Health inspection·February 20, 2020

F 0558 Reasonably accommodate the needs and preferences of each resident. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, medical record review and staff and resident interview, the facility failed to accommodate residents needs by ensuring call lights were within reach and accessible for Resident #25, #58 and #273. This affected three (#25, #58 and #273) of 48 residents reviewed for call light placement. Facility census was 68. Residents Affected - Few Findings include: 1. Record review revealed Resident #273 was admitted to the facility on [DATE] with diagnoses that included but not limited to fracture of lower end of left radius, unsteadiness on feet, and atrial fibrillation. Review of the admission Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed Resident #273 was moderately cognitively impaired and required extensive assistance of activities of daily living. Review of the care plan falls dated 02/12/20 revealed that call light should be within reach. Observation of Resident #273 on 02/18/20 at 9:36 A.M. revealed Resident #273 was sitting in a recliner with her legs elevated. When this surveyor asked Resident #273 if she uses the call light, Resident #273 stated that she was told to use the call light when she wants to get up, so she doesn't fall. The call light was wrapped around the side rail of the bed located the furthest from the resident. The Administrator on 02/18/20 at 9:37 A.M. verified the call light was not within reach of Resident #273. 2. Medical record review revealed Resident #25 had an admission date of 06/19/19. Diagnoses included chronic obstructive pulmonary disease, diabetes mellitus type two, dementia and chronic pain. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #25 had intact cognition. Observation on 02/18/20 at 10:07 A.M. revealed Resident #25 was sitting in his recliner on the right side of the bed. Further observation revealed Resident #25's call light was attached to the left side of the bed and not within the resident's reach. Interview on 02/18/20 at 10:07 A.M. with Licensed Practical Nurse (LPN) #47 verified Resident #25's call light was not within reach. LPN #47 stated Resident #25 required staff assistance for transfers. (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 10 Event ID: 366426 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 366426 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/20/2020 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Woods on French Creek Nursing & Rehab Center The 37845 Colorado Avenue Avon, OH 44011 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)