Canfield Healthcare Center

F 0551

Give the resident's representative the ability to exercise the resident's rights.

Level of Harm - Minimal harm or potential for actual harm

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on

record review and interview, the facility did not ensure Resident #83's guardian was permitted to consent or decline influenza and COVID immunizations. This affected one (Resident #83) of three residents reviewed for guardian's consent to treatment. The facility census was 72. Findings include:Review of the closed medical record revealed Resident #83 was admitted [DATE REDACTED] with diagnoses of ataxic cerebral palsy, epilepsy, nutritional anemia, schizophrenia, and obsessive-compulsive disorder. Review of the emergency contacts revealed co-guardians were listed as the primary contacts. Review of the Amended Letters of Co-Guardianship filed with Mahoning County Probate Court on 12/09/15 revealed Resident #83's father and Resident #83's son were appointed co-guardians of person only and not estate for an indefinite time period or until revoked. Review of the quarterly Minimum Data Set (MDS) 3.0 assessment dated [DATE REDACTED] revealed Resident #83 was cognitively intact as evidenced by a score of 15 out of 15 on the Brief Interview for Mental Status (BIMS). Resident #83 required moderate assistance for toileting hygiene, set up/clean up assistance for eating, and supervision for all other activities of daily living (ADL). Review of Resident #83's current care plan revealed the term guardian was absent from the care plan; however, the term resident representative was used throughout. Review of the undated COVID-19 Vaccination Declination Resident Form revealed it was signed by Resident #83 and not signed by a co-guardian. Review of the Influenza Vaccine Consent form dated 2/24 revealed it was signed by Resident #83 and not signed by a co-guardian.

Interview on 09/08/25 at 3:25 P.M. with the Director of Nursing (DON) confirmed she was unsure of the consent process, so she had Resident #83 sign the consent and/or declinations. The DON reported she contacted the guardian by phone first although it was not documented in the record.

Residents Affected - Few

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

Event ID:

Printed: 04/13/2026 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

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

09/17/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Canfield Healthcare Center

2958 Canfield Rd Youngstown, OH 44511

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)

F 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

1. 2. Record review revealed Resident #83 was admitted on [DATE REDACTED] with diagnoses of ataxic cerebral palsy,

epilepsy, nutritional anemia, schizophrenia, and obsessive-compulsive disorder.

Review of the Amended Letters of Co-Guardianship filed with Mahoning County Probate Court 12/09/15 revealed Resident #83's father and son were appointed co-guardians of person only for an indefinite time period or until revoked.

Review of the obituary for Resident #83 father revealed he passed away 11/27/22 thus making the son the sole guardian of person. The record was not updated to reflect Resident #83's son was the guardian and

the primary contact.

Review of the quarterly Minimum Data Set (MDS) 3.0 assessment dated [DATE REDACTED] revealed Resident #83 was cognitively intact as evidenced by a score of 15 out of 15 on the Brief Interview for Mental Status (BIMS). Resident #83 required moderate assistance for toileting hygiene, set up/clean up assistance for eating, and supervision for all other activities of daily living (ADL).

Review of progress note dated 06/19/25 at 9:08 A.M. revealed LPN #856 reported Resident #83 “looked out of it” when she went to her room. LPN #856 called Resident #83's name with no response then proceeded to do a sternal rub, still with no verbal stimuli; however, her eyes were open and blinking. Vital signs were taken. Resident #83 was assessed by the NP, and both the physician and NP ordered she be sent to the hospital for evaluation. Resident #83's family was contacted by the NP with no response. There was no other progress note entries made after 06/19/25 at 9:08 A.M.

Interview on 09/04/25 at 1:20 P.M. with LPN #856 confirmed she was the nurse that sent Resident #83 to

the hospital and the author of the 06/19/25 progress note. LPN #856 reported she attempted to contact Resident #83's son but was unsuccessful, so she then called the phone number listed for Resident #83's father which was not a valid number. No voice message was left for Resident #83's son who was the legal living guardian. LPN #856 then reported the NP “took over and called the son herself and left a voice message”. LPN #856 further reported that the father's number was called first for changes in condition, but the son was contacted when the father's number was disconnected.

Interview on 09/11/25 at 3:53 P.M. with NP #902 revealed that on 06/19/25 she attempted to contact Resident #83's father, but no one answered. She was unable to recall if she left a voice message but stated

she did not like to leave messages that may cause panic which was a habit of hers. NP #902 did advise the staff to continue to attempt to contact the family.

Review of the undated Notification of Change Policy revealed the center must inform the resident, consult with the resident's medical practitioner and/or notify the residents' representative, authorized family member or legal power of attorney/guardian when there is a change requiring such notification. Circumstances requiring notification included a transfer or discharge of the resident from the center.

This deficiency represents noncompliance investigated under Master Complaint Number 1366502 (OH00167399) and Complaint Numbers 1366501 (OH00167396) and 1366500 (OH00167393).

