Health inspection·September 5, 2024

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, observation, staff interview, and review of facility policy, the facility failed to ensure residents were treated with dignity/respect when staff failed to ensure residents names were not visible on their clothing. This affected one (Resident #31) of three residents reviewed for dignity. The facility census was 46. Findings include: Review of the medical record for Resident #31 revealed an admission date of 12/08/23 and diagnoses of rhabdomyolysis, heart disease, pneumonia, urinary tract infection, hypoglycemia, presence of cerebrospinal fluid drainage device, muscle weakness, altered mental status, depression, anxiety, anorexia. Review of the most recent quarterly Minimum Data Set (MDS) dated [DATE], revealed a Brief Interview for Mental Status (BIMS) score of three, indicating Resident #31 was severely cognitively impaired. Resident #31 required substantial/maximal assistance with upper and lower body dressing as well as putting on/taking off footwear. Observation on 09/03/24 at 12:38 P.M. revealed Resident #31 sitting in their wheelchair in the facility common area by the nurses station wearing yellow non-slip socks that were both visibly marked with Resident #31's first name. Staff interview on 09/03/24 at 12:39 P.M. with Licensed Practical Nurse (LPN) #210 verified the above findings. Review of the facility policy titled, Dignity, with a revision date of 02/21, revealed each resident shall be cared for in a manner that promotes and enhances his or her sense of well-being, level of satisfaction with life, and feelings of self-worth and self-esteem. Page 1 of 2 365885 365885 09/05/2024 Concord Care and Rehabilitation Center 620 W Strub Rd Sandusky, OH 44870

F 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, medical record review, staff and resident interviews, and policy review, the facility failed to ensure residents were safely smoking. This affected one (Resident #41) of one resident reviewed for smoking. The facility census was 46. Findings include: Review of the medical record for Resident #41 revealed an admission date of 06/11/24 with diagnoses of cardiomyopathy, hypoxemia, ascites, chronic passive congestion of liver, nicotine dependence, congestive heart failure, type two diabetes mellitus, hypertension, fatty liver, insomnia, hypotension, and dyspnea. Review of the most recent Minimum Data Set (MDS) dated [DATE], revealed a Brief Interview for Mental Status (BIMS) score of 13, indicating Resident #31 was cognitively intact. Observation on 09/03/24 at 10:09 A.M. of Resident #41 while they were smoking revealed Resident #41 extinguished their cigarette on the ground and then placed the butt between the cushion of their wheelchair and the wheelchair. Interview on 09/03/24 at 10:10 A.M. with Resident #41 revealed they extinguish their cigarettes on the ground and place the butt between the cushion of their wheelchair and the wheelchair until they are ready to return inside of the facility. When Resident #41 is ready to go inside, Resident #41 places the used cigarette butts into approved receptacles. Interview on 09/03/24 at 10:20 A.M. with Licensed Practical Nurse (LPN) #220 verified the above findings. Review on 09/05/24 at 11:18 A.M. of an undated facility policy titled, Smoking, revealed residents are to extinguish all cigarettes in a designated container. 365885 Page 2 of 2