Health inspection·June 11, 2023

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 observation, interview, and record review, the facility failed to provide personal care assistance in a dignified manner for Resident #14. This affected one resident (#14) of 27 residents reviewed for dignity. The facility census was 64. Findings include: Review of the medical record for Resident #14 revealed an admission date of 05/13/20. Diagnoses included chronic obstructive pulmonary disease with acute exacerbation, morbid severe obesity due to excess calories, diabetes mellitus type 2 with diabetic nephropathy, foot drop, essential primary hypertension, and major depressive disorder recurrent. Review of the Quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #14 had intact cognition. Resident #14 required extensive two staff assistance for bed mobility, extensive one staff assistance for toileting, was dependent on two staff assistance for transfers, and was dependent on one staff physical assistance for bathing. The assessment indicated Resident #14 was occasionally incontinent of urine and frequently incontinent of bowel. Review of the care plan completed 04/18/23 revealed Resident #14 had an activities of daily living (ADL) self-care performance deficit related to impaired mobility. Interventions included to provide physical assistance with bathing, hygiene, toileting, eating, dressing, and transfers, and to provide transfers with physical assist of two staff using a mechanical lift. Observation on 06/11/23 at 8:14 A.M. from the hallway into Resident #14's room revealed State Tested Nursing Assistants (STNAs) #517 and #560 providing personal care to Resident #14 after completing a mechanical lift transfer to the bed. Resident #14 was uncovered wearing a brief in the bed. STNA #560 stood on Resident #14's left side of the bed and STNA #517 stood on Resident #14's right side of the bed. The privacy curtain was not pulled, and the room entrance door was not closed. At the time of the observation, STNA #560 looked up from the personal care assistance being provided and requested identification of this surveyor who was standing in the hallway near Resident #14's room entrance door. After identification was provided, STNA #560 directed STNA #517 to close the privacy curtain for Resident #14. STNA #560 then walked to Resident #14's room entrance door and started to close the door. Interview at the time of the observation with STNA #560 confirmed Resident #14 was transferred to bed using the mechanical lift and personal care was in process of being provided without closing Resident #14's privacy curtain or the room entrance door. STNA #560 stated privacy was required when providing all personal care to residents. Page 1 of 2 366047 366047 06/11/2023 Rae Ann Geneva 839 W Main Street Geneva, OH 44041

F 0558 Reasonably accommodate the needs and preferences of each resident. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to maintain a call light within reach of Resident #24. This affected one resident (#24) of 27 residents reviewed for call light accessibility. The census was 64. Residents Affected - Few Findings include: Review of the medical record for Resident #24 revealed an admission date of 03/25/20. Diagnoses included hemiplegia and hemiparesis following cerebral infarction affecting right dominant side, vascular dementia, generalized anxiety disorder, chronic combined systolic and diastolic congestive heart failure, and chronic ischemic heart disease. Review of the Significant Change Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #24 had short-term and long-term memory problems. Resident #24 required extensive two staff assistance for bed mobility and toileting and was dependent on two staff assistance for transfers. The assessment indicated Resident #24 was always incontinent of urine and bowel. Review of the care plan completed 04/07/23 revealed Resident #24 had cognitive loss and a communication problem related to expressive aphasia from a cerebral vascular accident (CVA), and an activities of daily living (ADL) self-care performance deficit related to CVA. Interventions included to maintain a safe environment with call light in reach, to provide physical assistance as needed, and encourage to use the call bell for assistance. Observation on 06/11/23 at 8:16 A.M. revealed Resident #24 was in bed lying to the right side positioned on top of a mechanical lift sling and audibly moaning. There was no call light within reach. The call light was draped over the top of an oxygen concentrator which was not in use and was positioned to Resident #24's left side of the bed. Interview at the time of the observation with Resident #24 revealed a complaint of being uncomfortable and when questioned regarding use of the call light, Resident #24 extended the arm outward and behind the body toward the oxygen concentrator on the left side and clasped the left hand repeatedly. Resident #24 stated an inability to contact staff for assistance. Interview on 06/11/23 at 8:18 A.M. with State Tested Nursing Assistant (STNA) #560 verified Resident #24's call light was not in reach and was draped over the top of the oxygen concentrator positioned to Resident #24's left side of the bed. STNA #560 indicated Resident #24 was not able to use the call light then expressed to Resident #24 additional assistance would be obtained to get Resident #24 up out of bed. STNA #560 placed the call light within reach and left the room. Observation on 06/11/23 at 8:25 A.M. revealed Resident #24 pressed the call light using the left hand to alert staff for assistance. At 8:31 A.M. STNA #560 and Director of Nursing entered Resident #24's room and assisted. 366047 Page 2 of 2