Ayden Healthcare of Belle Springs.

Inspectors wroteBased on review of the self-reported incident (SRI) investigation, review of the employee time sheets, staff interviews, and review of facility policy, the facility failed to ensure further potential abuse was prevented by removing an employee suspected of sexual abuse pending the outcome of the abuse investigation. The affected one resident (#57) of three reviewed for abuse. The facility census was 80.

Inspectors wroteBased on observation, resident interview, and staff interview, the facility failed to provide a home-like environment in regards to facility's shower rooms being in good repair. This affected two residents (#1 and #4) with the potential to affect all residents residing in the facility. The current census is 87.

Inspectors wroteBased on observations, review of cleaning schedules, staff interviews, and policy reviews, the facility failed to ensure food products were dated when opened, kitchen sanitation was being maintained, and the proper sanitizer test strips were used with the dish machine. This had the potential to affect all 77 residents who received food from the kitchen. The facility census was 77.

Inspectors wroteBased on review of medical records, staff interview, observation, and review of policies, the facility failed to ensure staff follow enhance barrier precautions (EBP). This affected one (#31) of four residents reviewed for transmission based precautions. The facility failed to ensure clean laundry was not exposed to dirty surfaces and items. This had the potential to affect all residents of the facility. The facility also failed to prepare medications in a sanitary manner. This affected one (#22) of six residents reviewed for medication administration. The facility census was 77.

Inspectors wroteBased on observation, staff interview, and policy review, the facility failed to maintain the kitchen microwave in a safe operating condition. This deficient practice had the potential to affect all 77 residents who received meals from the kitchen. The facility census was 77.

Inspectors wroteBased on observation, staff interview, review of medication package insert, review of manufacturer recommendations, and policy review, the facility failed to ensure medications and solutions were dated when opened and stored under recommended conditions. This had the potential to affect all new admissions and residents who have their blood sugars checked using the glucometer. The facility identified 10 (#5, #6, #7, #19, #21, #29, #36, #55, #60, and #73) residents who had their blood sugars checked using the glucometer. The facility census was 77.

Inspectors wroteBased on observations, staff interview, and policy review, the facility failed to ensure pureed food was an appropriate smooth texture prior to serving residents on a pureed diet. The deficient practice had the potential to affect 10 (#6, #15, #32, #34, #41, #51, #53, #54, #63, and #184) of 10 residents on a prescribed pureed diet. The facility census was 77.

Inspectors wroteBased on observations, medical record review, family interview, staff interview and policy review, the facility failed to ensure a resident's room was maintain in good repair. This affected for one (#22) of two residents reviewed for physical environment. The facility census was 77.

Inspectors wroteBased on observations, record review, and staff interview, the facility failed to ensure care planned fall interventions were implemented. This affected one (#4) of three residents reviewed for falls. The facility census was 77.

Inspectors wroteBased on observation, medical record review, staff interview, and policy review, the facility failed to implement the policy on ensure oxygen tubing was changed weekly. This affected one (#36) of three residents reviewed for respiratory care. The facility census was 77.

Inspectors wroteBased on employee file review, staff interview, and policy review, the facility failed to implement the policy to ensure employees were checked against the Ohio Nurse Aide Registry. This affected five (Certified Nursing Assistant (CNA) #178, CNA #175, Licensed Practical Nurse (LPN) #162, Registered Nurse (RN) #171, and Activities Assistant (AA) #101 of six employee files reviewed. This had the potential to affect all residents who reside in the facility. The facility census was 77.

Inspectors wroteBased on medical record review, staff and resident interviews, policy review, and review of the Centers for Disease Control (CDC) guidelines, the facility failed to conduct Coronavirus Disease 2019 (COVID-19) testing as per facility policy and CDC guidelines. This affected one (#54) resident out of the five residents reviewed for infection control. The facility census was 78.

Inspectors wroteBased on interviews, record review and policy review the facility failed to issue a bed hold letter to one resident ( #79) out of two residents reviewed for hospitalization. The census was 83. Review of medical record for Resident #79 revealed admission date of 08/30/22 with limited cognitive deficits. The resident was admitted with diagnoses cerebral vascular disease, calculus of kidney, hyperlipidemia, and heart failure. On 09/22/22 Resident #79 was having outpatient testing for an upcoming surgery. At 5:15 P.M. Resident #79 representative notified the facility Resident #79 was being admitted directly into the hospital due to passing out during a magnetic resonance imaging (MRI) test earlier in the day. Review of the billing information in Resident #79 medical record revealed a stop date for services due to discharge was on 09/22/22. [...]

Inspectors wroteBased on interviews , record reviews, and policy and procedure review, the facility failed to update one resident's elopement assessment quarterly. This had the potential to affect one Resident ( #09) out of one resident reviewed for elopement. The facility census was 83.

Inspectors wroteBased on interviews and record reviews the facility failed to update a Residents Comprehensive Care Plan . This had the potential to affect one Resident (#42) out of four residents reviewed for care plan's. The facility census was 83.

Inspectors wroteBased on medical record review, interview, and review of facility policy, the facility failed to provide documentation to support Foley catheter care was provided and Foley catheter outputs were monitored for Resident #30. This affected one (Resident #30) of one resident reviewed for urinary tract infection. The facility census was 83.

Inspectors wroteBased on record review, interview, and policy review, the facility failed to ensure medications were stopped per prescription which led to resident receiving prednisone for an extended period of time. This affected one (Resident #28) of five residents reviewed for unnecessary medications. Facility census was 83.

Inspectors wroteBased on medical record review, staff interviews, observation, review of a facility policy, and review of information from the National Pressure Ulcer Advisory Panel (NPUAP), the facility failed to ensure monitoring of a pressure ulcer was completed to ensure appropriate care and treatment was provided to prevent deterioration of a pressure ulcer. This resulted in actual harm when Resident #39's pressure ulcer was not monitored on a weekly basis and resulted in the pressure ulcer to the coccyx developing to an unstageable deep tissue injury. Consequently, Resident #39's pressure ulcer to the coccyx required wound physician intervention including debridement of the area to remove necrotic tissue and the wound was assessed as a stage IV post debridement. This affected one (#39) of one resident reviewed for pressure ulcers. [...]

Inspectors wroteBased on review of employee files and staff interview the facility failed to provide documentation of State Tested Nursing Assistants (STNA) having completed 12 hours annual in-service training. This affected two STNAs (#206 and #229) of two reviewed for annual in-service training. This had the potential to effect all 60 residents residing in the facility.

Inspectors wroteBased on medical record review, observations, staff interviews, and review of facility policy, the facility failed to ensure treatments were in place to prevent a reduction in range of motion (ROM). This affected two (Resident #3 and #7) of three residents reviewed for limited range of motion. The facility identified nine residents with contractures. The facility census was 60.

Inspectors wroteBased on medical record review and staff interview the facility failed to ensure physicians responded timely to pharmacy recommendations. This effected two (Residents #6 and #19 ) of five residents reviewed for unnecessary medications. The facility census was 60.