Aperion Care Hanover

Inspectors wroteBased on record review, observation, and interview, the facility failed to implement fall interventions for 3 of 4 residents reviewed for Implementation of Care Plans. (Residents 6, 12, and 20)

Inspectors wroteBased on record review and interview, the facility failed to follow physician's orders related to hold parameters for medications and follow manufacturer's guidelines for administering insulin for 3 of 21 residents reviewed for Quality of Care. (Residents 20, 14, and 67)

Inspectors wroteBased on observation and interview, the facility failed to store medications appropriately for 3 of 4 Medication Carts and 1 of 2 Medication Rooms reviewed. (Wing 4, Wing 3/Cart 3, Wing 2/Cart 1, and Wing 3 Medication Room).

Inspectors wroteBased on observation, interview, and record review, the facility failed to assess a resident for self-administering medications for 1 of 18 residents observed for medications left at the bedside. (Resident 8)

Inspectors wroteBased on interview and record review, the facility failed to notify the Ombudsman of residents that were discharged from the facility for 3 of 3 discharged residents' records reviewed. (Residents 81, 79, and 3)

Inspectors wroteBased on record review, observation, and interview, the facility failed to identify a Deep Tissue Pressure Injury in a timely manner for 1 of 2 residents reviewed for pressure ulcers. (Resident 67)

Inspectors wroteBased on observation, interview, and record review, the facility failed to verify physician orders and accurately transcribe physician orders for 2 of 21 residents reviewed for pharmacy services. (Resident 21 and 14)

Inspectors wroteBased on record review and interview, the facility failed to follow pharmacy recommendations related to completing an Abnormal Involuntary Movement Scale (AIMS) assessment for a resident receiving an antipsychotic medication for 1 of 5 residents reviewed for unnecessary medications. (Resident 4)

Inspectors wroteBased on record review and interview, the facility failed to document a resident's medication administration for 1 of 21 residents record reviewed. (Resident 14)

Inspectors wroteBased on interview, observation, and record review, the facility failed to provide person centered activities that meet the resident's interests and supported the physical, mental, and psychosocial well-being of a resident for 1 of 3 residents reviewed for activities. (Resident B).

Inspectors wroteBased on interview and record review, the facility failed to ensure a resident's whole emotional and mental well-being was closely monitored during a followed accelerated behavior to support and prevent further behaviors for 1 of 3 residents reviewed for behavior health services. (Resident D)

Inspectors wroteBased on interview and observation, the facility failed to provide a safe and homelike environment for 2 of 4 residents reviewed. (Residents C and E)

Inspectors wroteBased on record review, and interview the facility failed to document medications being administered for 1 of 4 residents reviewed. (Resident D)

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a resident was treated with respect and dignity for 1 of 4 residents reviewed. (Resident B)

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure an effective pest control was in place for residents' bathrooms and bedrooms related to gnats or drain flies. This deficient practice had the potential to affect 70 of 70 residents that resided in the facility.

Inspectors wroteBased on observation and interview, the facility failed to have the State survey results available to view for 2 of 6 days during the survey.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a clean and safe environment related to a dirty shower room and safe walkways for 2 of 4 facility areas reviewed. (Wing 2 and the outside courtyard)

Inspectors wroteBased on observation and interview, the facility failed to store medications appropriately for 1 of 2 medication storage rooms (Wing 2 Medication Storage Room) and 3 of 4 medication carts observed (Wing 2 Medication Cart and Wing 3 Medication Carts).

Inspectors wroteBased on observation and interview, the facility failed to follow appropriate guidelines related to the use of hairnets in the kitchen for 3 of 3 kitchen observations. (Dietary Manager, Cooks 4 and 5, and the Corporate Dietary Consultant)

Inspectors wroteBased on record review and interview, the facility failed to administer prescribed medications related to insulin administration for 1 of 19 residents reviewed for Quality of Care. (Resident 12)

Inspectors wroteBased on record review and interview, the facility failed to monitor meal consumption's and have supplements available for 1 of 3 residents reviewed for nutrition. (Resident 43)

Inspectors wroteBased on record review and interview, the facility failed to ensure a medication was available for 1 of 19 residents reviewed for pharmacy services. (Resident 56)

