Health inspection·May 4, 2023

F 0561 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, resident interview, staff interview, and review of the facility policy, the facility failed to provide showers per resident preference. This affected one (Resident #73) of three residents reviewed for personal hygiene and bathing. The facility census was 86. Findings include: Review of the medical record for Resident #73 revealed an admission date of 03/24/23 with diagnoses including fracture of left tibia, bipolar disorder, schizophrenia, and anxiety disorder. Review of the Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #73 was cognitively impaired and required extensive assistance of one staff with personal hygiene and was totally dependent on staff assistance with bathing. Resident was coded negative for the presence of behavioral symptoms including rejection of care. Review of the care plan dated 03/24/23 revealed Resident #73 had an activities of daily living (ADL) self-care performance deficit and required assistance with ADLs. Interventions included the following: assistance required with ADLs may fluctuate based on time-of-day, mood, pain, or fatigue, adjust and document as indicated, report significant changes to charge nurse, identify tasks/events that cause frustration. provide assistance as needed, observe and anticipate resident's needs: thirst, food, body positioning, pain, toileting needs, place call light within reach, remind resident to call for assistance if cognitively intact, resident has poor safety awareness, praise all efforts at self-care. Review of the bathing records for Resident #73 for the previous 04/04/23 to 05/04/23 revealed resident did not receive a shower twice weekly as per her preference. Staff provided Resident #73 with a shower on 04/14/23, and she did not receive her next shower until 04/21/23. Staff provided Resident #73 with a shower on 04/24/23, and she did not receive her next shower until 05/01/23. Review of the nurse progress notes for Resident #73 dated 04/04/23 to 05/04/23 revealed there was no documentation of refusal of care or rationale for not providing twice weekly showers to the resident. Interview on 05/04/23 at 11:14 A.M. with Resident #73 confirmed the resident's preference was for staff to assist her with a shower twice weekly, and her shower days were Monday and Friday. Resident #73 confirmed that she often received only one shower per week. Page 1 of 4 365196 365196 05/04/2023 Pleasant Ridge Healthcare Center 5501 Verulam Cincinnati, OH 45213

F 0561 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Interview on 05/04/23 at 11:20 A.M. with Registered Nurse (RN) #420 confirmed Resident #73 was supposed to receive showers twice weekly on Monday and Friday. RN #420 confirmed Resident #73 required staff assistance with showers and did not have a behavior of refusing showers. Interview on 05/04/23 at 3:40 P.M. with the Administrator confirmed Resident #73's bathing records did not show the resident was bathed twice weekly. Review of the facility's undated policy titled Routine Resident Care revealed routine resident care was defined as care that was not necessarily medically or clinically based but necessary for quality of life promoting dignity and independence as appropriate. Routine resident care included assisting with bathing. This deficiency represents non-compliance investigated under Complaint Number OH00142159. 365196 Page 2 of 4 365196 05/04/2023 Pleasant Ridge Healthcare Center 5501 Verulam Cincinnati, OH 45213

