Aristos Nursing and Rehabilitation

Inspectors wroteBased on interviews, observation, record review, review of the facility infection control tracking and trending, review of Center of Disease Control and Prevention (CDC) guidelines, QSO-24-08-NH memorandum review and review of facility policy the facility failed to ensure enhanced barrier precautions (EBP) (an infection control intervention in nursing homes designed to reduce the spread of multi-drug resistant organisms (MDROs) were utilized during high contact resident care) and did not ensure transmission-based precautions were utilized as ordered. This affected one resident (Resident #4) of two residents observed for EBP and affected one Resident (#24) of two residents observed for transmission-based precautions. The facility also failed to ensure a comprehensive infection control program was in place to timely identify infections and monitor the effectiveness of interventions. [...]

Inspectors wroteBased on interview, record review and review of facility policy, the facility failed to ensure an effective antibiotic stewardship program was in place that monitored antibiotic use including reducing the risk of adverse effects of the development of multidrug-resistant organisms (MRDO) from unnecessary or inappropriate antibiotic use and tracking of infections. This had the potential to affect all 53 residents residing at the facility. The facility census was 53.

Inspectors wroteBased on observations, interview, and review of facility policy and procedure, the facility failed to ensure a homelike environment. This had the potential to affect all residents residing in the facility. The facility census was 53.

Inspectors wroteBased on interview, record review, narcotic sheet review, and facility policy review, the facility failed to ensure controlled substances were accurately accounted for, recorded in the residents' medical records, and narcotic sheets were legible. This affected five residents (#28, #33, #34, #40, and #51) of six residents reviewed for controlled substances. The facility census was 53.

Inspectors wroteBased on record review, interview, and review of the facility policy and procedure, the facility failed to ensure timely notification of a fall to the resident's responsible party. This affected one resident (#26) of three residents (#22, #23, and #26) reviewed for notification. The facility census was 53. Findings Include: Review of the medical record for Resident #26 revealed an admission date of 06/17/25. Diagnoses included fusion of spine, intellectual disabilities, abnormalities of gait and mobility, and anxiety. Further review of Resident #26's medical record indicated the resident had a guardian. Review of the progress note dated 12/22/25 at 2:34 P.M. revealed the nurse was alerted that Resident #26 had an unwitnessed fall on 12/22/25 in the resident's room during an unassisted transfer. [...]

Inspectors wroteBased on observation, interview, review of shower sheets, review of medical record, grievance log review, and facility policy review, the facility failed to provide residents, who were dependent on staff for activities of livings (ADL's), with timely fingernail care and showers as scheduled and/or per their preference. This affected three residents (#24, #26, #44) out of five residents reviewed for ADL care. The facility identified 31 residents (#1, #3, #7, #8, #9, #10, #13, #16, #17, #19, #20, #21, #22, #23, #24, #25, #26, #27, #28, #29, #35, #36, #41, #43, #44, #46, #47, #48, #51, #52, and #53) requiring assistance with bathing and/or assistance with fingernails. The facility census was 53. Findings Include:1. [...]

Inspectors wroteBased on interview, record review and review of facility policy the facility failed to ensure resident weights were completed per orders and ordered notification occurred. This affected two residents (#4, and #23) of three residents reviewed for daily weights. The facility also failed to ensure medications were administered per physician orders. This affected one resident (#33) of four reviewed for medication administration. The facility census was 53.

Inspectors wroteBased on record review, interview, and review of the facility policy and procedure, the facility failed to ensure physician orders were in place and a care plan was developed in a timely manner for nephrostomy care. This affected one resident (#46) of three residents (#22, #26, and #46) reviewed for appointments. The facility census was 53.

Inspectors wroteBased on interview, observation, review of medical records and review of facility policy, the facility failed to ensure ongoing communication and collaboration between the facility and the outside dialysis center. This affected two residents (#4 and #32) out of two residents that received dialysis services. The facility census was 53.

Inspectors wroteBased on interview and record review the facility failed to ensure the physician had signed off orders in a timely manner. This affected one resident (#47) of three reviewed for timely physician orders. The facility census was 53.

Inspectors wroteBased on record review, interview, and facility policy review, the facility failed to ensure as-needed (PRN) medications had a designated stop date of usage. This affected one Resident (#30) of three reviewed for as needed medications. The facility census was 53.

Inspectors wroteBased on interview, observation, record review and review of facility policy, the facility failed to ensure a urine culture and sensitivity (a laboratory diagnostic procedure that detects and identifies microorganisms (bacteria or yeast) in a urine sample to diagnose a Urinary Tract Infection (UTI)) was obtained per the nurse practitioner's (NP) recommendation. This affected one Resident (#46) out of three residents reviewed for laboratory services. The facility census was 53.

Inspectors wroteBased on record review, interview, and review of the facility policy and procedure, the facility failed to ensure room changes were documented in the resident's medical record. This affected two residents (#22 and #23) of three residents reviewed for room changes. The facility census was 52.

