Inspection·October 10, 2024

F 0558 Reasonably accommodate the needs and preferences of each resident. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, staff interview, resident interview, and record review, the facility failed to respond to call lights in a timely manner. This affected two residents (#35 and #49) of three reviewed for call light response. Facility census was 73. Residents Affected - Few Findings include: 1. Review of the medical record for Resident #35 revealed an admission date of 07/19/24. Diagnoses included diabetes, spinal muscular atrophy, chronic myeloid leukemia, respiratory failure with hypoxia, pulmonary fibrosis, and bipolar disorder. Review of the Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #35 was cognitively intact and required set up assist for eating, and was dependent with toileting, oral hygiene, showering, and personal hygiene. Review of the plan of care dated 10/07/24 revealed the resident require two person assistance for bed mobility and toileting. Observation and interview on 10/09/24 at 9:25 AM with Resident #35 revealed her call light had been on since about 8:00 A.M. for incontinence care. Interview on 10/09/24 at 9:27 A.M. Certified Nurse Aide (CNA) #63 confirmed the resident's call light had been activated for a long time, but she had been busy and did not have a chance to answer it. CNA revealed call lights take a long time to answer. CNA confirmed being unsure exactly how long the call light had been going off for, but revealed it was possible it was about an hour. Interview on 10/09/24 at 2:45 P.M. with Resident #35 revealed she would ask for showers or to get cleaned up after going to the bathroom. Resident #35 reported the response she would get from staff was they do not have time or they would say yes but then not come back or take one to two hours to return for incontinence care or answer the request. Interview on 10/09/24 at 3:00 P.M. with CNAs #69 and #88 revealed it was typical for long wait times for call lights. They revealed the hospitality aides were unable to help with care. 2. Review of the medical record for Resident #49 revealed an admission date of 09/06/24. Diagnoses included malignant neoplasm of the larynx, adult failure to thrive, chronic obstructive pulmonary disease, dysphasia and tracheostomy status. (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 7 Event ID: 365426 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 365426 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/10/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Arbors West 375 West Main Street West Jefferson, OH 43162 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)