Health inspection·September 24, 2025

F 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few rights policy with all staff via OnShift. On 09/17/25 at 10:49 A.M., SSD #524 assessed Resident #66's psychosocial status. at baseline psychosocial status. On 09/17/25 at 10:55 A.M., the Administrator in collaboration with Healthcare Services Group terminated Housekeeper #582's employment. On 09/17/25 at 10:56 A.M., the Administrator reiterated to Human Resources #587 to continue to ensure newly hired employees were educated on the abuse policy upon hire during orientation. Beginning on 09/22/25, the facility implemented a plan for SSD #524 to conduct interviews with five employees weekly related to abuse and five residents weekly related to abuse for four weeks, then monthly for two months. Compliance with the interviews would be overseen by the Administrator. Results of the interviews would be reviewed with the Quality Assurance and Performance improvement (QAPI) committee for additional recommendations as warranted. Although the Immediate Jeopardy was removed on 09/17/25, the deficiency remained at a Severity Level 2 (no actual harm with potential for more than minimal harm that is not Immediate Jeopardy) as the facility was in the process of implementing their corrective action plan and were monitoring to ensure on-going compliance. Findings include: Review of the medical record of Resident #66 revealed an admission date of 08/11/23 with diagnoses including displaced fracture of the base of the neck of the left femur, subsequent encounter for closed fracture with routine healing, diabetes mellitus type II, fracture of one rib, subsequent encounter for fracture with routine healing, repeated falls, alcohol dependence, cannabis dependence, bipolar disorder, nicotine dependence, cocaine dependence, major depressive disorder, insomnia and anxiety. Review of the Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed a Basic Interview for Mental Status (BIMS) score of 15 indicating Resident #66 had intact cognition. The assessment revealed Resident #66 required (staff) supervision and set-up for all activities of daily living (ADLs) and used a wheelchair for mobility. Review of the care plan dated 08/14/25 revealed Resident #66 was at risk for disruptions in his mood due to diagnoses of bipolar disorder, depression, insomnia and anxiety. Interventions included behavioral consultations as needed, encouraging the resident to express his feelings, encouraging the resident to maintain as much independence and control/decision making as possible. The care plan also indicated Resident 66 was at risk for falls due to falls prior to admission with fractures and impaired mobility. Interventions included educating the resident regarding safety with transfers and ensuring the resident's room was free of potential visible hazards. Review of a nursing progress note dated 09/16/25 at 11:30 A.M. authored by RDCO #578 revealed an alleged staff-to-resident physical altercation. The progress note included Resident #66 declined assessment but had a BIMS of 15 and denied pain or injuries. Medical Director #585 and Resident #66's brother informed. The progress note also included staff member was suspended pending the investigation. Review of an additional nursing progress note dated 9/16/25 at 12:02 P.M. authored by the DON revealed social services (SSD #524) found this nurse and asked for assistance in a situation with the resident. This nurse was led to the 200 unit, where Resident #66 was seen sitting upright on the floor. The resident's left leg was straight out and the right leg was bent, with his right foot near his inner left leg. The resident's wheelchair was a few feet away from him. The nurse practitioner (NP) and this nurse attempted to assess the resident, and he refused stating, I want to gather myself. This nurse asked the resident what happened, and he stated, I was talking to that one girl (Housekeeper #583) about being in my room and we got upset talking to each other, heading down the hallway. The housekeeper told me to talk to her boss about being in my room. I thought that guy (Housekeeper #582) was her boss. Words got exchanged back and forth then he (Housekeeper #582) grabbed me by my neck and knocked me out the wheelchair, then he got on top of me. The housekeeper whooped my [expletive]. After several minutes, the aides assisted the resident back to his wheelchair. This nurse asked the resident if there was (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365972 If continuation sheet Page 2 of 5 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 365972 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/24/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Canfield Healthcare Center 2958 Canfield Rd Youngstown, OH 44511 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)

