Health inspection·July 23, 2024

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review the facility failed to provide the necessary care and treatment to residents with nonpressure wounds for 2 of 3 residents (R2, R3) reviewed for nonpressure wounds in the sample of 4. Residents Affected - Few The findings include: 1. R2's admission skin and nursing assessments dated 7/14/24 showed R2 was admitted to the facility, from a local hospital, with diagnoses of infectious wounds to her right and left buttock related to a diagnosis of necrotizing fascitis (flesh eating bacterial infection) to both areas. Clusters of wounds were also noted to R2's right and left posterior lower legs. These assessments showed R2 was cognitively intact. R2's wound care notes dated 7/21/24 showed R2's wounds as the following: 1. A left buttock infectious wound measuring 6.5 cm (centimeters) x 16 cm x 0.3 cm. 2. A right buttock infectious wound measuring 10 cm x 28 cm x unknown. 3. A cluster of vascular wounds to R2's left lower leg measuring 15 cm x 17 cm x 0.3 cm. 4. A cluster of venous wounds to R2's right lower leg measuring 22 cm x 20 cm x 0.3 cm. R2's left and right buttock physician treatment orders dated 7/17/24 showed, Cleanse with 1/2 Dakins (wound cleanser), pat dry, pack wound with moist Kerlix (gauze dressing) every day. R2's left and right lower leg physician treatment orders dated 7/14/24 showed, Cleanse with 1/2 Dakins, pat dry, apply Neosporin (antibacterial ointment), Xeroform (petroleum gauze dressing), and wrap wound with gauze, secure with tape, every day. On 7/23/24 at 8:49 AM, R2 was in bed, lying flat on her stomach. A large, linear, open, weeping wound was noted to R2's right buttock. No dressing was noted to the wound. A large amount of serous drainage was noted to the bed sheet lying on top of R2's right buttock wound. A smaller linear wound was noted to R2's left buttock. No drainage was noted from the wound. No dressing was noted to the wound. Gauze dressings, dated 7/21/24, were noted around both of R2's ankles, leaving the wounds to R2's posterior right and left lower legs exposed. Large reddened, clusters of open wounds were noted to both of R2's posterior lower legs. When R2 was asked when her wound dressing were last changed, R2 stated, A couple of days ago. Page 1 of 2 145936 145936 07/23/2024 Aliya of Highwood 50 Pleasant Avenue Highwood, IL 60040

F 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few On 7/23/24 at 10:45 AM, V3 Wound Nurse stated, (R2) should have wound care done every day. She should have dressings to her right and left buttocks and lower legs. If I am not here to do wound treatments, the floor nurse can do wound care also. 2. R3's wound care notes dated 7/19/24 showed R3 had open wounds to his left axila, right axila, and left groin areas related to his diagnosis of Hiradenitis Suppurativa (chronic skin condition causing lumps and blistering to the skin). R3's left and right axila physician treatment orders dated 4/28/24 showed, Cleanse with 1/2 Dakins solution and apply Medihoney (wound cream) and leave open to air every day shift. R3's left groin physician treatment order dated 4/17/24 showed, Cleanse with NS (normal saline), pat dry, apply Bacitracin (antibacterial ointment), leave open to air daily. R3's July 2024 Treatment Administration record showed R3 received no wound care to his axila wounds or groin wound on 7/6/24, 7/9/24, 7/11/24, 7/16/24, 7/18/24, and 7/20/24. On 7/23/24, V1 Administrator was asked for a facility policy on the care and treatment of nonpressure resident wounds. No policy was provided by the facility. 145936 Page 2 of 2