Inspection·September 25, 2025

F 0698 Provide safe, appropriate dialysis care/services 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, interview and facility policy review, the facility failed to ensure there was consistent communication between the facility and the dialysis center regarding Resident #4's hemodialysis treatments. This affected one resident (#4) of three residents reviewed for dialysis. This had the potential to affect residents (#4, #21 and #41) identified by the facility who received dialysis. The facility census was 65. Findings include:Review of the medical record for Resident #4 revealed in admission date of 02/16/12. Diagnoses included end stage renal disease, schizophrenia, hypertension, depression, and chronic pain. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #4 was cognitively intact. She required setup help for eating, oral and personal hygiene, dressing, toileting, and showering. Review of the physician's orders for September 2025 revealed an order for hemodialysis on Mondays, Wednesdays and Fridays. Resident #4's thrill and bruit was expected to be checked every shift. Review of the care plan dated 09/05/25 revealed Resident #4's health status was compromised due to hemodialysis. Interventions included encouraging compliance with the recommended diet, consulting with the dialysis dietitian as needed, monitoring mental status after each dialysis treatment, monitoring for signs and symptoms of infection and monitoring labs and weights. The care plan also revealed Resident #4 demonstrated disregard for others by refusing to return her dialysis communication sheets to the facility after each dialysis session. Interventions included discussing the behavior with the resident, drawing on her strengths, and making limitations clear. Review of the dialysis communications sheets for August 2025 revealed pre and post dialysis assessments for Resident #4 were completed on 08/01/25, 08/04/25, 08/13/25, 08/18/25 and 08/25/25. Interview on 09/24/25 at 11:28 A.M. with the Director of Nursing (DON) confirmed the facility had a very difficult time obtaining communication sheets for Resident #4 from the dialysis center. She confirmed while Resident #4 was capable of returning the forms herself, she was not expected to do so, and the facility did attempt to follow up with the dialysis center on forms that had not yet been returned. She further explained she talked with both Resident #4 as well as the dialysis center on multiple occasions and explained the importance of the communication forms and making sure these forms were returned upon the residents' returned to the facility from dialysis but had not yet been successful in implementing a system to ensure effective communication and exchange of information. She confirmed she had no other evidence pre and post dialysis assessments had been completed. Review of the undated facility policy titled Pre Dialysis Patient Care revealed the facility would ensure ingoing assessment of the residents' condition and monitor for complications before and after dialysis treatments. Review of the facility policy titled Post Dialysis Care Policy dated June 2021 revealed a post dialysis assessment would be completed when a resident returned to the facility from dialysis and include monitoring the access site, assessing for pain, altered mental status and elevated temperature and assessing the bruit and thrill. Residents Affected - Few 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: 365545 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 365545 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/25/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Briarfield at Ashley Circle 5291 Ashley Circle Youngstown, OH 44515 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)