Ohio Living Dorothy Love

Inspectors wroteBased on review of the facilities Legionella Program Plan, staff interview and review of information from the Centers for Disease Control and Prevention (CDC), the facility failed to implement their water management program to reduce the risk of Legionella and/or other pathogens in their water system. This had the potential to affect all 43 residents residing in the facility. The facility census was 43.

Inspectors wroteBased on observations and staff interview, the facility failed to ensure a food thermometer was cleansed/disinfected between checking food temperature on multiple food items to potentially prevent cross contamination. This had the potential to affect 19 residents (#07, #15, #18, #21, #28, #90, #91, #92, #93, #94, #95, #96, #97, #98, #100, #101, #102, #103, and #104) on the Rehab Hall. The facility census was 43.

Inspectors wroteBased on medical record review, observations, staff interviews, and policy review, the facility failed to ensure a resident's fingernails were trimmed and without debris. This affected one (#20) out of two residents reviewed for activities of daily living (ADL's). The facility census was 43.

Inspectors wroteBased on record review, observation and staff interviews, the facility failed to provide a thorough assessment following a skin tear. This affected one (#94) of three residents reviewed for wound care. The facility census was 43.

Inspectors wroteBased on record review, observation, staff interview and review of the facility policy, the facility failed to timely assess a wound to determine if it was a pressure ulcer and to identify a stage of the wound. Additionally, the facility failed to properly wrap a pressure ulcer as instructed. This affected one (#97) of three residents reviewed for wound care. The facility census was 43.

Inspectors wroteBased on medical record review and staff interviews, the facility failed to ensure a transdermal patch was removed by a qualified staff member and as physician ordered. This affected one (#94) of 12 residents reviewed for medication administration. The facility census was 43.

Inspectors wroteBased on medical record review, observations, staff and resident interviews, and policy review, the facility failed to ensure food was served at an appetizing temperature. This affected one (#97) out of 12 residents review for food concerns. The facility census in the facility was 43.

Inspectors wroteBased on medical record review, observations, staff, resident and resident representative interviews, the facility failed to ensure residents were served diets as physician ordered. This affected one (#97) of two residents reviewed for dietary orders. The facility census was 43.

Inspectors wroteBased on medical record review, resident interview, staff interview, and review of facility policy, the facility failed to ensure bed hold notices were provided in writing to residents and their representatives when residents were transferred to the hospital. This affected two residents (#53 and #61) of two reviewed for hospitalization. The facility census was 81. Findings Include: 1. Review of Resident #53's medical record revealed an admission date of 05/03/22. Diagnoses included type II diabetes. Review of Resident #53's Minimum Data Set (MDS) dated [DATE] revealed a Brief Interview for Mental Status (BIMS) score of 15 indicating Resident #53 was cognitively intact. Resident #53 required extensive assistance with bed mobility, dressing and personal hygiene. Resident #53 was totally dependent on staff for transfers and toilet use. [...]

Inspectors wroteBased on observation, medical record review, resident interview, staff interview, and review of care card, the facility failed to ensure a resident identified with communication limitations, had devices and/or communication tools or techniques implemented to ensure effective resident to staff communication. Additionally, the facility failed to ensure a resident had access to her glasses. This affected two residents (#17 and #38) of three residents reviewed for communication devices. The census was 81.

Inspectors wroteBased on medical review, observations, resident interview, family interview, staff interview and review of the facility bowel protocol, the facility failed to ensure wound/skin dressings were properly applied for two (#8 and #25) of two residents reviewed for skin conditions requiring dressing changes. In addition, the facility failed to implement their bowel protocol after a resident had no bowel movement for over three days. This affected one resident (#429) of one reviewed for constipation. The facility census was 81.

Inspectors wroteBased on medical record review, staff interview, and review of facility policy, the facility failed ensure an appropriate diagnosis was obtained to justify the use of an antipsychotic medication. This affected one resident (#6) of five residents reviewed for unnecessary medications. The facility census was 81.

Inspectors wroteBased on review of Advanced Beneficiary Notices (ABN) and staff interview, the facility failed to adequately document resident representatives wishes regarding the right to appeal. This affected two residents (#67 and #73) of three residents reviewed for ABN accuracy. The census was 81.

Inspectors wroteBased on observation, staff interview and policy review, the facility failed to ensure expired medications and supplies were discarded appropriately. This had the potential to affect all 107 residents in the facility. Additionally, the facility failed to properly secure medications. This had the potential to affect four independently mobile and confused residents (#101, #23, #91, #57) identified by the facility. The facility census was 107.

Inspectors wroteBased on observation, staff interview record review and policy review, the facility failed to administer medication per standard to one Resident. This affected one (#23) out of seven residents reviewed during medication administration. The facility census was 107.

Inspectors wroteBased on observation, staff interview and policy review, the facility failed to ensure a nurse appropriately cleansed her hands prior to preparing and handling medications. This affected one (#62) out of seven residents reviewed during medication administration. The facility census was 107.

Inspectors wroteBased on review of quality assessment and assurance (QA&A) sign in sheets, staff interview and policy review, the facility failed to ensure the medical director attended all QA&A meetings. This had the potential to affect all 107 residents residing in the facility. The facility census was 107.