Health inspection·February 7, 2024

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, record review and facility policy review revealed the facility failed to ensure resident room temperatures were maintained at a comfortable level for residents and between 71 to 81 degrees Fahrenheit as required. This had the potential to affect 49 residents (#1, #2, #4, #5, #6, #7, #8, #9, #12, #13, #16, #17, #19, #20, #21, #22, #24, #29, #30, #31, #32, #34, #35, #36, #37, #39, #43, #49, #55, #56, #58, #59, #62, #64, #65, #67, #71, #73, #74, #75, #77, #78, #81, #82, #84, #85, #95, and #97) who resided on the Elmwood and [NAME] units and one additional resident (#26) who resided on the Magnolia Unit identified through interview. The facility census was 99. Findings Include: Review of the facility room temperature logs revealed the following temperatures obtained on 02/04/24, 02/05/24 and 02/06/24: On 02/04/24 at 8:00 A.M. 37 residents (32 rooms) had room temperatures below 71.0 degrees F: room [ROOM NUMBER] - 66.6 degrees F room [ROOM NUMBER] - 66.2 degrees F room [ROOM NUMBER] - 66.4 degrees F room [ROOM NUMBER] - 65.7 degrees F room [ROOM NUMBER] - 65.3 degrees F room [ROOM NUMBER] - 62.8 degrees F room [ROOM NUMBER] - 63.7 degrees F room [ROOM NUMBER] - 61.5 degrees F room [ROOM NUMBER] - 69.3 degrees F room [ROOM NUMBER] - 66.4 degrees F room [ROOM NUMBER] - 67.6 degrees F Page 1 of 4 365658 365658 02/07/2024 Cardinal Woods Skilled Nursing & Rehab Ctr 6831 Chapel Road Madison, OH 44057

F 0584 room [ROOM NUMBER] - 67.3 degrees F Level of Harm - Minimal harm or potential for actual harm room [ROOM NUMBER] - 68.5 degrees F room [ROOM NUMBER] - 68.5 degrees F Residents Affected - Some room [ROOM NUMBER] - 65.1 degrees F room [ROOM NUMBER] - 64.4 degrees F room [ROOM NUMBER] - 65.8 degrees F room [ROOM NUMBER] - 65.3 degrees F room [ROOM NUMBER] - 68.9 degrees F room [ROOM NUMBER] - 68.3 degrees F room [ROOM NUMBER] - 68.5 degrees F room [ROOM NUMBER] - 66.0 degrees F room [ROOM NUMBER] - 67.2 degrees F room [ROOM NUMBER] - 68.7 degrees F room [ROOM NUMBER] - 69.6 degrees F room [ROOM NUMBER] - 66.7 degrees F room [ROOM NUMBER] - 69.0 degrees F room [ROOM NUMBER] - 67.4 degrees F room [ROOM NUMBER] - 68.3 degrees F room [ROOM NUMBER] - 68.3 degrees F room [ROOM NUMBER] - 68.0 degrees F room [ROOM NUMBER] - 69.0 degrees F room [ROOM NUMBER] - 67.8 degrees F On 02/05/24 temperatures taken at 1:00 P.M. revealed eight resident rooms were below 71 degrees F: room [ROOM NUMBER] - 68.8 degrees F room [ROOM NUMBER] - 70.5 degrees F 365658 Page 2 of 4 365658 02/07/2024 Cardinal Woods Skilled Nursing & Rehab Ctr 6831 Chapel Road Madison, OH 44057

F 0584 room [ROOM NUMBER] - 70.0 degrees F Level of Harm - Minimal harm or potential for actual harm room [ROOM NUMBER] - 70.3 degrees F room [ROOM NUMBER] - 70.0 degrees F Residents Affected - Some room [ROOM NUMBER] - 70.9 degrees F room [ROOM NUMBER] - 69.6 degrees F room [ROOM NUMBER] - 69.3 degrees F On 02/06/24 temperatures taken at 8:30 A.M. revealed two resident rooms were below 71 degrees F: room [ROOM NUMBER] - 68.0 degrees F room [ROOM NUMBER] - 68.0 degrees F Interview on 02/06/24 at 12:50 P.M. with Interim Administrator #300 and Travel Director of Nursing (DON) #301 revealed in the older parts of the building there were registers that ran on a boiler system. The facility had identified an issue with these boilers approximately three to four weeks ago. The facility had repairs made but still had an air exchanger they were waiting on a part for. Interviews on 02/06/24 at 1:20 P.M. and 1:57 P.M. with Regional Maintenance Director #308 revealed the facility had a heat problem for the last three to four weeks. One boiler was working fine. The problem was with the air exchangers. There was one working now and they received quotes on the second one. They had been in contact with the company to get it fixed but had been unable to get the parts to fix it. The facility brought in four portable heat pumps. Interview on 02/06/24 at 3:31 P.M. with Resident #26, who resided on the Magnolia unit, stated her room was cold last night, and staff got her another blanket. The resident had a PTAC unit (individual heating unit) that broke, and she was moved to another room on the Magnolia unit. Interviews on 02/06/24 from 3:33 P.M. through 4:45 P.M. with residents from the [NAME] and Elmwood units revealed five residents, Resident #8 #16, #21, #22, and #77 voiced concerns with room temperatures/heat and indicated they felt their rooms were cold at night. On 02/07/24 from 7:45 A.M. through 7:56 A.M. observations of the resident room temperatures revealed two rooms on the Elmwood and [NAME] units were below 71 degrees F, the temperature in room [ROOM NUMBER] was 68.9 degrees F, and the temperature in room [ROOM NUMBER] was 69.4 degrees F. Interview on 02/07/24 at 11:38 A.M. with the Administrator verified the room temperature logs and temperatures taken during the survey identified resident room temperatures had not been maintained between 71 and 81 degrees Fahrenheit as required. Review of the facility undated policy and procedure for Extreme Cold Temperature defined optimal internal environment temperature range: (as defined by CMS) 71 degrees F and 81 degrees F. The policy revealed the facility would provide a safe, clean and comfortable and homelike environment including a comfortable and safe regulated temperature range of 71 degrees to 81 degrees within the facility. 365658 Page 3 of 4 365658 02/07/2024 Cardinal Woods Skilled Nursing & Rehab Ctr 6831 Chapel Road Madison, OH 44057

F 0584 Level of Harm - Minimal harm or potential for actual harm The policy included this ambient air temperature range minimized resident's susceptibility to loss of body heat and risk of hypothermia or hyperthermia and provides a comfortable homelike setting. This deficiency represents non-compliance investigated under Complaint Number OH00150821. Residents Affected - Some 365658 Page 4 of 4