Health inspection·June 14, 2023

F 0760 Ensure that residents are free from significant medication errors. Level of Harm - Minimal harm or potential for actual harm Based on record review, review of facility policy and interviews, the facility failed to ensure Resident #19 received pain medication as ordered by the physician. This affected one resident (#19) out of three residents reviewed for pain medication administration. The facility census was 80. Residents Affected - Few Findings include: Review of the medical record for Resident #19 revealed an admission date of 05/19/21. Diagnoses included cerebral infarction, multiple sclerosis, irritable bowel syndrome without diarrhea, type two diabetes mellitus, anxiety disorder, unspecified diastolic congestive heart failure, and major depressive disorder. Review of the annual Minimum Data Set (MDS) 3.0 assessment, dated 05/11/23, revealed Resident #19 was cognitively intact, had little interest or pleasure in doing things and felt down, depressed or hopeless nearly every day, required supervision of one person physical assist for bed mobility, required supervision of one person physical assist for dressing , toilet use, and personal hygiene, required physical help of one person physical assist in part of bathing activity, was independent with set up for eating, was occasionally incontinent of bladder and bowel, had received pain medication as needed and nonpharmacological interventions for pain, had frequent moderate intense pain which had not affected sleeping or day to day activities and received five days of an opioid (pain) medication. Review of physician orders for Resident #19 revealed an order dated 05/23/23 for one tablet of oxycodone-acetaminophen (a combination pain medication to help relieve moderate to severe pain) 7.5-3.25 milligram (MG) by mouth every six hours for pain. Review of June 2023 Medication Administration Record (MAR) revealed Resident #19 did not receive oxycodone-acetaminophen 7.5-3.25 MG tablet on 06/07/23 at 12:00 A.M. and 6:00 A.M. Review of the progress notes on 06/07/23 revealed Resident #19 had not received one tablet of oxycodone -acetaminophen 7.5-3.25 MG at midnight and 6:00 A.M., since it was out of stock and had been reordered. Review of the Controlled Drug Receipt Record/Disposition Forms, dated 05/30/23 to 06/13/23, revealed on 06/06/23, the last oxycodone -acetaminophen 7.5-3.25 MG tablet in stock for Resident #19 had been used at 6:00 P.M. There was no documentation on 06/07/23 Resident #19 had received one oxycodone -acetaminophen 7.5-3.25 MG tablet at 12:00 A.M. or 6:00 A.M Interview on 06/13/23 at 5:58 P.M. with the Director of Nursing (DON) confirmed the facility had (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 9 Event ID: 366195 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 366195 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/14/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Beeghly Oaks Center for Rehabilitation & Healing 6505 Market Street Youngstown, OH 44512 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)