F 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few anything we could do for him at this time, and he stated that he didn't want us to do anything for him. The note included the resident refused to have his vital signs assessed as well. The resident was calling his brother and going to the hospital. Once his brother arrived, the resident allowed this nurse to perform a partial skin check. There was a small abrasion and a [NAME] on the resident's lower left back. The resident complained of pain rated an eight to nine on a pain scale of zero to 10 with 10 being the worst pain. Pain medications were offered; however, the resident decided he wanted to wait until he got to the hospital to take any medication. Review of a facility self-reported incident (SRI) tracking number 265294 dated 09/16/25 revealed the facility reported an incident of alleged abuse involving Resident #66 to the State agency. A witness statement from Certified Nursing Assistant (CNA) #570 reported Housekeeper #582 choked Resident #66 during a verbal confrontation. A witness statement from Licensed Practical Nurse (LPN) #526 stated she saw Housekeeper #582's hands around Resident #66's neck and saw Resident #66 hit his head on the nurse's cart and fall to the floor. A witness statement from LPN #561 stated Housekeeper #582 held Resident #66 with one hand and punched him twice with closed fist with the other hand. Review of a nursing progress note revealed Resident #66 was transferred to the ER on [DATE] at 12:27 P.M. and returned to the facility on [DATE] at 7:09 A.M. with no new orders. Review of a local police report incident number 25Y043477 dated 09/16/25 revealed upon arrival, three officers made contact with the facility staff who stated that a patient, later identified as Resident #66 and a staff member, later identified as Housekeeper #582, were engaged in a physical altercation. The staff then directed the officers to Resident #66's room where the resident stated that he and this staff member (Housekeeper #582) had gotten into a verbal argument in the hallway on the opposite side of the facility. Housekeeper #582 then pushed him (who is stationed in a wheelchair) against a wall and began punching him on the right side and left neck area. The resident stated he just had surgery as well and his left hip was also in pain, but he did not remember exactly where all Housekeeper #582 had made contact with him. He stated then Housekeeper #582 jumped on top of him and continued hitting him. Housekeeper #582 then left the facility. No noticeable injuries could be seen on Resident #66 at that time. A telephone interview on 09/22/25 at 10:52 A.M. with Resident #66's brother revealed he was not present in the facility at the time of the incident on 09/16/25 but had been made aware of the altercation that had occurred. The resident's brother did not provide any additional information related to the circumstances of the incident. Interview with Resident #66 on 09/22/25 at 10:59 A.M. revealed on 09/16/25, Housekeeper #583 had been in his room too much and he asked her to leave. She told him she was told to mop his floor, and he would have to talk to her boss about it. Resident #66 stated he became angry, and he and Housekeeper #583 started heading down the hall to talk to her boss when Housekeeper #582 showed up and started a verbal confrontation. Resident #66 stated the next thing he knew, Housekeeper #582's hand was around his neck choking him and punching him with a closed fist. Resident #66 stated Housekeeper #582 kneed him and kicked him in the side once or twice and banged him against the wall while still seated in his wheelchair. Resident #66 stated the two of them somehow ended up on floor during the scuffle. He stated staff called police to file report and press assault charges against the housekeeper. The resident said he was sent to hospital in an ambulance and then returned to the facility. The resident stated he had nothing broken but was still sore all over from the incident. Interview with CNA #570 on 09/22/25 at 11:26 A.M. revealed on 09/16/25 he was sitting in the hallway when he heard some commotion and overheard Resident #66 complaining that housekeepers were in his room too much. The CNA revealed an argument ensued between Resident #66 and Housekeeper #582, and he tried to resolve the issue but was ignored. He stated Resident #66 was swearing and being loud and when he turned around, (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365972 If continuation sheet Page 3 of 5 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 365972 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/24/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Canfield Healthcare Center 2958 Canfield Rd Youngstown, OH 44511 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)

