Parma Care Center

Inspectors wroteBased on record review, interview, and facility policy review, the facility failed to ensure a resident's bowel protocol was timely implemented as ordered. This affected one Resident (#76) of three residents reviewed for bowel management. The facility census was 76.

Inspectors wroteTHE FOLLOWING DEFICIENCY REPRESENTS AN INCIDENT OF PAST NON-COMPLIANCE THAT WAS SUBSEQUENTLY CORRECTED PRIOR TO THIS SURVEY. Based on medical record review, review of a facility investigation, hospital documentation review, resident and staff interview, review of a mechanical lift manufacturer instructions document, policy review, and review of facility corrective action documentation, the facility failed to ensure residents who required staff assistance and use of a mechanical lift for transfers were safely transferred without injuries. Actual harm occurred to Resident #53 on 09/03/25 when two staff members were transferring the resident from the bed to a wheelchair; during the transfer, one of the mechanical (Hoyer) lift pad straps was not properly secured to the lift by the staff members which caused the resident to slip out of the sling and fall to the floor. [...]

Inspectors wroteBased on observation, interview, and facility policy review, the facility failed to ensure food was served at an appetizing temperature. This had the potential to affect 84 residents receiving meals from the kitchen. The facility identified one resident (#6) as receiving nothing by mouth (NPO). The facility census was 85.

Inspectors wroteBased on observation, interview, and facility policy review, the facility failed to maintain a clean and sanitary kitchen area. This had the potential to affect 84 residents receiving meals from the kitchen. The facility identified one resident (#6) as receiving nothing by mouth (NPO). The facility census was 85.

Inspectors wroteBased on observation, interview, review of pest control company invoices, and facility policy review, the facility failed to effectively manage pests in the kitchen area. This had the potential to affect 84 residents receiving meals from the kitchen. The facility identified one resident (#6) as receiving nothing by mouth (NPO). The facility census was 85.

Inspectors wroteBased on observation, interview, and policy review, the facility failed to ensure a call light was in reach for resident use to call for assistance. This affected one resident (Resident #91) of one resident sampled for call light placement. The facility census was 85.

Inspectors wroteBased on record review, observation and interviews, the facility failed to ensure that Resident #6 received oral care and was shaved per his preference. This affected one resident (#6) out of five residents reviewed for activities of daily living (ADLs). The facility census was 85.

Inspectors wroteBased on medical record review, observation, interview, and review of the facility policy, the facility failed to ensure a smoking assessment was completed for a resident who was smoking on the facility premises. This affected one (Resident #54) of one reviewed for smoking. The facility census was 85. Findings Include: Review of the medical record for Resident #54 revealed an admission date of 07/14/25. Diagnoses included but were not limited to hemarthrosis of the right knee, type two diabetes mellitus with chronic kidney disease, end stage renal disease and dependence upon renal dialysis. Further review of Resident #54's medical record revealed no documented evidence that a smoking assessment was completed to determine the resident's capabilities and deficits to determine whether or not supervision was required. [...]

Inspectors wroteBased on interview and observation, the facility failed to ensure that infection control guidelines were followed during incontinence care for Resident #6. This affected one (Resident #6) out one resident observed for incontinence care. The facility census was 85.

Inspectors wroteBased on record review, interview, and policy review the facility failed to ensure accurate documentation related to medication administration; ensure a clear and accurate reconciliation of controlled substances; ensure controlled medications were not administered without physician orders, and as needed medications were not removed from secured storage areas prior to being requested or needed by the residents. This affected seven (Residents #16, #5, #14, #40, #84, #85 and #79) of seven residents reviewed for medication administration. The facility census was 82.

Inspectors wroteBased on observation, record review, interview and policy and procedure review the facility failed to ensure staff performed hand hygiene during medication administration to Resident #40 and Resident #50 to prevent cross contamination of germs and failed to initiate isolation precautions for Resident #20 to prevent the spread of influenza. This affected two out of three residents observed during medication administration and one out of three residents reviewed for isolation precautions. The facility census was 82.

