Health inspection·July 18, 2023

F 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Based on observation, record review, and staff interview, the facility failed to ensure residents window blinds were not broken and sinks and air conditioning units were in working order. This affected two (Resident #106 and #150) of three residents reviewed for physical environment. The facility census was 141. Findings Include: 1. Review of medical record for Resident #150 revealed an admission date of 06/15/23. Review of the medical record revealed Resident #150 discharged to the hospital for behaviors on 06/18/23 and 06/28/23 but subsequently returned after a short stay. Diagnoses included mild neurocognitive disorder due to known physiological condition without behavioral disturbance, Huntington's disease, and post-traumatic stress disorder. Review of the medical record revealed Resident #150 had a legal guardian in place at the time of her admission. Review of the 5-Day, Minimum Data Set (MDS) assessment, dated 06/25/23 revealed Resident #150 had a Brief Interview for Mental Status (BIMS) score of 15 that indicated she was alert and oriented to person, place, and time. Review of the MDS assessment revealed Resident #150 was a one-person limited assist for Activities of Daily Living (ADLs). Review of the care plan dated 06/16/23, revealed Resident #150 had an ADL self-care deficit related to jerky and spastic uncoordinated movements and behaviors. Interventions included assisting ADLs including ADLs, dressing, grooming, toileting, oral care, feeding, medications as ordered, and observe, report to physician. Interview on 07/05/23 at 10:52 A.M. with Maintenance Supervisor (MS) #861 revealed any issues that he was aware of were fixed the same day unless parts had to be shipped or purchased. MS #861 revealed most items were stored in the facility and readily available to fix any issues that may arise such as with toilets, sinks, and window blinds. MS #861 revealed the facility was currently in the process of providing new blinds for all resident rooms. MS #861 revealed he was not aware of any issues with sinks or running water. MS #861 revealed if he was aware of any issues with blinds, he could fix them right away due to having extra sets in the basement of the facility. MS #861 revealed staff utilized a work order log that was checked daily and often. MS #861 revealed if staff did not utilize the log or inform him word of mouth, things needing repair could go unfixed. Tour of the facility on 07/05/23 at 10:59 A.M. with MS #861 revealed Resident #150 window blinds were visibly broken and the bathroom sink water was running but the pressure was low, and the flow was minimum. MS #861 revealed he was not made aware of the blinds or the sink. Tour revealed Resident Page 1 of 3 365832 365832 07/18/2023 University Manor Health & Reha 2186 Ambleside Rd Cleveland, OH 44106

F 0921 #150 shared a semi-private room with Resident #46. Level of Harm - Minimal harm or potential for actual harm Interview on 07/05/23 at 11:05 A.M. with Resident #150 revealed her blinds were broken and her sink did not work. Resident #150 revealed she could not brush her teeth or wash her hands. Resident #150 revealed she had told everyone, but no one fixed anything. Resident #150 revealed she could not say how long she had been without water. Residents Affected - Few Interview on 07/05/23 at 2:15 P.M. with SW #825 revealed Resident #150 family member informed him of the broken blinds, but he did not put it on a concern form. SW #825 also revealed family member reported there was no hot water in the bathroom but was not sure if it was addressed or not. 2. Review of medical record for Resident #106 revealed an admission date of 06/01/23. Diagnoses included chronic obstructive pulmonary disease, protein-calorie malnutrition, and quadriplegia. Review of the quarterly, Minimum Data Set (MDS) assessment, dated 06/10/23 revealed Resident #106 had a Brief Interview for Mental Status (BIMS) score of 15 that indicated he was alert and oriented to person, place, and time. Review of the MDS assessment revealed Resident #106 was a two-person extensive physical assist to total dependence for Activities of Daily Living (ADLs). Review of the care plan dated 05/08/23 revealed Resident #106 had an ADL self-care deficit related to paraplegia and was at risk for falls. Interventions included assisting ADLs, promoting independence, medications as ordered, and observe, report to physician. Observation on 07/05/23 at 3:32 P.M. with MS #861 of Resident #106 room revealed an air conditioning unit that was torn apart that had a current temperature setting of 60 degrees Fahrenheit. MS #861 revealed he was not aware of Resident #106 air condition unit issues. MS #861 revealed the room was not cool although the temperature was set at 60 degrees Fahrenheit. Interview on 07/05/23 at 3:40 P.M. with the Administrator revealed he was made aware of Resident #106 issue with his air condition unit on 07/03/23. The Administrator revealed the air conditioning unit was functioning but not cold enough for Resident #106. The Administrator revealed Resident #106 was scheduled to have a room change to make him more comfortable. Review of the concern log dated 07/03/23 revealed a concern was voiced by Resident #106 in regard to his air condition unit not working. Review of the concern log revealed an air conditioner was ordered and Resident #106 would be moved to a new room. Resident #106, as of 07/05/23, room had not been changed. Observation on 07/06/23 at 10:50 A.M. revealed staff assisting with changing Resident #106 room, 3 days after initial concern was voiced. Observation also revealed a replacement air conditioner that was set at 69 degrees Fahrenheit and blowing cooler air. Interview on 07/06/23 at 10:50 A.M. with Resident #106 revealed his air conditioning unit was replaced on 07/06/23 and he was now in the process of a room change, after 3 days after initial concern was voiced. Review of the current work orders revealed no orders related to the identified concerns. Review of the facility document titled Provisions for Temperature and Humidity Extremes revised 365832 Page 2 of 3 365832 07/18/2023 University Manor Health & Reha 2186 Ambleside Rd Cleveland, OH 44106

F 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few January 2016, revealed the facility had a policy in place to ensure a comfortable temperature would be maintained in all resident areas within the home between the range of 71- and 81-degrees Fahrenheit. Review of the policy revealed the facility, if necessary, would transfer the resident to another unit. Review of the document revealed the facility did not implement the policy in regard to the allegation. This deficiency represents noncompliance investigated under Master Complaint Number OH00144250 and Complaint Number OH00144132. 365832 Page 3 of 3