Inspection·December 9, 2025

F 0895 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many used character standards for CNA #46 to continue working at the facility. CNA #46 also notified the interim Administrator who obtained paperwork from the corporate office for her personnel file.A follow-up interview on 12/09/25 at 12:10 P.M. with HRD #47 (with the Administrator present) revealed HRD #47 was aware CNA #46 had been convicted of domestic violence, however CNA #46 continued employment with the facility due to CNA #46 meeting personal character standards.Interview on 12/09/25 at 1:00 P.M. and 1:40 P.M. with the interim Administrator revealed she (interim Administrator) and HRD #47 filled out CNA #46's personal character standards form together with guidance from the Corporate HRD. The interim Administrator verified CNA #46 had been convicted of domestic violence, which was a disqualifying offense according to State law. The interim Administrator also verified CNA #46 was recently convicted, still on probation until 10/15/26, CNA #46 did not meet (5) (b) of Rule 3701-13-06 for personal character standards and CNA #46 had access to all residents while CNA #46 worked in the facility since the conviction.Review of the facility's Staff Member Handbook, section titled Category III Work Rules, revised 06/04/24 revealed these offenses are the most serious and violations will subject a Staff Member to immediate termination. If an incident or situation requires further investigation, staff may be placed on suspension without pay pending an investigation and, if verified, will lead to termination.56. Staff members are responsible to report immediately upon being arrested, arraigned and/or convicted for one or more relevant criminal offenses under each respective state or federal law offenses. A Staff Member may be suspended without pay when charged with the respective state or federal law offense. Conviction of a respective state or federal law offense may result in termination.Review of the Rule 3701-13-05 Disqualifying offenses in the Ohio Administrative Code (OAC) Chapter 3701-13 Hiring of Direct-Care Provider (DCP) Employees effective 12/08/23 revealed, Except as set forth in the personal character standards established in rule 3701-13-06 of the Administrative Code, no DCP is allowed to employ a person in a position that involves providing direct care to an older adult if the person has been convicted of or pleaded guilty to: (1) A violation of any of the following sections of the Revised Code: .(rr) 2919.25 -- Domestic violence.Review of the Rule 3701-13-06 Personal character standards in the OAC Chapter 3701-13 Hiring of Direct-Care Provider (DCP) Employees effective 12/08/23 revealed, (A) A DCP may employ an applicant who has been convicted of or pleaded guilty to an offense listed in paragraph (A) of rule 3701-13-05 of the Administrative Code in a position involving direct care to an older adult, if all of the following standards are met:(1) The applicant is not a repeat violent offender as defined in paragraph (M) of rule 3701-13-01 of the Administrative Code;(2) The offense is not a sexually oriented offense as defined in paragraph (N) of rule 3701-13-01 of the Administrative Code;(3) The offense is not a violation of any of the following sections of the Revised Code or a violation of an existing or former law of this state, any other state, or the United States, if the offense is substantially equivalent to the offenses or violations described in the following sections of the Revised Code: 2903.01 (aggravated murder), 2903.02 (murder), 2903.03 (voluntary manslaughter), 2903.34 (patient abuse or neglect), or 3716.11 (placing harmful objects in food or confection);(4) If the applicant has more than one theft related offense as defined in paragraph (Q) of rule 3701-13-01 of the Administrative Code;(a) The victim of either offense was not an older adult; and(b) At least seven years have elapsed since the date the applicant was fully discharged from imprisonment, probation, or parole for the most recent offense;(5) If the offense is an offense of violence as defined in paragraph (J) of rule 3701-13-01 of the Administrative Code, other than one listed in paragraph (A)(3) of this rule; and(a) The victim of the offense was not an older adult; and(b) At least five years have elapsed since the date the applicant was fully discharged from imprisonment, probation and parole; or(6) If the offense is not an offense (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366274 If continuation sheet Page 2 of 3 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 366274 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Laurels of Chagrin Falls 150 Cleveland Street Chagrin Falls, OH 44022 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)

F 0895 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many FORM CMS-2567 (02/99) Previous Versions Obsolete of violence as defined in paragraph (J) of rule 3701-13-01 of the Administrative Code or an offense listed in paragraph (A)(3) of this rule; and(a) The applicant is either discharged from imprisonment, sentenced to probation, is fined or is on parole; and(b) The applicant provides proof that all conditions regarding fulfillment of sentencing requirements are being met.(7) The applicant's character is such that it is unlikely that the applicant will harm an older adult. In making that determination, the chief administrator is obligated to consider the following factors for each offense:(a) The applicant's age at the time of the offense;(b) Regardless of whether the applicant knew the victim prior to the committing of the offense, the age and mental capacity of the victim;(c) The nature and seriousness of the offense;(d) The number of previous offenses or length of time since the most recent conviction or guilty plea;(e) The degree to which the applicant participated in the offense and the degree to which the victim contributed to or provoked the offense;(f) The likelihood that the circumstances leading to the offense will reoccur;(g) The applicant's employment record;(h) The applicant's efforts at rehabilitation and the results of those efforts;(i) If known, whether the applicant has been convicted of or pleaded guilty to any violation of an existing or former municipal ordinance substantially equivalent to any offense listed or described in rule 3701-13-05 of the Administrative Code;(j) Whether any criminal proceedings are pending; and(k) Any other factors related to the position that the chief administrator considers relevant to the performance of job duties.(B) If the applicant fails to provide proof that the personal character standards listed in this rule are met, or if the DCP determines that the proof offered by the applicant is inconclusive, the applicant cannot be employed in a position that involves providing direct care to older adults.This deficiency represents non-compliance investigated under Complaint Number 2637627. Event ID: Facility ID: 366274 If continuation sheet Page 3 of 3