Ayden Healthcare of Piqua

Inspectors wroteBased on observations, staff interview, and review of the facility policy, the facility failed to ensure food was stored and prepared in a sanitary manner. This had the potential to affect all of the residents residing in the facility with the exception of one facility-identified resident (#79) who had a diet order for nothing by mouth. The facility census was 76 residents.

Inspectors wroteBased on medical record review, staff interview, and review of the facility policy, the facility failed to ensure members of the Interdisciplinary Team (IDT) were present at care conferences and failed to conduct care conferences as required. This affected five (Residents 16, #24, #28, #38, and #70) of five residents reviewed for care conferences. The facility census was 76 residents.

Inspectors wroteBased on medical record review, observation, staff interview, and review of the Long-Term Care Facility Resident Assessment Instrument (RAI) 3.0 User's Manual, the facility failed to ensure accurate coding of a Minimum Data Set (MDS) assessment. This affected one (Resident #54) of two residents reviewed for dental/oral status. The facility census was 76 residents.

Inspectors wroteBased on medical record review and staff interview, the facility failed to ensure a resident Preadmission Screening and Resident Review (PASARR) evaluations were accurate and updated. This affected one (Resident #2) of the two residents reviewed for PASARR evaluations. The facility census was 76 residents.

Inspectors wroteBased on medical record review, observation, staff interview, and review of the facility policy, the facility failed to develop accurate person-centered comprehensive care plans. This affected one (Resident #54) of two residents reviewed for dental/oral status. The facility census was 76 residents.

Inspectors wroteBased on medical record review, observation, resident interview, staff interview, and review of the facility policy, the facility failed to provide cares/services to dependent residents to maintain adequate personal hygiene. This affected one (Resident #6) of the three residents reviewed for activities of daily living (ADLs). The facility census was 76 residents.

Inspectors wroteBased on medical record review and staff interview, the facility failed to schedule timely ophthalmology appointments for residents. This affected one (Resident #28) of 21 residents sampled. The facility census was 76 residents.

Inspectors wroteBased on medical record review, staff interview, review of the facility policy, and review of online resources per the Centers for Disease Control and Prevention (CDC), the facility failed to administer antibiotic medications with appropriate indication for use. This affected one (Resident #13) of seven residents reviewed for medications. The facility census was 76 residents.

Inspectors wroteBased on medical record review, observation, staff interview, and review of manufacturer guidelines, the facility failed to ensure staff primed insulin pen devices prior to insulin administration resulting in significant medication errors. This affected one (Resident #46) of the three residents observed for medication administration. The facility census was 76 residents.

Inspectors wroteBased on medical record review, observation, staff interview and review of the facility policy, the facility failed to ensure medications were stored properly. This affected one (Resident #37) of the five residents observed for medication storage. The facility census was 76 residents.

Inspectors wroteBased on medical record review, observation, resident representative interview, staff interview, and review of the facility policy, the facility failed to provide routine dental services. This affected one (Resident #54) of two residents reviewed for dental services. The facility census was 76 residents.

Inspectors wroteBased on record review, staff interview, observation, review of online resources from Centers for Disease Control and Prevention (CDC), and review of facility policy, the facility failed to provide adequate infection control techniques during a resident's dressing change. This affected one (#20) resident of the three residents reviewed for infection control. The facility also failed to ensure staff properly discarded personal protective equipment (PPE) after completing a resident's dressing change who was in Enhanced Based Precautions (EBP). This had the potential to affect the 19 other residents (#01, #02, #03, #04, #05, #06, #07, #08, #09, #10, #11, #12, #13, #14, #15, #16, #17, #18, and #19) housed on the 100-hall who the facility identified as not being in EBP. The facility census was 80.

Inspectors wroteBased on medical records, observation, staff interviews, review of employee training records, review of employee personnel files, review of manufacturer guidelines for a sit-to-stand lift, and review of facility policy, the facility failed to safely transfer a resident using a sit-to-stand lift. This affected one (#30) resident of the three residents reviewed for transfers. The facility identified three residents were dependent on staff for transfers. The facility census was 80.

