Health inspection·September 18, 2023

F 0585 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, review of facility policy and interview the facility failed to timely address a concern/grievance and assist with a solution for Resident #202's responsible party related to the use of a video camera in the resident's room. This affected one resident (#202) of three residents reviewed for the use of video cameras. The facility census was 94. Findings include: Review of the medical record for Resident #202 revealed an admission date of 08/31/22 with diagnoses including end stage renal disease, dysphagia, bipolar disorder, dependence on renal dialysis, and contracture of left hand. Review of the quarterly Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed Resident #202 had moderate cognitive impairment. The assessment revealed Resident #202 required extensive assistance from one staff for bed mobility, transfers, dressing, personal hygiene, and bathing. Interview with the Responsible Party (RP) of Resident #202 on 09/13/23 at 9:35 A.M. revealed she received a call on 08/22/23 from the Administrator indicating a video monitoring camera (previously placed by the RP) was being removed from the resident's room as the facility was not required to provide internet/Wi-FI access for the use of the camera (although the facility did provide residents with internet service). The Administrator informed the RP she would need to obtain her own internet access for the use of the camera. The facility removed the camera on 08/22/23 at 4:04 P.M. per the timestamp of the video from the camera. Resident #202's RP stated since that time she has tried to obtain Wi-Fi with other suppliers but had been unable to since the facility already had their own Wi-Fi and stated she had been told they cannot have two (internet supplier) companies in the same building. Resident #202's RP stated she had also attempted to obtain a hotspot from two different phone carriers but was told the hotspot would not provide enough data to sustain the camera at all times regardless of the data plan she chose. The RP indicated since this time, the facility has failed to assist her with alternative means to ensure the camera could be utilized after informing them the alternate Wi-Fi sources were not an option. Interview on 09/13/23 at 3:02 P.M. with the Administrator revealed the facility does allow cameras per their policy and provides electricity but the resident and/or their responsible party would need to obtain their own internet to maintain the camera. The Administrator stated she informed Resident #202's RP the camera was going to be removed due to the camera using the facility Wi-Fi and that the family would need to obtain their own Wi-Fi to run the monitoring camera. There was no evidence of any additional effective follow-up by the facility to assist Resident #202's RP to have a video Page 1 of 2 366403 366403 09/18/2023 Bath Creek Estates 186 West Bath Road Cuyahoga Falls, OH 44223

F 0585 Level of Harm - Minimal harm or potential for actual harm camera in the resident's room since the time the camera was removed. During the interview, the Administrator denied knowing the resident's RP was not able to obtain an effective alternate Wi-Fi source. However, there was no evidence the facility was actively working to assist or had communication with the family regarding this. The administrator provided a list of devices (Wi-Fi) potentially used by other residents at other facilities but revealed she had not provided these options to Resident #202's RP as of this date. Residents Affected - Few Interviews on 09/13/23 between 3:45 P.M. and 4:10 P.M. with Residents #256 and #261 confirmed they were permitted to use the facility Wi-Fi to use internet on their phones. Interview on 09/14/23 at 12:30 P.M. with the Administrator revealed there were no current residents in the facility with video cameras. During a follow-up interview with Resident #202's RP on 09/18/23 at 12:15 P.M. the RP revealed she had communicated (date not recalled) to the facility the other sources of Wi-Fi were not an option due to them not having enough data to run the camera. She also stated as the administrator was removing the camera from the resident's room (on 08/22/23), she spoke to her through the camera telling her not to remove it as it was against Esther's Law (a law in Ohio only related to the use of video cameras/monitoring) to remove it, and the Administrator said she was removing it despite her request to leave it at that time until a resolution could be reached. The RP stated she primarily wanted the camera in the resident's room so the resident could see/talk to family members who were unable to visit. Review of the facility website under the services tab for long term care specialties states, Our specialized long term care services include but are not limited to cable television and internet access. Review of the policy titled Electronic Monitoring in Resident's Rooms Policy (Esther's Law: Ohio only), dated 03/23/22, revealed Our community will permit residents and legally authorized people to install and use fixed electronic monitoring devices in accordance with applicable laws. This deficiency represents noncompliance investigated under Complaint Number OH00146020. 366403 Page 2 of 2