Health inspection·April 23, 2024

F 0557 Level of Harm - Minimal harm or potential for actual harm Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. Based on record review, observation, and interview the facility failed to ensure residents had a dignified eating experience. This affected three ( #12, #19, #34) of 20 residents observed for meals. Residents Affected - Few Findings include: Review of the medical record for Resident #12 revealed an admission date of 12/26/23. Diagnoses included epilepsy, legal blindness, and cerebral infarction due to unspecified occlusion of the cerebral artery. Review of the quarterly Minimum Data Set (MDS) assessment, dated 03/31/24, revealed Resident #12 had impaired cognition and required moderate assistance for eating. Review of the medical record for Resident #19 revealed an admission date of 09/16/23. Diagnoses included multiple sclerosis, quadriplegia, and muscle weakness. Review of the quarterly MDS assessment, dated 02/03/24, revealed Resident #19 had intact cognition and required setup and clean up for eating. Review of the medical record for Resident #34 revealed an admission date of 09/02/23. Diagnoses included unspecified dementia and legal blindness. Review of the quarterly MDS assessment, dated 02/28/24, revealed Resident #34 had impaired cognition and required supervision and touch assistance with eating. Observation on 04/18/24 at 12:32 P.M. revealed State Tested Nurse Assistant (STNA) #203 seated at the dining room table next to Resident #19. STNA #203 was observed on her cell phone which was lying on the table as she fed Resident #19. Interview immediately after the observation with STNA #203 confirmed she was using her cell phone while feeing Resident #19 and she should have put the phone away. Observations on 04/18/24 at 12:32 P.M. revealed STNA #204 standing as she fed Residents #12 and #34. STNA #204 was also observed using her cell phone which was lying on the table as she fed the residents. Interview immediately after the observation with STNA #204 revealed she should have been seated when feeding the residents and not using her cell phone. Review of the facility policy Promoting/Maintaining Resident Dignity During Meals, dated 01/01/24 revealed staff were to focus on the resident while talking and addressing them individually and should be seated while feeding residents. This deficiency represents non-compliance investigated under Complaint Number OH00152849. Page 1 of 3 366377 366377 04/23/2024 Tranquility of Richmond Heights 562 Richmond Road Richmond Heights, OH 44143

F 0679 Provide activities to meet all resident's needs. Level of Harm - Minimal harm or potential for actual harm Based on record review, observations, and interview the facility failed to provide activities as scheduled and to support the residents' mental and psychosocial wellbeing. This affected three (#2, #45, #47) of 13 residents interviewed and had the potential to affect nine (#1, #2, #12, #17, #24, #26, #30, #34, and #36) of 48 residents observed for participation in activities. Residents Affected - Some Findings include: Review of the activity calendar for April 2024 revealed on 04/18/24 the facility would provide room visits at 10:00 A.M., exercise at 11:30 A.M., brain teasers at 11:45 A.M., and a scenic ride with ice cream stop at 2:00 P.M. Observations on 04/18/24 at 8:50 A.M. revealed Activity Aide #210 was doing leg exercises with residents in the common area. Observations on 04/18/24 at 11:11 A.M. revealed Residents #1, #2, #12, #17, #24, #26, #30, #34, and #36 were sitting in the common area watching television and sleeping. Staff were seated at the nurse's desk; no organized activities were observed. Observations on 04/18/24 at 1:10 P.M. revealed Residents #1, #2, #12, #17, #24, #26, #30, #34, and #36 were seated in the common area after lunch. No organized activities were observed. Observations on 04/18/24 at 1:37 P.M. revealed Residents #1, #2, #12, #17, #24, #26, #30, #34, and #36 were seated in the common area watching television and sleeping, no organized activities were observed. Observations on 04/18/24 at 2:27 P.M. revealed Residents #1, #2, #12, #17, #24, #26, #30, #34, and #36 were seated in the common area either watching television or sleeping, no staff were present. No organized activities were observed. Interview on 04/18/24 at 2:27 P.M. with Registered Nurse (RN) #207 verified the observation of the nine residents gathered in the common area with the television on and residents sleeping with no staff present and no organized activities in progress. RN #207 shrugged her shoulders and rolled her eyes in response. Observations and interview on 04/18/24 at 3:14 P.M. revealed five residents in the activity room watching television and eating popcorn. Residents #1, #2, #12, #17, #24, #26, #30, #34, and #36 were seated in the common area where no staff or activities were being provided. Interview during the observations with the Activity Director revealed the scenic ride with ice cream stop was canceled because the bus had a broken window. The Activity Director did not have an activity planned for the nine residents sitting in the common area watching television or sleeping. Interview on 04/23/24 from 9:21 A.M. to 9:27 A.M. with Residents #2, #45, and #47 revealed there were not enough activities offered throughout the day; they watched a lot of television. Review of facility policy Activities, dated 01/01/24, revealed the facility would provide activities including religious programs, exercise programs, social activities, education programs, and 366377 Page 2 of 3 366377 04/23/2024 Tranquility of Richmond Heights 562 Richmond Road Richmond Heights, OH 44143

F 0679 indoor/outdoor activities. Level of Harm - Minimal harm or potential for actual harm This deficiency represents non-compliance investigated under Complaint Number OH00152849. Residents Affected - Some 366377 Page 3 of 3