Inspectors wroteBased on medical record review, resident interview, review of the Certification and Licensure System (CALS), staff interview and review of facility policy, the facility failed to report an allegation of inappropriate staff touching as potential resident abuse to the Ohio Department of Health (ODH). This affected one resident (#38) of three residents reviewed for abuse. The facility census was 83.

Inspectors wroteBased on resident interview, review of the Certification and Licensure System (CALS), medical record review, staff interview, and review of facility policy, the facility failed to investigate an allegation of inappropriate staff touching as potential resident abuse. This affected one resident (#38) of three residents reviewed for abuse. The facility census was 83.

Inspectors wroteBased on medical record review, staff interview, and facility policy review, the facility failed to have physician visits and nurse practitioner visits notes signed in a timely manner. This affected three (#06, #34, and #60) of three residents reviewed for provider visits. The facility census was 84.

Inspectors wroteBased on record review, observations, staff interviews and review of Centers for Disease Control and Prevention (CDC) guidelines, the facility failed to ensure staff followed proper infection control procedures during incontinence care. This affected one (#16) out of three residents review for infection control. The facility census was 82.

Inspectors wroteBased on review of facility infection control records, observations, staff interviews, review of electronic mail (e-mail) correspondence, review of facility policies and procedures, review of the Center for Disease Control and Prevention CDC) guidance, and review of Ohio Department of Health's (ODH) guidance for reporting infectious diseases, the facility failed to develop and implement effective infection control policies and practices which includes a failure to ensure cleaning schedules for ice buckets were developed/implemented, failure to ensure storage areas were maintained in a sanitary manner to potentially prevent rodent/animal contamination, failure to ensure the handwashing sink in the kitchen was appropriately functioning, failure to develop written policies and procedures which included when and to who potentially communicable diseases should be reported, and failure to [...]

Inspectors wroteBased on medical record review, staff and resident interviews, and policy review, the facility failed to notify residents of room changes. This affected two (#35 and #49) out of the three residents reviewed for room changes. The facility census was 71.

Inspectors wroteBased on medical record review, staff interviews, review of the facility Self-Reported Incidents (SRI), and policy review, the facility failed to ensure residents were free from resident-to-resident sexual abuse. This affected two (#11 and #62) out of the three residents reviewed for abuse. The facility census was 71.

Inspectors wroteBased on medical record review, observations, and staff interviews, the facility failed to provide adequate behavioral supervision for Resident #35, in accordance with the residents physician orders. This affected one (#35) out of three reviewed for sexual behaviors. The facility census was 71.

Inspectors wroteBased on medical record review, physician and staff interviews, review of the facility policies and information from the National Pressure Ulcer Advisory Panel, the facility failed to accurately and timely assess a resident's nutritional status with decreased meal intakes, abnormal laboratory values, and two new in-house acquired unstageable pressure ulcers (slough and/or eschar: Known but not stageable due to coverage of wound bed by slough and/or eschar). Additionally, the facility failed to provide a diet to meet the resident's estimated energy and protein needs. Actual Harm occurred to Resident #05 when the facility was providing less calories and protein than the resident's estimated energy and protein needs resulting in the resident losing 4.7 percent weight loss in one month and the two unstageable pressure ulcers deteriorating. [...]

Inspectors wroteBased on medical record review, resident and staff interview, self-reported incident review, and review of a facility policy, the facility failed to report all allegations of abuse to the administrator and other officials in a timely manner. This affected two (#3 and #4) of six residents reviewed for abuse. The census was 75.

Inspectors wroteBased on medical record review and resident and staff interview, the facility failed to ensure Administration administered the facility in a manner to maintain the highest psychosocial well-being of the residents. This affected three (#2, #4, and #5) of six residents reviewed for psychosocial well-being. The census was 75.

Inspectors wroteBased on medical record review, observations, staff interview, and review of facility policy, the facility failed to provide routine oral care to a dependent resident who received tube feedings. This resulted in actual harm when Resident #27, who was dependent on staff for all aspects of care, displayed multiple areas of the lower gums that were observed to be bleeding and swollen with areas of dark brown holes on the teeth extending halfway up the teeth. Resident #27's teeth were observed to have significant yellow and gray build up on both the upper and lower natural teeth, that were yellowish gray in color. Resident #27's tongue was observed to be dry and pale pink in color. Resident #27's both upper and lower lips were discolored (a deep maroon color) with dry flaky skin. This affected one (#27) of one resident reviewed for gastronomy tube management. [...]

