Health inspection·March 28, 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 interview, record review, and facility policy review the facility failed to honor Resident #72's preferences for showers. This affected one resident (#72) of two residents reviewed for showers. The facility census was 67. Findings include: Review of the medical record for Resident #72 revealed she was admitted on [DATE] with diagnoses including hypertension (high blood pressure), diabetes mellitus, and muscle weakness. Review of the undated shower schedule revealed Resident #72 received her showers on Wednesdays and Saturdays from 3:00 P.M. to 11:00 P.M. Review of the shower sheet dated 03/09/24 revealed Resident #72 refused her shower on afternoons and wanted her showers in the mornings. Review of the nursing progress note dated 03/12/24 revealed Resident #72 wanted to change her shower times from the evenings to the mornings. Interview on 03/25/24 at 9:44 A.M. with Resident #72 revealed she wanted her showers earlier in the day. She stated she had asked the facility staff, and they told her she had to take them later in the day. Interview on 03/26/24 at 3:30 P.M. with Registered Nurse (RN) #331 verified Resident #72's showers were scheduled on Wednesdays and Saturdays on the evening shift. Review of the shower sheet dated 03/09/24 and nursing progress note dated 03/12/24 with RN #331 verified Resident #72 wanted her showers in the mornings. Review of the facility policy titled, Resident Care, revised June 2018, revealed the facility staff would provide general care as necessary for each resident per their preferences when able and per physician orders. The policy stated residents would be bathed or assisted to shower or bathe routinely and as needed per their preference. 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: 365753 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 365753 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/28/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Royal Oak Nursing & Rehab Ctr 6973 Pearl Rd Middleburg Heights, OH 44130 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)