Health inspection·August 19, 2025

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 observations, interviews, record reviews, and review of facility policy, the facility failed to ensure wound care treatment and assessments were appropriately implemented and completed. This affected one resident (#76) out of three residents reviewed for wound care. The facility census was 93.Record review for Resident #76 revealed the resident was admitted to the facility on [DATE] and had diagnoses which included Parkinsonism, dementia, and dysphagia.Review of the quarterly Minimum Data Set (MDS) assessment, dated 07/01/25, revealed the resident was assessed to have impaired cognition.Review of the nurses' progress note, dated 04/07/25, revealed right thigh healed. Treatment orders discontinued.Review of the care plan, revised 06/25/25, revealed the resident was at risk for impaired skin integrity. Interventions included blister to right thigh (05/10/25).Review of the facility eINTERACT SBAR (Situation, Background, Appearance, Review) form, dated 05/09/25, revealed the resident was assessed to have a new blister present to the right thigh with green and yellow drainage present. The physician was notified and new orders for laboratory testing and Levaquin (an antibiotic medication) were given and implemented.Review of the physicians orders for Resident #76 revealed no wound care treatment for the blister on the residents right thigh were implemented from 05/09/25 through 08/17/25.Review of the facility assessments from 05/09/25 through 08/17/25 revealed no assessment indicating the presence or description of the blister to Resident #76's right thigh was present.Observation on 08/18/25 at 2:14 P.M. revealed Resident #76 was lying in bed asleep with his pants removed for comfort. A small white bandage was in place to the residents right thigh which contained the initials of Licensed Practical Nurse (LPN) Manager #164. Interview with LPN Manager #164 at the time of the observation confirmed a small scab was observed on the residents right thigh and treatment orders were obtained from the physician and implemented. LPN #164 confirmed no new skin areas were present to her knowledge prior to 08/18/25.Observation on 08/19/25 at 9:15 A.M. with LPN Manager #164 revealed wound care was provided to the area on Resident #76's right thigh. A small open area approximately the size of a dime was present. The skin surrounding the open area was pink and no signs of infection were noted.Interview with LPN #262 on 08/19/25 at 10:47 A.M. confirmed Resident #76 had a small burn present to his right thigh which had healed around 04/07/25. LPN #262 confirmed she was working and providing care for Resident #76 on 05/09/25 and noticed a new blister to the residents right thigh which had green and yellow drainage present. LPN #262 confirmed she had notified the physician and obtained new orders for Levaquin to be administered and laboratory testing to be conducted. LPN #262 confirmed she notified Registered Nurse (RN) #166 of the presence of the wound and was told to clean the wound, apply Medi-honey (an ointment to treat wounds), apply a bandage and check on the wound as often as possible. LPN #262 confirmed wound care treatment orders were never implemented and wound assessments had never been conducted or documented. LPN #262 confirmed herself and RN #166 had been changing the bandage to the residents thigh when working in the facility and the area had continued to be present Residents Affected - Few (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 3 Event ID: 365250 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 365250 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/19/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Buckeye Care and Rehabilitation 1900 East Main Street Lancaster, OH 43130 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)