Health inspection·May 5, 2022

F 0623 Level of Harm - Potential for minimal harm Residents Affected - Many Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 5. Record review of Resident #40 revealed she was hospitalized [DATE] due to having a distended abdomen. She returned to the facility on [DATE]. No evidence was found indicating the ombudsman was informed of the transfer. The above finding was confirmed with the Administrator on 05/05/22 at 9:18 A.M. The administrator said the facility did not make ombudsman notification for short-term visits. Based on record review and staff interview the facility failed to ensure the ombudsman was notified of resident transfers to the hospital as required. This affected five of five residents reviewed for hospitalization, Residents #31, #38, #40, #119 and #270. Facility census was 119. Findings Include: 1. Resident #31 was admitted to the facility on [DATE] with diagnoses that include dysphagia, anxiety disorder and major depressive disorder. Review of the census records revealed Resident #31 was discharged to an acute care hospital on [DATE] and returned to the facility on [DATE]. Review of both the electronic and paper charts revealed no evidence the office of the State and local ombudsman were notified of Residents #31's discharge to the hospital. 2. Resident #38 was admitted to the facility on [DATE] with diagnoses that include kidney failure, type two diabetes and major depressive disorder. Review of the census records revealed Resident #38 was discharged to an acute care hospital 03/31/22 and returned to the facility on [DATE]. Review of both the electronic and paper charts revealed no evidence the office of the State and local ombudsman were notified of Residents #38's transfer to the hospital. 3. Resident #270 was admitted to the facility on [DATE] with diagnoses that included muscle weakness, asthma and difficulty walking. Review of the census records revealed Resident #270 was discharged to an acute care hospital 12/14/21 and returned to the facility on [DATE]. Page 1 of 2 365109 365109 05/05/2022 Altenheim 18627 Shurmer Road Strongsville, OH 44136

F 0623 Level of Harm - Potential for minimal harm Review of both the electronic and paper charts revealed no evidence the office of the State and local ombudsman were notified of Residents #270's discharge to the hospital. 4. Resident #119 was admitted to the facility on [DATE] with diagnoses that included acute and chronic respiratory failure with hypoxia, history of COVID-19, and pneumonia. Residents Affected - Many Review of the progress note dated 01/10/22 at 1:19 P.M. revealed Resident #119 was discharged to the hospital on [DATE]. Review of the progress note dated 02/21/22 at 10:58 A.M. revealed Resident #119 was discharged to the hospital on [DATE]. Review of the progress note dated 03/13/22 at 10:25 A.M. revealed Resident #119 was discharged to the hospital on [DATE]. Review of the medical chart revealed no evidence the state ombudsman was notified of Resident #119's discharges to the hospital. Interview with the Administrator on 05/04/22 at 10:10 A.M. revealed the facility was not notifying the State or local ombudsman's office of resident discharges to the hospital. The facility notified the ombudsman of facility initiated discharges. Review of a blank copy of the Altenheim Transfer Notice under the subsection notifications revealed a copy of this notice has been sent to the Ohio Department of Health, Legal Services Office, 246 North High Street, Columbus, Ohio 43215 and a copy will be sent to the Ohio State Long-Term Care Ombudsman no later than 30 days from the date of the transfer. 365109 Page 2 of 2