Inspectors wrote3. The clinical record for Resident 4 was reviewed on 03/26/25 at 3:08 P.M. An Annual MDS assessment, dated 03/06/25, indicated the resident was moderately cognitively impaired. The resident's diagnoses included, but were not limited to, Parkinson's disease, hypertension, diabetes, dementia, anxiety, and psychotic disorder. The pharmacist reviewed the resident's medications monthly and made the following recommendations: - A Consultant Pharmacist Recommendation to Prescriber, dated 12/20/24, indicated the resident currently received Mirtazapine (antianxiety) 15 mg every night, Sertraline (antidepressant) 50 mg every night, and Trazadone (antidepressant) 50 mg every night. A trial dose reduction was recommended. There was no indication the physician or prescriber responded to the pharmacist's recommendation. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to follow infection control guidelines related to enhanced barrier precautions for 3 of 3 wound care observations. (Residents 75, 4, and 31)

Inspectors wroteBased on interview and record review, the facility failed to ensure care planned interventions were updated related to a resident's behaviors for 1 of 3 residents reviewed for care plan revision. (Resident C)

Inspectors wroteBased on record review and interview, the facility failed to ensure a resident who displayed psychosocial adjustment difficulties and a history of trauma received appropriate treatment to attain the highest practicable mental well-being for 1 of 3 residents reviewed for psychosocial services.(Resident C)

Inspectors wroteBased on interview and record review, the facility failed to thoroughly investigate 1 of 1 abuse allegations reviewed. (Resident B)

Inspectors wroteBased on interview, record review, and observation, the facility failed to ensure a resident's rights were honored related to their personal possessions for 1 of 3 residents reviewed for resident rights. (Resident E)

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure an effective pest control program was maintained and the facility was free of rodents. This deficient practice had the potential to affect 65 of 65 residents that resided in the facility.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a clean and sanitary kitchen for 2 of 2 kitchen observation. This deficient practice had the potential to affect 63 of 65 residents that resided in the facility.

Inspectors wroteBased on record review and interview, the facility failed to ensure all investigations and outcomes of the investigations were reported to the Indiana Department of Health (IDOH), within 5 working days of the incident, for 9 of 9 reported incidents. (Residents B, C, D, E, F, G, H, J, K, L, M, and N)

Inspectors wroteBased on observation, interview, and record review, the facility failed to administer medications and monitor and residents with behavioral health concerns for 2 of 4 residents reviewed for behavioral health. (Residents B and D)

Inspectors wroteBased on observation, interview, and record review, the facility failed to store food safely, monitor the dishwasher, and provide a clean kitchen environment for 3 of 3 kitchen observations. This deficient practice had the potential to effect 67 of 67 residents that resided in the facility.

Inspectors wroteBased on record review and interview, the facility failed to provide appropriate transfer/discharge paperwork and assessments for 4 of 4 residents reviewed for transfer/discharge. (Residents 52, E, 69, and B)

Inspectors wrote4. The clinical record for Resident E was reviewed on 01/08/24 at 10:46 A.M. An Annual MDS assessment, dated 10/21/23, indicated the resident was moderately cognitively impaired. The diagnoses included, but were not limited to, Huntington's disease, hypertension, depression, and pressure ulcers to the right foot. A Physical Therapy Wound Assessment, dated 10/12/23, indicated the resident's right foot had 3 pressure wounds on the areas of the right Achilles (heel area), dorsal (top) foot, and medial (inside) ankle. All wound beds were covered with pale pink good tissue. A Weekly Skin Condition Report for the resident's right heel, was provided by LPN 6 on 01/10/24 at 1:34 P.M. The assessments included the following: - Dated 09/29/23, the resident's Stage 2 wound measured 3.0 cm x 2.5 cm x 0.2 cm, - Dated 10/20/23, the resident's Stage 2 wound measured 1.8 cm x 2.2 cm x <0.2 cm. [...]

Inspectors wroteBased on record review and interview the facility failed to track antibiotic use for 3 of 6 residents reviewed for antibiotic stewardship. (Residents D, 6, 32, and 16)

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a resident that self-administered medications was appropriately assessed for self-administration for 1 of 6 residents reviewed for medications. (Resident 44)

Inspectors wroteBased on observation, interview, and record review, the facility failed to thoroughly investigate and have the appropriate monitoring in place for an alleged resident to resident abuse for 1 of 25 residents reviewed. (Resident 29)

Inspectors wroteBased on interview and record review, the facility failed to update a resident's plan of care related to preferences for 1 of 17 residents reviewed for care plans. (Resident 36)

Inspectors wroteBased on record review and interview, the facility failed to properly assess a resident after a fall for 1 of 6 residents reviewed for Quality of Care. (Resident 25)