Inspectors wroteBased on observation, record review, and staff interview, the facility failed to maintain a clean kitchen and serve food in a sanitary manner. This affected all residents except one resident (#41) who the facility identified as received nothing by mouth. The facility census was 49.

Inspectors wroteBased on record review, policy review and staff interview, the facility failed to develop and implement baseline care plans for residents. This affected four (Residents #1, #10, #32, and #57) of 22 residents reviewed for baseline care plans. The facility census was 49.

Inspectors wroteBased on observation, staff interview, and record review, the facility failed to ensure the correct servings for the pureed vegetable were provided to the residents who received a pureed diet. This affected four residents (#4, #15, #17, and #37) who the facility identified who received a pureed diet. The facility census was 49.

Inspectors wroteBased on observation, interview and record review, the facility failed to effectively implement the facility smoking policy. This affected one (Resident #12) of two residents reviewed for smoking. The facility identified 16 residents who smoke. The facility census was 49.

Inspectors wroteBased on record review and staff interviews, the facility failed to ensure a Preadmission Screening and Resident Review (PASARR) included the resident's mental health diagnosis. This affected one (Resident #46) of two residents reviewed for PASARR. The facility census was 49.

Inspectors wroteBased on record review, policy review, and interviews with staff and hospice provider, the facility failed to ensure the residents were timely assessed when new wounds were identified and failed to ensure the wounds were documented accurately in the facility's records. This affected one (Resident #1) of two residents reviewed for pressure ulcers. The facility census was 49.

Inspectors wroteBased on observation, record review, policy review, and staff interview, the facility failed to ensure there were smoking assessments of the resident's capabilities and deficits to determine whether or not supervision is required. This affected two (#15 and #46) of three residents reviewed for smoking. The facility census was 49.

Inspectors wroteBased on record review, policy review, and staff interview, the facility failed to ensure pharmacy medication regimen reviews were adequately addressed and followed through in a timely manner. This affected two residents (#13 and #45) of five residents reviewed for unnecessary medications. The facility census was 49.

Inspectors wroteBased on record review, facility policy review, and staff interview, the facility failed to ensure the residents were being monitoring for side effects while taking antidepressant medications. This affected one (#45) of five residents reviewed for unnecessary medications. The facility census was 49.

Inspectors wroteBased on record review and interview, the facility failed to ensure effective collaboration of care for a hospice resident. This affected one (Resident #1) of one resident reviewed for hospice services. The facility census was 49.

Inspectors wroteBased on observation, resident and staff interview, and record review, the facility failed to ensure a clean and sanitary environment and the walls received timely repairs. This affected two (#42, and #45) of 28 residents reviewed for physical environment. The facility census was 49.

Inspectors wroteTHE FOLLOWING DEFICIENCY REPRESENTS AN INCIDENT OF PAST NON-COMPLIANCE THAT WAS SUBSEQUENTLY CORRECTED PRIOR TO THIS SURVEY. Based on personnel file review, staff timecard review, review of the state board of nursing license verification website, staff interview, and review of facility corrective action, the facility failed to ensure nursing staff providing care and services to residents had an active and unencumbered license to practice through the state authority. This had the potential to affect all 46 residents residing in the facility. The facility census was 46. Findings Include: Review of Registered Nurse (RN) #500's personnel file revealed a hire date of [DATE]. Further review revealed at the time of hire, RN #500 had an active valid nursing license from the Ohio Board of Nursing (OBN). [...]

Inspectors wroteBased on observation, staff interview, and medical record review, the facility failed to notify Resident #100's emergency contact of a significant change in condition. This affected one of three residents reviewed. The facility census was 43.

Inspectors wroteBased on observation and interviews, the facility failed to serve hot and palatable foods. This had the potential to affect all residents, except two (Residents #13 and #35) identified as receiving no food by mouth (NPO). The facility census was 54.

Inspectors wroteBased on staff interview, resident interview, meal schedule review, and menu review the facility failed to provide a substantial snack when 16 hours elapsed between the evening meal and breakfast. This had the potential to affect 43 out of 50 residents that received meals from the kitchen. Nine (Residents #21, #33, #44, #46, #100, #101, #102, #104 and #105) who participated in intense therapy located on the substance abuse (GATE) unit received snacks regularly. Two (Residents #13 and #35) were identified as receiving no food by mouth (NPO). The facility census was 54.

Inspectors wroteBased on observation, record review, and interview the facility failed to ensure call lights were within reach and accessible for Residents #6 and #19. This affected two (Residents #6 and #19) of 54 residents reviewed for call light placement. The facility census was 54.