FORM CMS-2567 (02/99) Previous Versions Obsolete

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 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

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

09/17/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Canfield Healthcare Center

2958 Canfield Rd Youngstown, OH 44511

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)

F 0600 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on

record review, interview, observation and facility policy review, the facility failed to ensure Resident #25 were free from staff-to-resident verbal abuse. This affected one (Resident #25) or two residents reviewed for abuse. The facility census was 72. Findings include:Review of the medical record revealed Resident #25 was admitted on [DATE REDACTED] with diagnoses including schizoaffective disorder, major depressive disorder (MDD), anxiety, hypertension, and the need for assistance with personal care. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE REDACTED] revealed Resident #25 had impaired cognition. She required set up assistance with eating, substantial assistance with oral hygiene, toileting hygiene, dressing, personal hygiene and bed mobility. Resident #25 was dependent on staff for showers. Review of the care plan dated 07/31/25 revealed Resident #25 had impaired cognition related to intellectual disability and cognitive communication deficit. Interventions included staff were to administer all medications, keep routine as consistent as possible in order to decrease confusion, and staff to provide visible clocks, a calendar, low-glare, consistent care routines, familiar objects, and reduced sensory noise as much as possible. Observation on 08/28/25 at 9:45 A.M. revealed Certified Nursing Assistant (CNA) #816 was verbally abusive to Resident #25 when she yelled loudly and aggressively at Resident #25 and stated, Stop crying, or I will shut your door. There were no other residents in the room or hallway. Resident #25 was crying but could barely be heard. Review of the progress notes dated 08/28/25 revealed there were no progress notes related to the incident of witnessed verbal abuse that occurred on 08/25/25. Interview on 08/28/25 at 9:46 A.M. with CNA #816 revealed when the Surveyor asked why she was speaking to the resident in that tone and manner, CNA #816 stated because she needs to shut up and stop crying, she was upsetting other residents, and it needs to stop. On 08/28/25 at 9:47 A.M. incident of verbal abuse was reported to the Administrator and the Regional Director of Clinical Operations (RDCO) #869. While walking up the hall to the Administrators office, CNA #816 came down the hall and very closely approached the surveyor and asked where the [expletive] are you going then went back down to the nurses' station and waited there. On 08/28/25 at 9:49 A.M. the Administrator and RDCO #869 interviewed CNA #816, ensured Resident #25 was safe and escorted CNA #816 out of the building and began their investigation. Interview

on 09/08/25 at 2:00 P.M. with Resident #25 revealed she was scared when CNA #816 yelled at her and told her she was going to shut the door. Observation on 09/04/25 at 9:58 A.M. of Resident #25 revealed she was sitting on the side of their bed crying with staff present trying to console the resident. Observation made on 09/08/25 at 1:54 P.M. of Resident #25 revealed they were resident quietly in their room with no distress noted. Review of the undated facility policy titled Ohio Abuse, Neglect, and Misappropriation revealed it was the intent of this facility to prevent the abuse, mistreatment, or neglect of residents or the misappropriation of tier property, corporal punishment and/or involuntary seclusion and to provide guidance to direct staff to manage any concerns or allegations of abuse, neglect or misappropriation of their property.

Furthermore, it is the intent of this facility to employ only properly screened persons as a part of the resident care team by the applicable requirements. This deficiency represents noncompliance investigated under Complaint Number 1366499 (OH00167390).

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 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

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

09/17/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Canfield Healthcare Center

2958 Canfield Rd Youngstown, OH 44511

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)

F 0657 Level of Harm - Minimal harm or potential for actual harm

facility would review care plans quarterly and/or with significant changes in care. Attendees would sign and date the care plan meeting agendas/documents. This deficiency represents noncompliance investigated under Complaint Number 1366500 (OH00167393).

Residents Affected - Some

FORM CMS-2567 (02/99) Previous Versions Obsolete

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 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

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

09/17/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Canfield Healthcare Center

2958 Canfield Rd Youngstown, OH 44511

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)

F 0677

Provide care and assistance to perform activities of daily living for any resident who is unable.

