Inspection·October 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 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of the medical record, staff interview, and review of the facility policy, the facility failed to implement timely care and treatment for trauma wounds. This affected one (Resident #64) of three residents reviewed for skin impairment. The facility census was 129 residents. Residents Affected - Few Findings include: Review of the medical record for Resident #64 revealed an admission date of 11/12/23 with diagnoses including multiple myeloma, chronic respiratory failure, malignant neoplasm of brain, and hypertension. Review of the hospital continuity of care (COC) form for Resident #64 dated 09/09/24 revealed the resident had an order to cover the left lower leg wound with Mepilex border and change every three days and as needed for drainage. Resident #64 was to follow-up with the wound care clinic on 09/13/24. Review of the progress note for Resident #64 dated 09/09/24 at 3:55 P.M. revealed the resident was readmitted from the hospital with an open area to the left leg. Review of the wound clinic progress note for Resident #64 dated 09/13/24 revealed the resident had a trauma wound to the left lateral lower leg which was acquired 08/12/24. Wound dressing to the trauma wound was to be completed daily. Review of the Minimum Data Set (MDS) assessment for Resident #64 dated 09/17/24 revealed the resident had moderate cognitive impairment and was dependent on staff assistance with activities of daily living (ADLs.) Review of the physician's orders for Resident #64 revealed an order dated 09/18/24 to cleanse left lateral leg with normal saline, apply Medihoney gel, Mepilex border and secure with Tubi grip once daily. Review of the Treatment Administration Record (TAR) for Resident #64 dated September 2024 revealed the resident did not receive treatments for the left lateral leg wound from 09/09/24 through 09/17/24. Interview on 10/21/24 at 2:52 P.M. with the Director of Nursing (DON) confirmed Resident #64 was readmitted from the hospital on [DATE] with a trauma wound to the left lower leg. The DON confirmed the hospital COC form included treatment orders for the resident's left lower leg. Further interview with the DON confirmed the treatments orders for Resident #64's trauma wound were not implemented (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 4 Event ID: 365005 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365005 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/23/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Chateau at Mountain Crest Nursing & Rehab Ctr 2586 Lafeuille Avenue Cincinnati, OH 45211 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)