Health inspection·June 21, 2025

F 0677 Provide care and assistance to perform activities of daily living for any resident who is unable. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, resident interview, and staff interview, the facility failed to ensure sufficient bathing was provided to all dependent residents. This affected two (Residents #1 and #20) of three residents reviewed for activities of daily living (ADL). The census was 45. Residents Affected - Few Findings Include: 1. Resident #1 was admitted to the facility on [DATE]. His diagnoses were infection and inflammatory reaction due to indwelling urethral catheter, sepsis due to MRSA, COPD, muscle wasting and atrophy, dysphagia, type II diabetes, urinary tract infection, obstructive and reflux uropathy, unspecified severe protein calorie malnutrition, congestive heart failure, pleural effusion, hypertensive heart and chronic kidney disease, acute kidney failure, atrial fibrillation, anemia, aortic stenosis, and hyperlipidemia. Review of his Minimum Data Set (MDS) assessment, dated 04/17/25, revealed he had mild cognitive impairment and was dependent on staff for bathing/showering. Review of Resident #1 current shower schedule revealed he was scheduled to have a bath/shower on Mondays and Thursdays in the evening. Review of Resident #1 shower logs/documentation, dated 04/10/25 to 06/20/25, revealed the following dates did not have documentation as shower/baths being offered to Resident #1: 04/28/25, 05/01/25, 05/05/25, 05/08/25, and 05/15/25. Interview with Director of Nursing (DON) and Administrator on 06/20/25 at 3:30 P.M. confirmed there is no documentation for Resident #1 being offered a bath/shower on the above listed days. They confirmed the resident needs at least some physical assistance and/or reminders to take a bath/shower from staff. 2. Resident #20 was admitted to the facility on [DATE]. His diagnoses were cognitive social or emotional deficit following other cerebrovascular disease, alcoholic cirrhosis of liver, dementia, patient's non-compliance with other medical treatment, adult failure to thrive, unspecified severe protein calorie malnutrition, edema, cellulitis of left axilla and right upper limb, anxiety disorder, asthma, hoarding disorder, delusional disorder, dietary folate deficiency anemia, restlessness and agitation, and alcohol abuse. Review of his MDS assessment, dated 04/10/25, revealed he was cognitively intact. Review of Resident #20 MDS assessment, section GG, dated 04/10/25, revealed he refused to take a bath/shower during Page 1 of 2 366274 366274 06/21/2025 The Laurels of Chagrin Falls 150 Cleveland Street Chagrin Falls, OH 44022

F 0677 that time to determine his ability level. Level of Harm - Minimal harm or potential for actual harm Review of Resident #20 current shower schedule revealed he was scheduled to have a bath/shower on Tuesdays and Fridays in the evening. The facility provided a list identifying Resident #20 needing physical assistance with bathing/showering. Residents Affected - Few Review of Resident #20 shower logs/documentation, dated 04/10/25 to 06/20/25, revealed the following dates did not have documentation as shower/baths being offered to Resident #1: 03/27/25, 04/14/25, 04/21/25, 04/28/25, 05/09/25, 05/16./25, 05/30/25, and 06/06/25. Interview with Resident #20 on 06/20/25 at 2:30 P.M. confirmed he is not offered a bath/shower when he needs or wants it. He confirmed he will refuse at times, and there are times he does want to wash himself in the sink, but he stated he is not always offered a bath/shower when he desires it. Interview with DON and Administrator on 06/20/25 at 3:30 P.M. confirmed there is no documentation for Resident #20 being offered a bath/shower on the above listed days. They confirmed the resident needs at least some physical assistance and/or reminders to take a bath/shower from staff. Both confirmed Resident #20 will refuse care, including bath/showers quite often, but they confirmed there should be documentation for each scheduled bath/shower; whether it was completed or refused. This deficiency represented non-compliance investigated under Complaint Number OH00165113. 366274 Page 2 of 2