Health inspection·October 31, 2024

F 0600 Level of Harm - Minimal harm or potential for actual harm Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. THE FOLLOWING DEFICIENCY REPRESENTS AN INCIDENT OF PAST NON-COMPLIANCE THAT WAS SUBSEQUENTLY CORRECTED PRIOR TO THIS SURVEY. Residents Affected - Some Based on interview, review of employee personnel files, review of employee handbook and review of abuse policy revealed the facility did not ensure residents were free from potential neglect when staff were sleeping while on duty. This had the potential on 08/05/24 to affect 16 Residents: #1, #4, #9, #10, #13, #18, #20, #22, #28, #29, #36, #44, #58, #76, #85, and #99 when Licensed Practical Nurse (LPN) #608 was assigned to on the south hall was found sleeping. This also had the potential on 09/04/24 to affect 22 Residents: #1, #4, #9, #10, #13, #18, #20, #22, #28, #29, #36, #42, #44, #58, #66, #71, #76, #85, #90, #99, #106, and #107 when LPNs #604 and #613 were assigned to on the south hall were found sleeping. The facility census was 105. Findings included: 1. Review of personnel file for LPN #608 revealed a hire date of 07/02/24 and she received new hire orientation on 07/02/24 which included the handbook regarding the following actions by an employee would be considered gross misconduct and would result in immediate termination that included sleeping while on duty. Review of Daily Schedule for 08/05/24 revealed LPN #608 was assigned to the south hall from 7:00 P.M. to 7:30 A.M. She was assigned the following 16 Residents: #1, #4, #9, #10, #13, #18, #20, #22, #28, #29, #36, #44, #58, #76, #85, and #99. Review of witness statement dated 08/06/24 and completed by LPN #610 revealed she went to lunch and when she came back LPN #608 was sleeping. She revealed she was intentionally noisy, and LPN #608 awoke. Review of witness statement dated 08/07/24 and completed Director of Nursing (DON) revealed she called LPN #608, and LPN #608 verified on 08/05/24 she had nodded off. Review of Termination Report dated 08/12/24 revealed LPN #608 was terminated due to sleeping while on duty. The report was signed by the Administrator, and Human Resource (HR) #614 on 08/12/24. LPN #608 did not sign the termination. Interview on 10/30/24 at 4:13 P.M. with Former Certified Nursing Assistant (CNA) #609 revealed on 08/05/24 she saw LPN #608 sleeping multiple times throughout the shift on 08/05/24. She revealed she would sleep approximately ten to twenty minutes each time as she would wake up and then dose back (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 4 Event ID: 366428 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 366428 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/31/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE O'Neill Healthcare Fairview Park 20770 Lorain Road Fairview Park, OH 44126 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)