Inspection·October 30, 2024

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, and staff interview the facility failed to ensure resident heating and air conditioning equipment was operational inside resident rooms. This affected one (Resident #2) of four residents reviewed for environmental heating, ventilation and cooling in the facility. The total facility was census of 34. Findings include: Resident #2 admitted to the facility on [DATE] with the diagnoses including Alzheimer's disease, multiple sclerosis, dementia, mood disturbance, anxiety disorder, and hypertension. According to the minimum data set assessment dated [DATE] Resident #2 was assessed with intact cognition, required supervision and touch assistance with activities of daily living and utilized a wheelchair for mobility. Review of facility census information Resident #2 was moved to the current room on 09/03/24. According to physician orders on 10/21/24 Resident #2 was placed into SARS-CoV-2 (COVID-19) COVID isolation. Observation on 10/29/24 at 11:40 A.M. located Resident #2 inside a single occupancy room with the door closed. The ambient air temperature was recorded at 72 degrees Fahrenheit. Resident #2 was in bed covered with multiple blankets. No heating ventilation air conditioning (HVAC) duct work was installed inside the room. A Packaged Terminal Air Conditioner (PTAC) unit was identified as the single HVAC source. The PTAC unit was unplugged from the electrical outlet. Resident #2 stated heat and cooling was not operational since being placed into the room and at times requested additional blankets. On 10/29/24 at 1:10 P.M. interview with Maintenance Director (MD) #1 confirmed the PTAC unit inside Resident #2 room had not been operational for an undetermined time. The facility was attempting to obtain a replacement. MD #1 stated when room temperatures were obtained, readings included Resident #2 room and temperatures were recorded between 71-81 degrees Fahrenheit. MD#1 also verified Resident #2 would not be able to adjust the room temperature due to no additional source of heat or cooling installed inside the room. Observation on 10/30/24 at 9:20 A.M. noted Resident #2 remained in the room. The PTAC unit remained unplugged from the electrical outlet. Resident #2's room temperature was recorded at 73.2 degrees Fahrenheit. (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 4 Event ID: 366081 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 366081 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/30/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Parkview Care Center 1406 Oak Harbor Rd Fremont, OH 43420 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)