Inspectors wroteBased on record review and interview the faciliy failed to be administered in a manner which allowed each resident to maintain their highest level of physical, mental, and psychosocial well-being and to prevent the use of illegal substances/drugs on facility grounds. This had the potential to affect all 54 residents residing in the facility including Residents #49, #303, #29, #37, and #300. Findings Include: 1. On 08/25/19 at 10:30 A.M. interview with Resident #49 revealed she had been a resident in the facility for a few months. During the interview, Resident #49 shared one resident in the facility, Resident #40, had repeatedly offered to supply drugs to the other residents while she had resided here. The resident stated she had told administration about this but no one had done anything to stop it. [...]

Inspectors wroteBased on medical record review and staff interview the facility failed to initiate care plans with resident centered interventions in a timely manner after identifying resident concerns. This affected 10 residents (Resident #49, #29, #33, #251, #30, #38, #19, #32, #1, and #37) of 54 residents reviewed for care plans. Findings Include: 1. Record review revealed Resident #49 was admitted to the facility on [DATE] with diagnoses including alcohol dependence, nicotine dependence, chronic obstructive pulmonary disease (COPD), heart disease, bipolar disorder, and high blood pressure. The smoking care plan for Resident #49 was initiated on 08/23/19. 2. Record review revealed Resident #29 was admitted to the facility on [DATE] with diagnoses including schizoaffective disorder, diabetes, heart disease, major depression, nicotine dependence, COPD, substance dependence, and high blood pressure. [...]

Inspectors wroteBased on interview and record review the facility failed to develop or revise care plans for Residents #29 for activities of daily living, Residents #5 and #19 for dementia care, Resident #43 for dialysis and positioning, and Resident #10 for edema. This finding affected one (Resident #29) of two residents reviewed for activities of daily living, two (Residents #5 and #19) of five residents reviewed for unnecessary medications, one (Resident #10) of one resident reviewed for edema, and one resident (Resident #43) of one resident reviewed for dialysis and positioning. Findings Include: 1. Record review revealed Resident #19 was admitted to the facility on [DATE] with diagnoses including vascular dementia with behavioral disturbance, dysphagia following cerebral infarction and personal history of self-harm. [...]

Inspectors wroteBased on observation, record review, and interview, the facility failed to maintain dignity at all times for Resident #10, #15, and #29. This affected three residents (#10, #15 and #29) of three reviewed for dignity. The facility census was 54.

Inspectors wroteBased on record review and interview the facility failed to ensure Residents #40, #300 and #303's advance directives were available in the paper chart and/or in the electronic charting system. This affected three of five residents reviewed for advance directives.

Inspectors wroteBased on observation, record review and interview, the facility failed to timely notify hospice of Resident #9's skin concerns. This finding affected one (Resident #9) of two residents observed for pressure ulcers.

Inspectors wroteBased on record review and interview, the facility failed to ensure Resident #31's narcotic medications were not misappropriated. This finding affected one (Resident #31) of three residents reviewed for misappropriation.

Inspectors wrote2. Record review revealed Resident #5 was admitted to the facility on [DATE] with diagnoses including Alzheimer's disease with early onset, unspecified dementia without behavioral disturbance, anxiety disorder. Review of the quarterly MDS 3.0 dated 06/05/19 comprehensive assessment revealed Resident #5 exhibited severe cognitive impairment. Review of Resident #5's medication orders revealed physician's order dated 02/07/19 for aripiprozole 2 mg once a day for schizophrenia, bipolar disorder and depression and a physician's order dated 05/24/19 for Cymbalta capsule delayed release 60 mg once a day for depression. Review of Resident #5's assessments revealed AIMS assessments were not completed by the facility. Interview on 08/29/19 at 8:55 A.M. [...]

Inspectors wroteBased on observation, record review, and interview, the facility failed to provide care and services in the areas of dressing and personal hygiene for Resident #10, #15, and #29. This affected three residents (#10, #15 and #29) of three reviewed for care and services. The facility census was 54.

Inspectors wroteBased on record review and interview the facility failed to ensure Resident #43 was assessed and monitored for complications before and after hemodialysis treatments. This affected one (Resident #43) of one resident reviewed for hemodialysis.

Inspectors wroteBased on medical record review and staff interview the facility failed to ensure documentation was entered into resident records regarding the care provided by the facility. This affected two residents (Resident #49 and #37) of 34 residents reviewed for documentation. The facility census was 54. Findings Include: 1. Record review revealed Resident #49 was admitted to the facility on [DATE] with diagnoses including alcohol dependence, nicotine dependence, chronic obstructive pulmonary disease (COPD), heart disease, bipolar disorder, and high blood pressure. Review of the Minimum Data Set (MDS) 3.0 comprehensive quarterly assessment dated [DATE] revealed Resident #49 was cognitively intact, demonstrated no adverse behaviors, and was participating in therapy services. [...]

Inspectors wroteBased on observation and interview, the facility failed to provide an adequate supply of towels for resident care. This affected all 54 of 54 residents residing in the facility.