Inspection·January 18, 2024

F 0561 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, resident interview, staff interview, and review of the electronic mail (e-mail) correspondence), the facility failed to honor Resident #45's preference for showers and grooming. This affected one (#45) of three residents reviewed for activities of daily living. The facility census was 64. Findings include: Review of the medical record revealed Resident #45 was admitted to the facility on [DATE]. Diagnoses included syncope and collapse, hypotension, acute kidney failure, chronic kidney disease, dysphagia, hereditary and idiopathic neuropathy, hypertension, hyperlipidemia, muscle weakness, intervertebral disc displacement lumbar region, and allergic rhinitis. Review of Resident #45's admission nursing evaluation dated 01/05/24, revealed the resident was alert, short-term and long-term memory were intact, and the resident's independent cognitive skills for decision-making were consistent and reasonable. Resident #45 required the assistance of one staff for activities of daily living. Review of Resident #45's assessment for preferences for customary routine dated 01/08/24, identified a question which asked how important it was for the resident to choose between a tub bath, shower, bed bath, or sponge bath. The response indicated it was very important. The assessment indicated for the assessor to specify and the area for response stated N/A. Review of Resident #45's bathing documentation revealed the resident received assistance with bathing on 01/10/24, 01/12/24, and 01/15/24. Interview on 01/16/24 at 10:02 A.M., with Resident #45 reported he had been at the facility for 11 days and had not received a shower. Resident #45 reported asking for a shower on numerous occasions and that everyone kept saying he should be getting one. Resident #45 also reported he preferred to keep his beard trimmed but that no one had offered to assist him with this. Resident #45 reported he was more concerned with receiving a shower before getting his beard trimmed. Resident #45 reported he would like to have a shower between one and two times per week, but at least once per week. When told this would be looked into, Resident #45 responded you are about the 10 th person to say that. Observation, at the time of Resident #45's interview, revealed Resident #45 had facial hair which covered the lower face, was uneven, and ranged in length. Interview on 01/16/24 at 3:20 P.M., with State Tested Nurse Aide (STNA) #110 reported assisting (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: 365523 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 365523 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/18/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Arbors at Oregon 904 Isaac Streets Drive Oregon, OH 43616 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)