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. Based on record review, observation, family and resident interview, staff interview, and review of the facility policy, the facility failed to ensure a clean and comfortable environment for residents. This affected one (Resident #72) of three residents sampled for dignity and respect. The facility census was 86. Findings include: Review of the medical record for Resident #72 revealed an admission date of 04/10/23 with diagnoses including diabetes mellitus (DM), schizoaffective disorder, and chronic obstructive pulmonary disease (COPD). Review of the Minimum Data Set (MDS) assessment for Resident #72 dated 04/17/23 revealed the resident was cognitively intact, was coded negative for the presence of behavioral symptoms including rejection of care and required supervision and set up help of staff with activities of daily living (ADLs.) Observation and interview on 05/04/23 at 11:17 A.M. of Resident #72's room revealed in the center of resident's bed sheets there was a large area, approximately 12 inches by four inches in diameter, of a dried brown substance on the sheets. Resident #72 was out of bed and ambulating throughout the room. Resident #72 stated he had diarrhea sometime in the middle of the night, early morning hours on 05/04/23. Resident #72 confirmed he told the staff and asked them to change his sheets and they said they would do so, but no one had been in to change his bed linens. Interview on 05/04/23 at 11:18 A.M. with Resident #73, resident's roommate and spouse confirmed Resident #72 had diarrhea during the night and the stain on his sheets was dried feces. Resident #73 confirmed staff said they would come in and change his bed linens, but they hadn't done so. Interview on 05/04/23 at 11:20 A.M. with Registered Nurse (RN) #420 confirmed there was a large brown stain in the center of Resident #72's bed linens which appeared to be dried feces. RN #420 confirmed she was unaware of this concern, and she would send someone in to change his linens. Review of the facility policy titled Infection Control Practices for Laundry and Linens, dated 02/24/22, revealed employees will handle linens in a way that cleans and sanitizes the laundry to reduce and prevent the spread of infectious microorganisms. Review of the facility's undated policy titled Routine Resident Care revealed routine resident care was defined as care that was not necessarily medically or clinically based but necessary for quality of life promoting dignity and independence as appropriate. Routine resident care included providing care for incontinence and personal care needs. This is an incidental finding discovered during the course of this complaint investigation. 365196 Page 3 of 4 365196 05/04/2023 Pleasant Ridge Healthcare Center 5501 Verulam Cincinnati, OH 45213

F 0677 Provide care and assistance to perform activities of daily living for any resident who is unable. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, observation, resident interview, staff interview, and review of the facility policy, the facility failed to assist residents who required assistance with personal hygiene with the removal of unwanted facial hair. This affected one (Resident #73) of three residents reviewed for personal hygiene and bathing. The facility census was 86. Residents Affected - Few Findings include: Review of the medical record for Resident #73 revealed an admission date of 03/24/23 with diagnoses including fracture of left tibia, bipolar disorder, schizophrenia, and anxiety disorder. Review of the Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #73 was cognitively impaired and required extensive assistance of one staff with personal hygiene and was totally dependent on staff assistance with bathing. Review of the care plan dated 03/24/23 revealed Resident #73 had an activities of daily living (ADL) self-care performance deficit and required assistance with ADLs. Interventions included the following: assistance required with ADLs may fluctuate based on time-of-day, mood, pain, or fatigue, adjust and document as indicated, report significant changes to charge nurse, identify tasks/events that cause frustration. provide assistance as needed, observe and anticipate resident's needs: thirst, food, body positioning, pain, toileting needs, place call light within reach, remind resident to call for assistance if cognitively intact, resident has poor safety awareness, and praise all efforts at self-care. Review of the bathing records for Resident #73 revealed Resident #73 received her last shower on 05/01/23. Review of the nurse progress note for Resident #73 dated 05/04/23 at 11:38 A.M. revealed the resident told nurse she wanted a shower later today and wanted her chin hairs to be shaved because they were irritating for her. Observation and interview on 05/04/23 at 11:14 A.M. of Resident #73 revealed the resident had multiple long white hairs growing from her chin which were approximately one fourth of an inch long. Resident #73 stated she had long hairs growing from her chin which she found irritating and uncomfortable, and she didn't like the way they looked. Resident #73 stated she was embarrassed about the chin hairs, and no one had offered to shave them or otherwise assist her with removing them. Interview on 05/04/23 at 11:20 A.M. with Registered Nurse (RN) #420 confirmed Resident #73 had long hairs growing from her chin which the resident was unable to remove per self. Review of the facility's undated policy titled Routine Resident Care revealed routine resident care was defined as care that was not necessarily medically or clinically based but necessary for quality of life promoting dignity and independence as appropriate. Routine resident care included assisting with personal care. This deficiency represents non-compliance investigated under Complaint Number OH00142159. 365196 Page 4 of 4