Inspection·October 7, 2022

F 0686 Provide appropriate pressure ulcer care and prevent new ulcers from developing. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, medical record review, and policy review, the facility failed to thorough assess Resident #33's pressure ulcer, notify the physician of the pressure ulcer, and timely initiate wound treatment. This affected one resident (Resident #33) out of two residents reviewed for pressure ulcers. Residents Affected - Few Findings include: Review of Resident #33 medical record revealed an admission date of 05/19/22 with diagnoses including morbid obesity due to excess calories, diabetes mellitus type two, and stage four pressure ulcer to the residents coccyx. Review of Resident #33's Nursing Note, dated 6/30/2022, revealed the nurse was notified of open areas to the residents buttocks. The resident's left buttock area measured 1.6 centimeter (cm) by 1.6 cm and an open area on right buttock measured 0.5 cm x 2.0 cm. The areas were cleaned and cream applied. The note did not indicate the physician or family were notified. Review of Resident #33's June and July 2022 Physician orders revealed that the facility did not seek treatment for the residents open areas until 07/04/22. Orders included to cleanse the area pat dry, apply zinc, and apply border gauze daily and as needed for wound treatment. Review of Resident #33's first document Wound Assessment sheet, dated 07/06/22, revealed the resident had a stage three pressure ulcer to the resident's coccyx that was acquired on 06/30/22. They were described as being 40 percent (%) granulation and 60% skin. The area measured 4.3 cm (length) by 7.5 cm (width), no depth. The note stated the resident had a recurrent stage three pressure ulcer noted to the resident's bilateral buttocks/coccyx with intervening skin. Review of Resident #33's quarterly Minimum Data Set (MDS) assessment, dated 08/17/22, revealed the resident had impaired cognition and required extensive assistance of two people for bed mobility. Interview on 10/06/22 at 12:40 P.M. with Licensed Practical Nurse #539, who identified herself as the wound nurse, revealed Resident #33 developed a pressure area on 06/30/22. She confirmed the facility did not notify the physician and begin treatment of the area until 07/04/22. She confirmed the facility did not complete a full assessment of the area until 07/06/22 and at this time it was assessed as a stage three pressure ulcer. She stated it is facility policy to assess the areas and notify the physician right away to start timely treatment. Review of the facility's undated policy, Pressure Injury Prevention and Management, revealed the attending physician would be notified of the presence of a new a new pressure injury upon (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 10 Event ID: 365320 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 365320 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/07/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Regency Care of Copley 2631 Copley Road Akron, OH 44321 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)