Inspection·February 22, 2024

F 0602 Protect each resident from the wrongful use of the resident's belongings or money. Level of Harm - Minimal harm or potential for actual harm Based on review of the facility Self-Reported Incident (SRI), record reviews and interviews the facility failed to ensure Resident #98 was free from misappropriation. This affected one resident (Resident #98) of three residents reviewed. The census was 103. Residents Affected - Few Findings include: Review of the medical record for Resident #98 revealed an admission date of 04/22/22. Diagnoses included blindness, dementia and adjustment disorder. Review of the SRI on 01/29/24 revealed Resident #98 gave his debit card and personal identification number (PIN) to State Tested Nursing Assistant (STNA) #306 on 01/25/24 to purchase some items for him. On 01/28/24 he reported to Licensed Practical Nurse (LPN) #301 he had not received his debit card or items purchased yet. LPN #301 notified LPN #302, manager on call, who reported it to the Director of Nursing (DON) and the Administrator. A thorough investigation was completed including interviews of residents on his unit, witness statements and education on abuse policy. STNA #306 admitted to having used the resident's debit card and said she had yet to drop off the items. The STNA was terminated on 01/29/24 related to attendance. The facility replaced the items purchased. The allegation was substantiated. Interview on 02/22/24 at 11:22 A.M. with Resident #98 revealed he willingly gave his debit card to STNA #306 however he was concerned she had not returned it or brought him the items she said she purchased for him. He stated she would say she was too busy to get them out of her car. He stated he did not want the police called and the facility helped him get a new debit card. He stated he kept the card in his wallet in his pants. Denied wanting a lock box. He felt the facility handled the situation well. Interview on 02/22/24 at 12:56 P.M. with LPN #301 revealed she reported the misappropriation immediately to LPN #306. She verified the facility did re-education on abuse policy as part of the process. Interview on 02/22/24 at 1:28 P.M. with LPN #302 revealed she reported the misappropriation to the DON and LNHA who started the investigation. She stated she assisted Resident #98 in canceling his debit card and replacing it. She stated he denied wanting the police involved though it was offered. LPN #302 stated they offered to replace the money or purchase the items he wanted. He chose the items. Review of the facility policy titled Abuse, Neglect and Exploitation, dated 2023 revealed the facility will prohibit and prevent abuse, neglect, and exploitation of residents and misappropriation of (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: 365259 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 365259 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/22/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Divine Rehabilitation and Nursing at Canal Pointe 145 Olive St Akron, OH 44310 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)