Health inspection·July 7, 2022

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, record review, and policy review the facility failed to ensure staff ensured a dignified dining experience for Resident #3 during lunch time dining. This affected one (Resident #3) of three (Resident's #2, #3, and #21) who required feeding assistance. The facility census was 30. Findings include: Review of the medical record revealed Resident #3 was admitted on [DATE] with diagnoses including Parkinson's disease, heart failure, dysphagia a swallowing disorder. The quarterly Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed Resident #3 had impaired cognition and required extensive assistance of one staff for eating. Review of Resident #3's care plan initiated on 05/17/22 for activities of daily living (ADL) revealed self-care performance deficit related to Parkinson's disease with an intervention including to provide one staff assistance for eating. Dining observation on 07/05/22 at 12:54 P.M. of the lunch meal revealed State Tested Nurse Aide (STNA) #100 was standing next to Resident #3 providing feeding assistance. Interview on 07/05/22 at 1:10 P.M. with STNA #100 confirmed she was standing while feeding Resident #3. STNA #100 stated she would normally sit while feeding a resident. Review of the facility policy titled Assistance with Meals, dated July 2017, revealed residents who cannot feed themselves will be fed with attention to safety, comfort, and dignity, for example: Not standing over residents while assisting them with meals. Page 1 of 3 366390 366390 07/07/2022 North Park Care Center 14801 Holland Road Brook Park, OH 44142

F 0732 Post nurse staffing information every day. Level of Harm - Potential for minimal harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation and interview, the facility failed to post up-to-date staffing information in public areas. This had the potential to affect all 30 residents living at the facility at the time of the survey. Residents Affected - Many Findings include: Observation upon entry into the facility on [DATE] at 8:08 A.M. revealed the direct-care staffing information posted by the facility was dated 06/30/22. Interview on 07/05/22 at 8:30 A.M. with Registered Nurse (RN) #101 verified the findings. Interview on 07/05/22 at 4:30 P.M. with the Receptionist #102 revealed the direct care posting for the weekend is created by the receptionist on duty, and it was the receptionist duty to post staffing information in the morning. Receptionist #102 stated she was on vacation, and the receptionist on duty did not post the staffing information for the holiday weekend. Receptionist #102 stated she updated the staffing information and posted the updated version after she arrive to work. 366390 Page 2 of 3 366390 07/07/2022 North Park Care Center 14801 Holland Road Brook Park, OH 44142

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on observation and staff interview the facility failed to maintain its kitchen area in a manner to prevent food spoilage and prevent food borne illnesses. This had the potential to affect all 30 residents who received food from the facility kitchen. The facility census was 30. Findings include: During the initial kitchen tour conducted on 07/05/22 between 8:15 A.M. and 8:33 A.M. the following was observed and verified with [NAME] #997 at the time of the observation: • Three cabbage heads were observed to be significantly brown in color. • Two stalks of celery were noted to be extremely wilted and brown in color. • Significant ice buildup was noted on the facility freezer. • An unlabeled and undated bag of approximately 15 to 20 frozen omelets were noted in the freezer. • The outside rubber seal was noted to be dislodged from the refrigerator door, and the temperature of the refrigerator was noted to be 48 degrees Fahrenheit (F) which was reading outside normal on the refrigerator temperature gauge. 366390 Page 3 of 3