Level of Harm - Minimal harm or potential for actual harm

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on

record review, staff interview, review of the shower audit tool and facility policy review, the facility failed to ensure Resident #6 received showers as scheduled. This affected one (Resident #6) of one resident reviewed for activities of daily living (ADL). The facility census was 72. Findings include:Record review revealed Resident #6 was admitted on [DATE REDACTED] with diagnoses of immobility syndrome, severe protein-calorie malnutrition, and extended spectrum beta lactamase (ESBL) resistance. Review of the quarterly Minimum Data Set (MDS) 3.0 assessment dated [DATE REDACTED] revealed Resident #6 was dependent on staff for toileting hygiene, showers, dressing, and transfers. Resident #6 was cognitively intact. Review of Resident #6's current care plan revealed Resident #6 had an ADL self-care performance deficit and required the staff to do all of the effort or have two or more staff to assist. Interview on 08/25/25 at 11:08 A.M. with Resident #6 revealed she was not bathed regularly and at times went one to two weeks without a shower or bed bath. Review of Resident #6's progress notes from June to September 2025 revealed on Thursday 08/28/25 it was noted Resident #6 refused a shower but requested a bed bath be given the following day. There was no documented evidence Resident #6 ever received a shower/bed bath on 08/29/25 as requested. The progress note dated 09/03/25 at 6:28 A.M. revealed Resident #6 received a bed bath. Interview on 09/08/25 at 10:49 A.M. with Certified Nursing Assistant (CNA) #829 revealed specific room numbers were assigned for showers each day; however, there were issues getting showers completed either because there was not enough staff or some staff unwilling to shower residents. Interview

on 09/08/25 at 8:42 A.M. with Resident #6 revealed a shower was received the evening of 09/07/25 by CNA #845 which was not the assigned shower day. The shower was received on Sunday when her scheduled shower days were Wednesdays and Fridays. Interview on 09/08/25 at 10:21 A.M. with the Director of Nursing (DON) who was unable to dispute Resident #6 did not receive showers as scheduled and denied there were any staffing issues that affected residents getting showered. Interview on 09/08/25 at 10:49 A.M. with CNA #845 confirmed Resident #6 requested a shower. CNA #845 provided Resident #6 a shower because time allowed. CNA #845 denied any staffing concerns and was unable to provide an explanation as to why Resident #6 was not showered on Wednesdays and Fridays, which were the scheduled days.

Review of the Shower Audit Form updated 08/25/25 confirmed Resident #6's scheduled shower days were Wednesdays and Fridays on the night shift which was from 7:00 P.M. to 7:00 A.M. Review of the Shower Sheet and Body/Skin Infection Form for Nurse Aides revealed a bed bath/shower was completed for Resident #6 on 06/09/25, 06/15/25, 06/27/25, 07/02/25, 07/25/25 (refused), 08/27/25 (refused) and 09/02/25. No other documentation was provided to show additional showers or bed baths were given.

Review of the undated Routine Resident Care Policy stated routine daily care was provided by a CNA under the supervision of a nurse. Routine care included but was not limited to bathing, dressing, eating/hydration, and toileting. Review of the undated Perineal Care Policy stated perineal care would be planned for each individual resident to meet his/her specific needs, choice, and frequency.

Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 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

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

09/17/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Canfield Healthcare Center

2958 Canfield Rd Youngstown, OH 44511

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)

F 0679 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

the end of November 2024, the resident #83 would attend activities including nails, coffee social, birthday party, Bingo, even if she did not participate. After Christmas and spring, she started to get moodier with residents and declined to come down to activities, looked sicklier, and had declining health. Interview on 09/09/25 at 12:00 P.M. with AA #803 revealed Resident #83 was placed on one-on-one room activities due to the residents' decline in health; however, most of her one-on-one activities were sitting and chatting with

the resident. AA #803 stated no documented evidence of the one-on-one activities existed. Review of the undated facility policy titled Activities Program revealed the facility was to provide resident centered care that meets the psychosocial, physical, and emotional needs and concerns of the residents. The activity program consists of individual and small and large group activities which are designed to meet the needs and interests of each resident and includes, at a minimum: social activities, indoor and outdoor activities, activities away from the facility, Religious programs, Creative activities, intellectual and educational activities, exercise activities, individualized activities, in-room activities, and community activities.

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 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

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

09/17/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Canfield Healthcare Center

2958 Canfield Rd Youngstown, OH 44511

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)

F 0684

hospitalizations, or death.This deficiency represents noncompliance investigated under Complaint Number 1366500 (OH00167393).

Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 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

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

09/17/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Canfield Healthcare Center

2958 Canfield Rd Youngstown, OH 44511

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)

F 0689 Level of Harm - Immediate jeopardy to resident health or safety

included in the count for the floor aides and was to keep eyes on Resident #61 at all times. Observation at

the time of the interview revealed CNA #822 was assigned to Resident #61 and was seated in a chair on

the left side of the doorway to his room. Resident #61's assigned 1:1 CNA was not included in the count for

the floor aides.

Interview on 08/27/25 at 2:07 P.M. with LPN #858 revealed she was not schedul

Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 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

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

09/17/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Canfield Healthcare Center

2958 Canfield Rd Youngstown, OH 44511

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)

Federal health inspectors cited CANFIELD HEALTHCARE CENTER in YOUNGSTOWN, OH for a deficiency under regulatory tag F-F0842 during a complaint investigation conducted on 2025-09-17.

Category: Resident Assessment and Care Planning Deficiencies

The facility was found deficient in the following area: Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Scope/Severity Level F: widespread, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 9 deficiencies cited during this inspection of CANFIELD HEALTHCARE CENTER.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-10-15.