Health inspection·July 25, 2024

F 0697 Provide safe, appropriate pain management for a resident who requires such services. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview the facility failed to ensure a palliative care consult was arranged for Resident #24 to address the resident's chronic pain. This affected one resident (#24) of three residents reviewed for pain management. The facility census was 58. Residents Affected - Few Findings included: Review of the medical record revealed Resident #24 was admitted to the facility on [DATE] with diagnoses including osteoarthritis left knee, spinal stenosis, radiculopathy, pain in the left knee, benign prostatic hyperplasia, hypertension, chronic pain, alcohol abuse, anxiety disorder, and depression. Review of a progress notes dated 05/02/24 at 3:46 P.M. revealed the nurse spoke to the resident regarding his chronic pain. Resident #24 stated he had tried everything for pain and nothing seemed to be working. Resident #24 was informed that palliative care was an option to which he responded he would like to try it. A request was sent to the nurse practitioner. Review of the physician's order dated 05/04/24 revealed Resident #24 had an order for a referral for palliative care. Record review revealed no evidence the resident had been seen for palliative care as of this time. On 07/23/24 at 3:10 P.M. an interview with Resident #24 revealed he had pain in his lower back that was related to spinal stenosis. The resident stated there was some possibility of him having back surgery, but that seemed to no longer be an option at this time. The resident stated the head nurse (Director of Nursing) had spoken to him a while back and said they (the facility) would look into palliative care for him to help with his pain control; however, the resident stated he had not heard anything at all since that time (over two months prior per the facility written progress note). On 07/24/24 at 2:10 P.M. interview with the Administrator confirmed there had been no palliative care consultation completed for Resident #24 as of this date. This deficiency is a recite to the complaint survey completed on 06/27/24. 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: 365316 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 365316 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/25/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Highland Square Nursing and Rehabilitation 1211 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)