Inspectors wroteBased on observations, staff interviews, and review of Centers for Disease Control and Prevention (CDC) guidance, the facility failed to follow infection control standards to prevent the spread of COVID-19, by not having staff wear appropriate personal protective equipment (PPE). This had the ability to affect all the residents of the facility. The census was 72.

Inspectors wroteBased on observation and staff interview, the facility failed to ensure walk in freezer was sanitary and free of water leaking onto stored food and drinks. This had the potential to affect 67 of 72 residents residing in the facility who receive their meals from the kitchen. The facility identified five (#19, #65, #27, #34 and #26) residents who receive no food from the kitchen. The facility census was 72.

Inspectors wroteBased on record review and staff interview, the facility failed to ensure the medical record contained the advanced directive information. This affected one (#319) of one resident reviewed for advanced directives. The facility census was 72.

Inspectors wroteBased on record review and staff interview, and review of the Centers for Medicare and Medicaid Services (CMS) website, the facility failed to issue an Advanced Beneficiary Notice (ABN) as required. This affected two (#15 and #11) of three residents reviewed. The facility census was 72.

Inspectors wroteBased on medical record review and staff interview, the facility failed to issue bed hold notification to a resident. This affected one (#34) of seven reviewed for hospitalization. The census was 72.

Inspectors wroteBased on medical record review, resident and staff interviews, and review of policy, then facility failed to assess and monitor a resident's bruising. This affected one (#30) of four residents reviewed for non-pressure related skin concerns. The census was 72.

Inspectors wroteBased on medical record review, observation, and staff interview, the facility failed to ensure a palm protector was applied as ordered. This affected one (#27) of three residents reviewed for limited range of motion and supportive devices. The facility census was 72.

Inspectors wroteBased on observations, medical record reviews, resident and staff interviews, and review of facility policies, the facility failed to ensure medications were securely stored. This affected two (#39 and #72) of two resident reviewed for medications. The facility census was 72.

Inspectors wroteBased on record review, observation and physician, dietitian and staff interviews, the facility failed to assess a resident for personal food preferences and provide a diet to meet the nutritional needs. This affected one (#319) of one resident reviewed reviewed for nutrition. The facility census was 72.

Inspectors wroteBased on medical record review, observation and Nurse Practitioner and staff interviews, the facility failed to maintain accurate medical records. This affected one resident (#29) of 79 residents records reviewed during the annual recertification. The facility census was 72.

Inspectors wroteBased on medical record review, staff interview, review of Self-Reported Incidents (SRI), and review of the facility policy, the facility failed to follow and implement the facility's abuse policy to ensure residents were protected from potential sexual abuse from other residents. This affected two (Resident #13 and Resident #20) of three residents reviewed for abuse. The facility census was 59.

Inspectors wroteBased on medical record review, staff interview, review of Self-Reported Incidents (SRI), and review of the facility policy, the facility failed to report incidents of potential resident to resident sexual abuse. This affected two (Resident #13 and Resident #20) of three residents reviewed for abuse. The facility census was 59.

Inspectors wroteBased on medical record review, staff interview, review of Self-Reported Incidents (SRI), and review of the facility policy, the facility failed to investigate incidents of potential resident to resident sexual abuse. This affected two (Resident #13 and Resident #20) of three residents reviewed for abuse. The facility census was 59.

Inspectors wroteBased on medical record review and staff interview, the facility failed to ensure resident's Minimum Data Set (MDS) assessments were accurately coded. This affected three (Resident #6, #24, and #51) of fifteen residents reviewed for MDS accuracy. The facility census was 59.

Inspectors wroteBased on medical record reviews, staff interview, and review of a facility policy, the facility failed to ensure timely treatment of a resident's urinary tract infection. This affected one (Resident #35) of two residents reviewed for urinary tract infections. The facility census was 59.

Inspectors wroteBased on medical record review, staff interviews, and review of a facility policy, the facility failed to ensure timely physician response to pharmacy recommendations. This affected two (Resident #6 and #5) of five residents reviewed for unnecessary medications. The facility census was 59.