F 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few Resident #66 and Housekeeper #582 were on floor, and Housekeeper #582 was choking Resident #66. Another staff member separated Resident #66 and Housekeeper #582 and asked Resident #66 if he needed help, but the resident wanted to stay on the floor for a minute. The police were called and then an ambulance was called. Interview with LPN #526 on 09/22/25 at 1:55 P.M. revealed she was sitting at the nurse's station on 09/16/25 when she witnessed Resident #66 following housekeeping staff down the hallway. Resident #66 wanted to speak to Housekeeping Supervisor #580 due to staff mopping his floor twice. LPN #526 stated Resident #66 was swearing at housekeeping staff. Housekeeper #582 tried to get Housekeeper #583 away from Resident #66 when Resident #66 got verbally aggressive toward Housekeeper #582. LPN #526 saw Housekeeper #582's hands around Resident #66's neck and then Resident #66 hit his head on nurse's cart and fell to floor. Staff came running and separated Housekeeper #582 and Resident #66. Resident #66 refused to be assessed and wanted to sit on the floor for a minute following the incident. LPN #526 stated the police were called and took statements, and Resident #66 then went to the hospital. Interview with LPN #561 on 09/22/25 at 2:02 P.M. revealed she was walking down hall on 09/16/25 when she saw Housekeeper #582 and Resident #66 in each other's faces. Housekeeper #582 started walking away but came back toward Resident #66 and grabbed him by the neck. Housekeeper #582 then pushed Resident #66 into the nursing cart when Resident #66's wheelchair tipped, and he ended up on ground with Housekeeper #582. Another staff member separated them. LPN #562 stated she saw hands flying and saw Housekeeper #582 holding Resident #66 with one hand and punching him twice with a closed fist with the other hand. LPN #561 further stated the police were called, Resident #66's brother was called and came to the facility. Then an ambulance was called and took Resident #66 to the hospital. Interview with the Administrator on 09/22/25 at 11:40 A.M. revealed she was in her office when this incident (on 09/16/25) occurred and staff had come to get her. When she arrived at the scene of the incident, everyone involved was clustered near the nurse's station. Resident #66 was on the floor and didn't want helped or assessed. Resident #66 wanted to wait until his brother came to the facility to go to the hospital and then went to hospital when his brother arrived. Resident #66 returned to the facility with no new orders and no reported injuries from the incident. She further stated Housekeeper #582 vanished after the incident. Staff called the police who came immediately and took statements from everyone involved. Housekeeper #582 and Housekeeper #583 were immediately suspended pending investigation, and all codes on all facility doors were immediately changed. Housekeeper #582 was subsequently fired. Observation of a video recording of the incident on 09/22/25 at 2:15 P.M. revealed the entire incident on 09/16/25 lasted approximately 16 seconds. Housekeeper #582 was seen approaching Resident #66 who was seated in his wheelchair. Housekeeper #582 placed both hands on Resident #66's neck/shoulder area and pushed him out of the frame. Several staff members were seen running towards the altercation. Resident #66's leg was seen on the floor from the upper right corner of frame but nothing else could be seen until Resident #66 was seen sitting up against a wall on the floor for several minutes following the incident. Housekeeper #582 was seen walking toward the camera until he walked out of frame. Interview with Police Detective #586 on 09/23/25 at 2:05 P.M. revealed a meeting with the City Prosecutor was scheduled for Friday 09/26/25 when he anticipated felony abuse charges would be filed against Housekeeper #582. Interview with the facility's Medical Director #585 via telephone on 09/23/25 at 2:29 P.M. revealed the facility notified him and all other appropriate parties in a timely manner after the incident involving Resident #66 on 09/16/25 occurred. Review of the facility policy titled Abuse, Neglect, and Exploitation, revised 09/20/22, revealed abuse was defined as the willful inflection of injury, unreasonable confinement, intimidation, or punishment resulting physical harm, pain, or mental anguish. Physical abuse was defined as (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365972 If continuation sheet Page 4 of 5 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 365972 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/24/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Canfield Healthcare Center 2958 Canfield Rd Youngstown, OH 44511 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)

F 0600 Level of Harm - Immediate jeopardy to resident health or safety including but was not limited to hitting, slapping, pinching, and kicking or flicking with fingers or striking with any manner that is demeaning. It also included controlling behavior through corporal punishment. This deficiency represents non-compliance investigated under Master Complaint Number 2621975 and Complaint Numbers 2621911 and 2617679 and is an example of continued noncompliance from the survey completed on 09/17/25. Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365972 If continuation sheet Page 5 of 5