Health inspection·October 10, 2019

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review and interview the facility failed to provide dignified care for Resident #22 who had an indwelling urinary catheter. This affected one of one resident reviewed for dignity. The facility census was 61. Findings include: Resident #22 was admitted to the facility on [DATE]. Admitting diagnoses included healing femur (thigh bone)fractures, chronic kidney disease and dementia. According to the minimum data set (MDS) admission assessment dated [DATE], Resident #22 was cognitively impaired, required extensive assistance for bed mobility and personal hygiene, and was totally dependent on staff for dressing, toileting and bathing, and needed staff supervision with eating. Resident #22 had an indwelling urinary catheter and was frequently incontinent of bowel. On 10/07/19 at 10:07 A.M. Resident #22 was observed in a reclining chair in her room. Her urinary catheter drainage bag was visible from the hallway and was not covered with a privacy cover. Interview with State Tested Nursing Assistant (STNA) #112 at the time of the observation verified Resident #22's urinary catheter drainage bag was not covered as required. On 10/08/19 at 11:08 A.M. Resident #22 was observed sitting in the dining room with an unknown visitor. There was no privacy cover over the urinary catheter drainage bag. On 10/08/19 at 1:29 P.M. Resident #22 was observed in the common area watching television with no privacy cover over the urinary catheter drainage bag. Interview with Licensed Practical Nurse (LPN) #500 at the time of observation verified Resident #22's urinary catheter drainage bag was not covered for dignity as required. On 10/09/19 at 8:01 A.M. Resident #22 was observed in the dining room during the breakfast meal. Resident #22 was in a reclining chair positioned upright, leaning forward with her head resting onto the table in front of her partially eaten breakfast plate. Resident #22 was observed wearing a hospital gown, secured only at the neck, exposing her incontinence brief and there was no privacy cover over the urinary catheter drainage bag. Resident #22's back was fully exposed with the top portion of the incontinence brief visible. Resident #22 was observed at a table with four other residents and two staff members who were assisting those residents with eating the breakfast meal. Interview with STNA #125 at the time of the observation verified Resident #22's back and incontinence brief were exposed and the urinary catheter drainage bag was not covered for dignity as required. (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 5 Event ID: 365287 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 365287 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/10/2019 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Altercare of Cuyahoga Falls Ctr for Rehab & Nursin 2728 Bailey Rd Cuyahoga Falls, OH 44221 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)