Health inspection·May 15, 2025

F 0657 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, interview and review of the facility policy, the facility failed to ensure Resident #63's comprehensive care plan was revised regarding her desire to live in the community and failed to assist Resident #63 with her discharge planning. This affected one resident (#63) out of three residents reviewed for discharge planning. The facility census was 62. Findings include: Review of the closed medical record for Resident #63 revealed an admission date of 12/31/24 with diagnoses including multiple sclerosis (MS), diabetes, anxiety disorder, bipolar disorder, schizoaffective disorder and major depression. Review of the care plan dated 12/31/24 revealed Resident #63's discharge planning was long-term placement. The care plan revealed Resident #63 stated she would stay at the facility, for now. Interventions included allowing resident choices, assessing resident's understanding and ability in safety during transfers, mobility, and activities of daily living, and offering opportunity to verbalize feelings related to placement. Review of the nursing note dated 12/31/24 at 2:41 P.M. and completed by Social Service Designee (SSD) #604 revealed she met with Resident #63, and she stated her plan was to stay at the facility, for now. Review of the admission Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #63 was cognitively intact and had no behaviors. Review of the nursing note dated 03/27/25 at 11:51 A.M. and completed by Former Administrator #605 revealed Former Administrator #605 and Former Director of Nursing (DON) #608 met with Resident #63 as she returned from the hospital emergency department today, 03/27/25. Resident #63 reported that she wanted to leave the facility and get an apartment. She reported she planned to contact an apartment complex to see if she could move there. Resident #63 revealed she had been previously evicted from the apartment complex as she owed the complex money and had a melt down while living at the complex. Resident #63 revealed she was hopeful the apartment complex would reconsider. The note revealed she was offered assistance with discharge and/or transfer, but Resident #63 declined stating she did not want to go to another facility. There were no other nursing notes regarding follow up with Resident #63 regarding her request to leave the facility and/or discharge planning. Review of the nursing note dated 04/07/25 at 8:00 A.M. completed by Registered Nurse (RN) #607 (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 2 Event ID: 366326 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 366326 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Geneva Center for Rehabilitation and Nursing 1140 South Broadway Geneva, OH 44041 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)