Health inspection·April 7, 2023

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on observation, interview, record review and Center for Medicare and Medicaid Services (CMS) food temperature guidance the facility failed to ensure temperatures of food leaving the kitchen were at the appropriate temperature to prevent food borne illness, and failed to keep the can opener clean. This had the potential to affect all 85 residents receiving food from the kitchen. Residents #1, #8, #10, #12, #14, #15, #28, #30, #31, #36, #50, #51, #54, #57, #58, #61, #62, #74, #78, #105, and #106 did not receive food from the kitchen. The facility census was 106. Findings included: 1. Interview on 04/05/23 at 12:08 P.M. with Dietary Supervisor #209 revealed the facility documented temperature checks on the menus and not all food that had been temperature checked prior to leaving the kitchen. Interview on 04/05/23 at 12:10 P.M. with Registered Dietitian (RD) #202 verified every meal from the kitchen should be temperature checked prior to being served to confirm it has reached a safe temperature to prevent food-borne illness. Review of food temperature logs from 01/29/23 to 04/01/23 revealed food temperatures were not taken during preparation or during holding. The following dates had one meal with no temperature checks: 02/11/23, 03/06/23, 03/07/23, 03/09/23, and 03/11/23. The following dates had two meals with no temperature checks: 02/05/23 and 02/18/23. The following dates had all three meals with no temperature checks: 02/06/23, 02/08/23, 02/09/23. 02/10/23, 02/14/23, 02/15/23, 01/26/23, 02/17/23, 02/26/23, 02/27/23, 02/28/23, 03/01/23, 03/02/23, 03/03/23, 03/04/23, 03/25/23, and 03/26/23. From 01/29/23 to 04/01/23 was 63 days resulting in a total of 189 meals with food which should have been temperature checked. Sixty meals during this time did not have temperature checks resulting in 31.74% of meals with food not temperature checked. The meals which were not temperature checked included chicken, pork, beef, and fish. Review of facility form titled, Food Temperature: CMS Interpretive Guidance, undated, provided by RD #202 revealed poultry should reach a final cooking temperature of 165 degrees Fahrenheit, and ground meat should reach a final cooking temperature of 155 degrees Fahrenheit, and fish and other meats (beef, pork, veal) should reach a final cooking temperature of 145 degrees Fahrenheit. 2. Observation on 04/05/23 at 12:00 P.M. of the large can opener revealed a black dried substance on the piece that punctures the can. Further observation revealed the table base which holds the piece that punctures the can to be dirty. Page 1 of 3 365195 365195 04/07/2023 McNaughten Pointe Nursing and Rehab 1425 Yorkland Road Columbus, OH 43232

F 0812 Level of Harm - Minimal harm or potential for actual harm Interview on 04/05/23 at 12:02 P.M. with the Registered Dietitian (RD)#202 verified the can opener was dirty. Interview on 04/05/23 at 12:05 P.M. with Dietary Supervisor #209 verified the can opener was dirty and not just from use on 04/05/23 but from multiple days of use. Residents Affected - Some Review of the kitchen cleaning log for 04/05/23 revealed the can opener and base had been cleaned. This deficiency is an incidental finding investigated under Complaint Number OH00141360. 365195 Page 2 of 3 365195 04/07/2023 McNaughten Pointe Nursing and Rehab 1425 Yorkland Road Columbus, OH 43232

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and facility policy review the facility failed to follow proper hand washing and glove use protocols to prevent infection when providing incontinence care and reconnected ventilator tubing. This affected one resident (#78) of four residents reviewed for incontinence care. The facility census was 106. Residents Affected - Few Findings included: Review of Resident #78's medical record revealed an admission date of 02/16/22 with diagnoses including chronic respiratory failure with hypoxia, dependence on ventilator, type two diabetes, persistent vegetative state, supraventricular tachycardia, and essential hypertension. Review of Resident #78's quarterly Minimum Data Set (MDS) 3.0 assessment, dated 01/30/23, revealed she was not cognitively independent and always incontinent of bladder and bowel. Observation on 04/05/23 at 10:45 A.M. of bed bath with incontinence care for Resident #78 with State Tested Nursing Assistants (STNAs) #204 and #205 revealed concerns regarding infection control. STNA #204 and STNA #205 washed their hands and donned (put on) gloves to provide incontinence care. The anterior (front) of Resident #78 was cleaned and dried by STNA #205. Resident #78 was then rolled toward STNA #204 and STNA #204 held Resident #78 on her right side as STNA #205 provided incontinence care posteriorly (back) for Resident #78. Resident #78 had been incontinent of stool and STNA #205 cleaned and dried her. STNA #204 and #205 traded locations and STNA #204 was making the bed while STNA #205 held Resident #78 on her right side. The ventilator tubing became disconnected, and the ventilator alarm started to sound. STNA #204 reached up and reconnected the ventilator tubing with the gloved hands she had just provided incontinence care for urine and stool. She then doffed (removed) her gloves and donned (put on) new gloves at the bedside without washing her hands. While the bed was being made, the ventilator tubing became disconnected again and she reconnected the ventilator tubing. Interview on 04/05/23 at 11:10 A.M. with STNA #205 verified she did reconnect the ventilator tubing the first time while wearing the gloves she had on when she provided incontinence care of urine and stool. She also verified she did not wash her hands or use hand sanitizer after doffing (removing) the first pair of gloves and donning (putting on) the second pair of gloves at the bedside. Interview on 04/05/23 at 11:28 A.M. with the Director of Nursing (DON verified that a resident's ventilator tubing which has come disconnected during care should not be reconnected with gloved hands just used to provide incontinence care. Review of the facility policy titled, Hand Hygiene, revised 11/18/17, revealed staff are to perform hand hygiene (even if gloves are used) in the following situations: before and after contact with the resident, after contact with blood body fluids, or visibly contaminated surfaces or other surfaces in the resident's environment, and after removing personal protective equipment (e.g. gloves, gown, facemask). This deficiency is an incidental finding investigated under Complaint Number OH00141360. 365195 Page 3 of 3