Health inspection·November 5, 2025

F 0689 Level of Harm - Actual harm Residents Affected - Few CNA #50 asked CNA #30 for assistance getting Resident #100 up off the floor. CNA #30, CNA #50 and CNA #20 went to Resident #100's room and immediately called for the nurse, RN #5. Interview on 10/30/25 at 9:49 A.M. with CNA #20 revealed she was working with CNA #50 on 09/11/25 but not on the same unit. CNA #50 did not ask CNA #20 for assistance with Hoyer lift transfers. However, CNA #30 and CNA #50 did ask CNA #20 for assistance with Resident #100 after the incident occurred. Upon entering the room, they immediately called for the nurse, RN #5. Interview on 10/30/25 at 4:19 P.M. with RN #5 revealed CNA #50 was working the same unit as RN #5 on 09/11/25 and the CNA did not ask for assistance with transferring Resident #100 with the Hoyer lift. The CNAs working did notify her Resident #100 was on the floor and RN #5 immediately assessed him and called for the Director of Nursing (DON). Resident #100 was transferred to the ER.Interview with the DON on 10/30/25 at 11:06 A.M. confirmed Resident #100 fell while he was being transferred by staff using a Hoyer lift. She stated, based on the facility investigation, CNA #50 was using the Hoyer lift to transfer Resident #100 by herself, which was not the guidance provided in the manufacturer's guidelines and not according to facility policy, the lift tipped and Resident #100 fell to the floor resulting in a right hip fracture. The DON verified the resident did not return after hospital discharge but was admitted to another facility. The DON shared, following the incident, the facility completed the investigation, and initiated a plan of correction for this situation, which included education for nurses and CNAs, audit of residents who required mechanical lifts to ensure the lifts were being used appropriately, and mechanical lift transfer audits three times a week for four weeks with concerns being shared with Quality Assurance (QA) Committee. The DON revealed the corrective actions had been completed.Review of CNA #50's employee file revealed a hire date of 08/27/25 and acknowledgement of facility policies and procedures dated 08/27/25. Further review revealed a suspension disciplinary action dated 09/11/25 for the employee being in violation of prohibited behavior as described in the employee handbook. The violation was of an established policy, procedure or risk. Also contained in the employee file was a termination disciplinary action dated 09/15/25 with the nature of the disciplinary action to be the employee was in violation of prohibited behavior as described in the employee handbook for failure to follow the Hoyer lift policy. Review of facility policy titled Using a Mechanical Lifting Machine revised July 2017 revealed the purpose of this procedure is to establish the general principles of safe lifting using a mechanical lifting device. It was not a substitute for manufacturer's training or instructions. General guidelines at least two nursing assistants are needed to safely move a resident with a mechanical lift.Review of the facility policy titled Managing Falls and Fall Risk revised March 2018 revealed based on previous evaluations and current data, the staff would identify interventions related to the resident's specific risks and causes to try to prevent the resident from falling and to try to minimize complications from falling. Review of facility's mechanical lift manual dated 2022, for Invacare Reliant 450/600 revealed Although Invacare recommends that two assistants be used for all lifting preparation and transferring from and transferring to procedures, the equipment will permit proper operation by one assistant. The use of one assistant is based on the evaluation of the healthcare professional for each individual case.The deficient practice was corrected on 10/10/25, when the facility completed the following corrective actions: On 09/11/25, CNA #50 who was responsible for the error was immediately educated on transferring a resident with a mechanical lift and had a transferring competency completed by the DON with no new variances identified.On 09/11/25, CNA #50 was suspended by the DON and Administrator. As a result of the employee's failure to follow the Hoyer Lift policy, CNA #50 was terminated on 09/15/25.On 09/11/25, the MDS coordinator completed a full audit of residents (#10, #11, #13, #14, #15, #27, #29, #52, #56, #58, #59 and #100) with (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366391 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 366391 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/05/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Astoria Skilled Nursing and Rehabilitation 3537 12th Street, NW Canton, OH 44708 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 0689 Level of Harm - Actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete mechanical lifts to ensure mechanical lifts were being used appropriately and per policy by staff.On 09/11/25 direct care staff; 10 RNs, 11 LPNs, and 37 CNAs were educated on proper transferring. Staff were required to complete a mechanical lift demonstration by DON/designee. A plan for new staff to be educated upon hire as part of orientation was also implemented. Beginning 09/12/25 the DON/designee began auditing mechanical lift transfers for three residents, three times a week, for four weeks. The audits were completed on 10/10/25.Variances were corrected immediately upon discovery and education provided as needed. The results of the audits were reported to the facility quality assurance (QA) committee monthly. On-going compliance would be maintained through recommendations of the committee. No transfer injuries occurred between 09/12/25 and 10/30/25. This deficiency demonstrates non-compliance investigated under Master Complaint Number 2620511 and Complaint Number 2615493. Event ID: Facility ID: 366391 If continuation sheet Page 3 of 3