Inspection·April 10, 2025

F 0583 Keep residents' personal and medical records private and confidential. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, review of the medical record, review of facility policy, and interview with staff, the facility failed to provide privacy during wound care to Resident #1. This affected one resident (Resident #1) of one observed for wound care. Residents Affected - Few Findings included: Review of the medical record revealed Resident #1 was admitted to the facility on [DATE]. Diagnoses included respiratory failure, diabetes, pulmonary hypertension, atrial fibrillation, coronary atherosclerosis, flaccid neuropathic bladder, insomnia, dementia, depression, and congestive heart failure. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #1 had moderately impaired cognition. Review of Resident #1's physician orders revealed the resident had treatment orders for a right heel wound dated 03/13/25 to cleanse the wound with normal saline, apply Santyl ointment to the wound, and cover it with a foam dressing daily and as needed. Observation of wound care on 04/09/25 at 10:00 A.M. revealed Licensed Practical Nurse (LPN) #100 provided wound care to Resident #1 with the assistance of Registered Nurse #102. During the observation, the staff failed to close the door to the residents room or pull the privacy curtain. The resident was able to be observed receiving wound care by anyone in the hallway. On 04/09/25 at 10:30 A.M. an interview with LPN #100 confirmed she did not close the door or the privacy curtain to provide privacy during wound care to Resident #1. Review of the undated facility policy titled, Privacy, revealed before performing assessments or procedures, the staff should close the doors or pull the privacy curtains to prevent others from seeing or overhearing, thereby respecting the residents privacy and dignity. 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: 365836 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 365836 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/10/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Village at St Edward Nrsg Care 3131 Smith Rd Fairlawn, OH 44333 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)