Health inspection·September 5, 2023

F 0557 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, observations, and interview the facility failed to allow residents to have personal items in their rooms. This affected one (Resident #65) of three residents reviewed for access to personal items. The census was 65. Findings included: Review of the medical record for Resident #65 revealed an admission date of 03/30/22. Diagnoses included multiple sclerosis (MS), Alzheimer's disease, and dementia. Review of the comprehensive Minimum Data Set (MDS) assessment, dated 07/19/23, revealed Resident #65 had intact cognition. Review of plans of care care dated 01/17/23 revealed Resident #65 had behaviors of including calling emergency services and daughter several times a day. No behaviors were documented related to threatening staff, recording staff or other residents. Review of the nurse progress notes for the past three months revealed no entries regarding Resident #65 having unsafe behaviors. Interview on 08/31/23 at 7:49 A.M. with Resident #65 revealed she had MS and it was difficult to use her hands. Resident #65 stated her daughter gave her an Echo Show (a physical device that is used to interact with [NAME] [artificial intelligence service] to listen to music, watch movies and speak to family through facetime. Resident #65 stated the device did not have the capability to video record staff or other residents. Interview on 08/31/23 at 1:39 P.M. with the daughter of Resident #65 revealed the Echo Show device did not have the capability to video record and the device was used to listen to music, watch movies and call family. Resident #65 had a behavior of calling emergency services; however, the device was disabled to prevent Resident #65 from calling emergency medical services. The intent of the Echo Show device was not for recording purposes. The daughter stated the facility removed the Echo Show device from Resident #65's room in July 2023. Interview on 08/31/23 at 1:48 P.M. with the Administrator revealed Resident #65's Echo Show device was taken away to prevent video recording of staff and residents in the facility. The Administrator stated the facility policy stated any recording device must be secured/mounted to a wall to protect staff and residents. The Administrator confirmed they had no knowledge Resident #65 was using the device to record staff or residents. The Administrator indicated the family did not bring in the device so they could monitor Resident #65. The Administrator stated she had limited knowledge of the Page 1 of 4 366488 366488 09/05/2023 Avenue at Lyndhurst 5442 Rae Road Lyndhurst, OH 44124

F 0557 Level of Harm - Minimal harm or potential for actual harm capabilities of the Echo Show device but staff told her the daughter told staff she was recording them at times. The Administrator spoke with the facility legal team who told her to remove the device. Observations on 08/31/23 at 2:35 P.M. confirmed Resident #65's Echo Show device was in the administrator office. Residents Affected - Few Follow up interview and observation of the Echo Show with the Administrator on 08/31/23 at 2:40 P.M. revealed the applications included a streaming feature to view movies and ability to listen to music, make phone calls, and video chat. There were no applications that would allow the device to video record. The Administrator verified the applications and indicated the Echo Show would remain in her office until someone told her differently. This deficiency represents non-compliance investigated under Complaint Number OH00145775. 366488 Page 2 of 4 366488 09/05/2023 Avenue at Lyndhurst 5442 Rae Road Lyndhurst, OH 44124

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 record review, observations and interview, the facility failed to ensure call lights and resident telephones were within reach. This affected four (Residents #25, #34, #45 and #54) of 10 residents observed for call light placement. The census was 65. Residents Affected - Some Findings included: Review of the medical record for Resident #25 revealed an admission date of 08/23/23. Diagnoses included encephalopathy, unspecified, paraplegia, and dementia. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #25 had intact cognition and required extensive assistance for bed mobility. Review of the medical record for Resident #34 revealed an admission date of 07/24/23. Diagnoses included morbid obesity, altered mental status and Parkinson's disease. Review of the comprehensive MDS assessment dated [DATE] revealed Resident #34 had impaired cognition and required extensive assistance for bed mobility. Review of the medical record for Resident #45 revealed an admission date of 08/11/23. Diagnoses included hemiplegia and hemiparesis following a cerebral infarction affecting the left side of body, and chronic kidney disease. Review of the comprehensive MDS assessment dated [DATE], revealed Resident #45 had impaired cognition and required extensive assistance for bed mobility. Review of the medical record for Resident #54 revealed an admission date of 03/06/23. Diagnoses included hemiplegia affecting right dominant side and schizoaffective disorder, bi-polar type. Review of the quarterly MDS assessment dated [DATE], revealed Resident #54 had impaired cognition and required extensive assistance for bed mobility. Observation on 08/31/23 at 8:03 A.M. revealed Resident #34 lying in bed, the call light was located under the bed on the floor. Interview immediately after the observation with Licensed Practical Nurse (LPN) #200 verified the observation and LPN #200 placed the call light within Resident #34's reach. Observation on 08/31/23 at 8:08 A.M. revealed Resident #54 sitting in a Broda chair alongside her bed; the call light was located on the floor approximately four feet behind the resident. Interview immediately after observations with State Tested Nurse Assistant (STNA) #202 verified the observation and STNA #202 placed the call light within reach of Resident #54. Observation on 08/31/23 at 9:55 A.M. revealed Resident #25 lying in bed, the call light cord and the remote to operate the bed were tangled up together and lying over the edge of the mattress, out of reach of Resident #25. Interview immediately after the observation with the Assistant Director of Nursing (ADON) verified the observations. The ADON untangled the cords and placed the call light and bed remote control within Resident 25's reach. Observation on 09/05/23 at 11:21 A.M. revealed Resident #45 lying in bed with her body shifted to the left side of the bed. Resident #45's phone was ringing. Resident #45 could not answer the phone because the phone was located on the dresser next to the bed, approximately four feet from Resident #45. Resident #45 said she could not reach the phone. Interview immediately after observation with 366488 Page 3 of 4 366488 09/05/2023 Avenue at Lyndhurst 5442 Rae Road Lyndhurst, OH 44124

F 0558 LPN #204 verified the observation. Level of Harm - Minimal harm or potential for actual harm This deficiency represents non-compliance investigated under Complaint Number OH00145775. Residents Affected - Some 366488 Page 4 of 4