Health inspection·June 24, 2024

F 0569 Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** THE FOLLOWING DEFICIENCY REPRESENTS AN INCIDENT OF PAST NON-COMPLIANCE THAT WAS SUBSEQUENTLY CORRECTED PRIOR TO THIS SURVEY. Residents Affected - Few Based on record review and interview, the facility failed to issue refunded monies to discharged residents in a timely manner. This affected two residents (#145 and #160) of three residents reviewed for resident refunds. The total census was 130. Findings included: 1. Closed record review revealed Resident #145 was admitted on [DATE] and was discharged on 02/05/24. His payor source was Private Pay. On 06/24/24, a review of the Resident Ledger for Resident #145 revealed that a final payment was made on 03/13/24 of $19,528.00. After the facility balance was paid, Resident #145 was due a refund of $1,572.00. This was due within 30 days or by 04/13/24. The amount was approved on 05/17/24 and was paid out on 05/22/24. Interview on 06/24/24 at 1:15 P.M. with the Administrator confirmed the refund payment was issued almost six weeks late. 2. Closed record review revealed Resident #160 was admitted on [DATE] and was discharged on 10/05/23. Her payor source was Private Pay. On 06/24/24, a review of the Resident Ledger for Resident #160 revealed that a final payment was made on 07/01/23 of $14,049.20. After the facility balance was paid, Resident #160 was due a refund of $8,548.60. This was due within 30 days or by 07/30/23. The amount was approved on 07/26/23 and was paid out on 08/04/23. Interview on 06/24/24 at 1:05 P.M. with the Business Office Manager (BOM) #505 confirmed the refund payment was issued late. Review of facility policy titled Resident Refund Policy and Procedure, (updated 09/22/23), revealed refunds are due to residents within 30 days of discharge. This deficiency represents non-compliance investigated under Complaint Number OH00154375. The deficient practice was corrected on 05/22/24 when the facility implemented the following Page 1 of 2 366078 366078 06/24/2024 Laurels of Massillon, The 2000 Sherman Circle NE Massillon, OH 44646

F 0569 corrective actions: Level of Harm - Minimal harm or potential for actual harm o On 08/04/23 Resident #160's refund was paid out. o On 05/17/24 a full house audit performed with no negative findings. Residents Affected - Few o On 05/22/24 Resident #145's refund was paid out. o Regional BOM increased facility visits to twice a week during facility BOM's leave. 366078 Page 2 of 2