Cleveland House

The facility failed to maintain clean and well-repaired walls, ceilings, and floors. Specifically, four shared bathrooms were not clean, one bathroom had a damaged wall, and two resident rooms were cluttered with clothing, boxes, and food. Additionally, previous inspections noted damaged walls and peeling paint in resident room 38.

The facility failed to maintain clean and well-repaired walls, ceilings, and floors. Specific issues included brown stains in several shared bathrooms, a damaged half wall with peeling paint and missing material in room 38, and cluttered resident rooms containing clothing, boxes, and food.

The facility failed to ensure contact with a resident's physician to clarify a treatment order for a cognitive-enhancing medication. Specifically, the facility did not verify whether a dose of donepezil should be continued or discontinued following a previous discontinuation note in the resident's progress notes.

The facility failed to ensure contact with a resident's physician for clarification of a treatment order. Specifically, for one resident, there were conflicting entries in the medication administration records regarding the discontinuation and administration of donepezil, and the facility did not verify the correct order with the provider.

The facility failed to ensure physician notification and follow-up for a resident with blood sugar readings outside of physician-ordered parameters. Specifically, multiple instances were identified where fingerstick blood sugar readings were below the ordered threshold, but there was no documentation that the physician was notified. This failure impacts the facility's ability to assure the routine and acute health care needs of residents.

The facility failed to maintain a heating system sufficient to keep temperatures at 75 degrees Fahrenheit. Specifically, resident rooms #12 and #13 and the dining room were found to be below the required temperature, with the dining room thermostat reading as low as 67 degrees Fahrenheit.

The facility failed to maintain a heating system sufficient to keep temperatures at 75 degrees Fahrenheit. Specifically, the dining room and resident rooms #12 and #13 were found to be below the required temperature, with the dining room thermostat reading only 67 degrees Fahrenheit. Maintenance issues included a non-functional dining room heating unit for two months and uncontrollable thermostats in resident rooms.

The facility failed to provide adequate supervision for five sampled residents related to falls. Specifically, the facility did not follow its Falls Management Program protocols regarding assessments and monitoring following fall incidents.