Health inspection·April 28, 2023

F 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Based on record review, observation and interview the facility failed to develop a comprehensive, person-centered care plan for needed care and services to maintain the highest practicable well-being for Resident #48. The affected one resident (Resident #48) of three residents reviewed for care plans. The census was 58. Findings include: Review of the medical record for Resident #48 revealed an admission date of 03/23/23. Resident #48's diagnoses included hypertension, hyperlipidemia, other chronic osteomyelitis, atherosclerotic heart disease, peripheral vascular disease, hypotension, cognitive communication deficit, muscle weakness, history of falling, and chronic obstructive pulmonary disease. Review of the Minimum Data Set (MDS) 3.0 assessment, dated 03/30/23, revealed she was cognitively intact, required extensive physical assistance of one staff for personal hygiene and was totally dependent on one staff for toilet use. Review of Resident #48's care plan revealed it did not identify any area of concern specifically related to Resident #48 refusing nail care or digging in her brief after having a bowel movement nor was there a plan for cleaning her hands/fingernails after digging in her brief after a bowel movement. The care plan did mention she could refuse care, but there was no plan or intervention related to her fingernail care for her habit of digging in her own stool. Observation on 04/28/23 at approximately 4:20 P.M. revealed Resident #48 sitting in her wheelchair, talking with multiple members of her family. Observation of both hands and under her fingernails revealed a dry, brown colored substance under eight of the ten fingers. Interview with Resident #48 on 04/28/23 at 4:22 P.M. confirmed she had a dry, brown substance underneath her fingernails. She wouldn't say what was underneath the nails, but said she would like her hands cleaned more often. Resident #48 explained the facility staff offered and completed a bed bath almost every day, but she confirmed her fingernails were still dirty and not being cleaned by staff. Interview with Resident #48's family members present at the bedside on 04/28/23 at 4:25 P.M. revealed Resident #48 had a habit of digs in her brief and the substance underneath her fingernails was more than likely feces. The family stated Resident #48 had a habit of doing this, but the facility staff did not have a schedule or plan to have her hands cleaned after each time she dug in her feces. Family also confirmed Resident #48 would refuse a bath/shower when offered, but felt the facility should have a plan in place to clean under Resident #48's fingernails, especially since it was known (continued on next page) 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: 365844 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 365844 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/28/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Aurora Manor Special Care Cent 101 S Bissell Rd Aurora, OH 44202 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)