Inspectors wroteBased on interview and record review, the facility failed to ensure a resident with a urinary tract infection received antibiotic treatment in a timely manner for 1 of 3 residents reviewed for Urinary Tract Infections. (Resident 6)

Inspectors wroteBased on observation and interview, the facility failed to post nurse staffing daily for 3 of 7 days observed. (1/2, 1/8, and 1/9/24)

Inspectors wroteBased on record review and interview, the facility failed to accurately reconcile a resident's medications upon readmission to the facility and to verify a diagnosis was appropriate for the administration of an antibiotic for 2 of 6 residents reviewed for pharmacy services. (Residents 6 and 32)

Inspectors wroteBased on interview and record review, the facility failed to follow pharmacy recommendations for 1 of 5 residents reviewed for medication irregularities. (Resident 6)

Inspectors wroteBased on observation and interview, the facility failed to appropriately store medications for 1 of 2 medication rooms (Unit 1 medication room) and 2 of 4 medication carts reviewed. (Wing 1 Medication Cart and Wing 2 Medication Cart)

Inspectors wroteBased on record review and interview, the facility failed to provide a COVID-19 immunization in a timely manner for 1 of 6 residents reviewed for immunizations. (Resident 64)

Inspectors wroteBased on record review, observation, and interview, the facility failed to accurately inventory residents' personal property for 2 of 15 residents reviewed for personal property. (Residents F and G)

Inspectors wroteBased on record review and interview, the facility failed to provide behavior health services for a resident's psychological needs (Resident J), and to complete ongoing monitoring for residents with behaviors (Residents C and B) for 3 of 15 residents reviewed for behavior health.

Inspectors wroteBased on interview and record review, the facility failed to ensure resident to resident abuse did not occur related to sexual abuse resulting in a severely cognitive resident and a cognitive resident found in an unsupervised sexual situation for 2 of 5 residents reviewed for abuse. (Resident C and Resident D) The immediate jeopardy began on 8/24/23, when the facility failed to prevent resident to resident sexual abuse when a cognitively alert male resident was found with a severely cognitively impaired female resident in an inappropriate sexual position. The DON, ADON, MDSC, and the consultant were notified of the immediate jeopardy on 9/22/23 at 2:55 p.m. The Immediate Jeopardy was removed on 9/27/23, but noncompliance remained at the lower scope and severity of isolated, no actual harm with potential for more than minimal harm that is not immediate jeopardy.

Inspectors wroteBased on interview and record review, the facility failed to accommodate a resident receiving familial visitors late at night for 16 of 71 residents reviewed for visitation. (Dementia Unit/Wing 1)

Inspectors wroteBased on observation, interview, and record review, the facility failed to develop and implement individualized activities programming to meet individual resident needs for 2 of 3 specialized resident units reviewed for activities. This deficient practice had the potential to affect 42 of 71 resident that reside in the facility. (Huntington's unit and the Dementia unit)

Inspectors wroteBased on record review and interview, the facility failed to have adequate supervision to prevent frequent resident falls and negative behaviors, ensure a metal unit exit door was repaired timely and secured, chemicals and hazardous supplies were secured for 1 of 3 resident units reviewed for accidents. This deficient practice had the potential to affect 26 of 71 residents who reside in the facility. (Wing 2/Huntington's Unit)

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure staffing levels were adequate related to abuse prevention, falls, dining assistance, meal timing, and call lights for 42 of 71 residents reviewed for staffing. (Wing 1 and Wing 2)

Inspectors wroteBased on interview and record review, the facility failed to ensure the appropriate temperature and palatability of food served for 1 of 3 resident wings/units served for dietary services. (Wing 2) This deficient practice had the potential to affect 14 of 26 residents that resided on the Huntington's unit.

Inspectors wroteBased on interview, record review, and observation, the facility failed to follow appropriate infection control guidelines related to droplet isolation/Covid for 10 of 35 residents reviewed for Infection Control. (Resident D, Resident G, Resident H, Resident C, Resident J, Resident K, Resident B, Resident DD, Resident EE, and Resident CC)

Inspectors wroteBased on observation and interview, the facility failed to maintain a sanitary and safe environment related to wet floors, missing privacy curtains, gouged wall with exposed wires, broken security door, flies around food, and damaged bed side tables on 1 of 3 units observed. (Wing 2)

Inspectors wroteBased on record review and interview, the facility failed to ensure interventions were effective and appropriate interventions were implemented to prevent recurrent resident aggressive/attention seeking behaviors for 1 of 4 residents reviewed for behaviors. (Resident D)