Health inspection·September 21, 2023

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, interview, and record review the facility failed to ensure call lights were within reach. This affected three residents (#23, #26, and #283) of 84 residents. The census was 84. Residents Affected - Few Findings include: 1. Review of the medical record for Resident #23 revealed an admission date of 02/23/21. Pertinent diagnoses include diabetes mellitus type 1, sacrolitis, hydrocephalus, fibromyalgia, other vertebral disc displacement, presence of cerebral fluid drainage device and, ataxia. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed resident was dependent for toileting, hygiene, bathing, and dressing. Substantial assistance was needed for transfers between surfaces and bed mobility. Review of the care plan dated 02/24/21 revealed the resident required assistance by one staff to turn and reposition in bed every two hours and as necessary. The resident required assistance by one staff with bathing/showering. The resident required assistance by one staff with personal hygiene and oral care. The resident required assistance by two staff with sit to stand positioning to transfer. Interventions included a remind to call don't fall or ask for assistance when needed. Observation on 09/18/23 at 2:30 P.M. revealed Resident #23 was in a wheelchair next to bed facing the wall with the television on it. The call light was on the bed by pillow behind Resident #23. At the time of the observation, State Tested Nurses Assistant (STNA) #314 verified the call light was not in reach and handed it to Resident #23. 2. Review of the medical record for Resident #26 revealed an admission date of 06/01/16. Pertinent diagnoses include type II diabetes mellitus, muscle weakness, major depressive disorder, anxiety, unspecified psychosis, unspecified affective mood disorder. Pertinent orders include a hoyer lift for all transfers. A review of the Quarterly MDS assessment, section G dated 07/01/23 revealed the Need for extensive assistance for bed mobility and dependence on staff for transfers. It also revealed two or more staff for physical assistance with toileting and all other activities of daily living. (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 3 Event ID: 366431 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 366431 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avenue at Aurora 425 South Chillicothe Road Aurora, OH 44202 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)