Inspectors wroteBased on observation, review of physician orders, review of the bowel movement (BM) log, review of the hospital discharge instructions, review of the medical records, review of the facility policy Bowel Management and Treatment and interviews with the Director of Nursing, Regional Nurse #625 and Certified Nurse Practitioner (CNP) #626 the facility failed to provide appropriate care and treatment of constipation for one resident (Resident #53) who had an established diagnoses of constipation and physician orders to prevent exacerbation of the constipation. This resulted in Immediate Jeopardy on 03/02/22 when Resident #53, who had not had a bowel movement for four days, was not assessed for constipation and no treatment was provided by the facility. [...]

Inspectors wroteBased on observation of Resident #04, review of the medical records for Resident #04, Review of the current, online Medscape application titled Medscape Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, review of the facility policy titled Status Change in Resident Condition Notification, dated October 2017, and interviews with the Director of Nursing (DON), Physician #900 and Licensed Practical Nurse (LPN) #574, the facility failed to provide timely care and services for the monitoring and treatment of Resident #04s' hyperglycemia with a blood glucose level greater than 500 milligrams (mg) per deciliter (dL) for 12 hours. This resulted in Immediate Jeopardy on 03/26/22 at approximately 10:51 A.M. [...]

Inspectors wroteBased on observation, interview, and review of the facility policy, the facility failed to ensure expired medications and expired medical supplies were removed from the medical supply rooms and the medication cart, after the expiration date. This had the potential to affect all 73 residents residing at the facility.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure cold foods were stored and served at proper temperatures, and failed to ensure the high temperature dish machine was consistently hitting 180 degrees Fahrenheit to properly sanitize the dishes and cookware. This had the potential to affect all residents receiving meals from the kitchen except for one resident (#226) who did not eat by mouth. The census was 73.

Inspectors wroteBased on record review and interview with the Administrator, the facility failed to provide a Facility Assessment identifying what resources would be needed to provide competent care to the residents during both day-to-day operations and emergencies. This had the potential to affect all 73 residents residing in the facility. The facility census was 73.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to implement appropriate infection control practices regarding the proper use of personal protective equipment (PPE) by all direct care staff providing care and services to residents on transmission based precautions for COVID-19 and COVID-19 quarantine precautions. This had the potential to affect all 73 residents residing in the facility. The facility also failed to ensure reusable medical equipment (glucometer) was appropriately sanitized in between residents affecting Resident #29, #51 and #324. The facility census was 73.

Inspectors wroteBased on observation, interview and record review the facility failed to ensure the high temperature dish machine was in good repair and functioning properly, and failed to ensure the kitchen's food processor used to make pureed foods was in good repair. This had the potential to affect all residents residing in the facility except for one resident (#226) who did not eat by mouth. The facility census was 73.

Inspectors wroteBased on observation, interview, record review, and review of the Employee Handbook, the facility failed to ensure activities were provided in a dignified and professional manner for 11 residents (Resident #22, #45, #19, #64, #21, #67, #04, #68, #03, #60, and #224) of 31 residents who resided in the Memory Care Unit. The facility census was 73.

Inspectors wroteBased on observation, interview and record review the facility failed to ensure pureed food was prepared to the appropriate, smooth consistency for residents requiring pureed diets. This affected three residents (Resident's #9, #19, and #30) who had a physician order for pureed diet texture. The facility census was 73.

Inspectors wroteBased on observation, interview, record review and review of facility policy, the facility failed to ensure incontinence care was provided timely for two residents (Residents #27 and #226) and failed to ensure one resident (Resident #226) was shaved. This affected two residents (Residents #27 and #226) out of three residents reviewed for care for dependent residents. The facility census was 73.

Inspectors wroteBased on observation, interview, record review and review of facility policy the facility failed to ensure one resident's (Resident #51) catheter was evaluated timely due to urine leakage around the catheter insertion site. This affected one resident (Resident #51) out of three residents reviewed for catheters. The facility census was 73.