Health inspection·September 11, 2024

F 0732 Post nurse staffing information every day. Level of Harm - Potential for minimal harm Based on observation and staff interview, the facility failed to have daily staffing information posted in a prominent place on 09/05/24. This had the potential to affect all 150 residents in the facility. Residents Affected - Many Findings include: On 09/05/24 at 10:45 A.M., observation of the facility revealed there was no daily staffing information available for that day. On 09/05/24 at 10:53 A.M., interview with the Administrator stated the daily staffing information should be in a binder at the front desk. The Administrator verified the daily staffing information for 09/05/24 was not available at the front desk and was currently being printed. Page 1 of 3 365046 365046 09/11/2024 Daughters of Miriam Center for Nursing & Rehabilit One David N Myers Parkway Beachwood, OH 44122

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, staff interview, and review of facility policy, the facility failed to ensure medications were stored in a secure location at all times. This had the potential to affect 40 residents (#1, #6, #7, #10, #12, #13, #15, #16, #19, #22, #24, #27, #30, #36, #37, #46, #51, #60, #62, #65, #67, #69, #77, #79, #85, #88, #91, #99, #103, #105, #106, #107, #110, #118, #119, #123, #130, #132, #147, and #148) residing on [NAME] three unit. The facility census was 150. Findings include: On 09/09/24 at 10:05 A.M., an observation of the [NAME] three unit revealed a medication cart was unattended and unlocked in the hallway between Resident #7's room and Resident #107's room. At the time of observation, there was one resident ambulating in the hallway with a walker and one family member present in the hallway. On 09/09/24 at 10:10 A.M., upon returning to the medication cart, Licensed Practical Nurse (LPN) #700 confirmed the medication cart was left unattended and unlocked in the hallway. LPN #700 further stated the medication cart should have been locked. Review of the facility census revealed 40 residents (#1, #6, #7, #10, #12, #13, #15, #16, #19, #22, #24, #27, #30, #36, #37, #46, #51, #60, #62, #65, #67, #69, #77, #79, #85, #88, #91, #99, #103, #105, #106, #107, #110, #118, #119, #123, #130, #132, #147, and #148) resided on [NAME] three unit. Review of the facility's policy titled Medication Administration/Treatment, dated 10/18, indicated the nurse would cover all patient information to protect privacy and lock the medication cart before leaving the cart to pass the medication. 365046 Page 2 of 3 365046 09/11/2024 Daughters of Miriam Center for Nursing & Rehabilit One David N Myers Parkway Beachwood, OH 44122

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm Based on record review, observations, and interview the facility failed to maintain standard infection control protocol when administrating medications. This affected one (Resident #137) of one resident reviewed for medication administration. Residents Affected - Few Findings include: Review of medical record for Resident #137 revealed an admission date of 07/17/24. Diagnoses included acute kidney failure, spastic quadriplegic cerebral palsy, and neuromuscular dysfunction of the bladder. The resident had impaired cognition. A random observation on 09/09/24 at 9:31 A.M. revealed Licensed Practical Nurse (LPN) # 515 administering medications for Resident #137. LPN #515 placed three of 13 medications from medication cards into her bare hand. Interview during observations LPN#515 stated medications should be placed into the medication cup, not a bare hand. Review of the facility policy titled Administering Oral Medications, dated 2010 revealed staff were directed not to touch medications with their hands and to place all medications into a medication cup. 365046 Page 3 of 3