Health inspection·January 21, 2025

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, facility policy review and interview, the facility failed to provide timely and necessary treatment for Resident #22 following laboratory testing that included a critically high sodium level to prevent a hospitalization. This affected one resident (#22) of three residents reviewed for laboratory testing. The facility census was 88. Residents Affected - Few Findings included: Review of the medical record for Resident #22 revealed an admission date of 07/10/18 with diagnosis including attention to gastrostomy (tube), severe protein-calorie malnutrition, acute kidney failure, end stage renal disease, dementia, bipolar disorder with current episode manic severe with psychotic features, and patient's noncompliance with other medical treatment and regimen. Review of the care plan dated 08/01/23 revealed Resident #22 had increased risk for nutritional status related to diagnosis of end state renal disease, dysphagia with risks associated with overall disease process, underweight, low body mass index (BMI) with history of suboptimal intake and history weight fluctuation. Interventions included monitor lab values and monitor for signs and symptoms of dehydration. Review of the progress note dated 09/11/24 at 4:58 P.M. documented as a late entry on 09/12/24 at 10:00 P.M., authored by RN #166 revealed an aide notified this nurse resident brief was dry throughout the day and this nurse asked the oncoming nurse to monitor (the resident) for output. Review of the progress note dated 09/12/24 at 10:00 P.M. revealed Registered Nurse (RN) #166 documented the resident did have a wet brief prior to bed. The nurse assessed the resident in the morning and his brief was wet times one. Review of Resident #22's progress note dated 09/17/24 revealed the revealed the resident refused all meals on this date, the nurse and care staff offered multiple times and tried to feed the resident during all meals, and he still refused. The note revealed the resident did drink four chocolate boosts and two mighty shakes on this day. Review of a monthly ordered laboratory report dated 09/18/24 at 5:08 P.M. revealed Resident #22 had a critically high sodium (NA+) level of 164 (normal range 138 to 145). High sodium levels, known as hypernatremia, can include thirst, urinating less, vomiting, diarrhea, confusion, muscle twitching, seizures, lethargy, irritability and stupor or coma. The lab results had a handwritten note (dated 09/18/24) with no new orders (NNO), monitor and consult nephrology and was initialed by Licensed Practical Nurse (LPN) #213. (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 7 Event ID: 366403 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 366403 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Bath Creek Estates 186 West Bath Road Cuyahoga Falls, OH 44223 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)