception and was a fall risk. Observation of Resident #19's room on 08/07/23 at 3:32 P.M., 08/08/23 at 8:30 A.M. and 08/09/23 at 9:43 A.M. revealed both wooden doors to her clothing closet full of her clothing were off track at the bottom and leaning against her clothing. The top of the wooden closet doors were attached to the closet door frame, but the bottom of the doors swung loosely back and forth upon opening and there was no bottom track placement to safety secure the doors. Interview was conducted on 08/08/23 at 9:47 A.M. with STNA #301 who stated Resident #19 made her own choices and was able to go into her own closet to pick out her own clothes. Interview was conducted on 08/08/23 at 9:57 A.M. with Maintenance Director #332 who verified Resident #19's closet doors were not safely secured at the bottom so there was nothing to prevent the doors from falling out. Interview was conducted on 08/09/23 at 9:43 A.M. with Physical Therapy Assistant #335 who verified the loose closet doors and added this was not safe for Resident #19 because she was at risk for falls. 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 3 Event ID: 365051 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 365051 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/10/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Ohio Living Rockynol 1150 W Market St Akron, OH 44313 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)