Health inspection·July 14, 2023

F 0584 Level of Harm - Potential for minimal harm 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 observation and interview, the facility failed to ensure housekeeping and maintenance services kept resident's air conditioning vents clean. This affected all 137 residents residing in the facility. Residents Affected - Many Findings include: Observation of resident rooms on 07/14/23 between 3:45 P.M. and 5:11 P.M. revealed there were 117 resident rooms. Each room had metal air conditioning unit under the window. The metal air conditioning units were painted an almond color. The paint on the metal front and sides of the air conditioners was intact. The top of each air conditioner had a painted metal panel consisting of five to seven squares of vents all attached into one continuous panel. None of the panels were clean or had intact paint. Dust had collected ,blocking some of the vents with a fuzzy blackish debris. The large areas of the painted metal vents were peeling. The exposed metal on the vents appeared black and rust in color. The metal appeared to be deteriorating The areas of the vents with paint intact, the paint had discolored and was soiled brown/black. Interview on 07/14/23 at 4:22 P.M. with Resident #66 revealed the vents on her air conditioner had not been cleaned since she was admitted . Interview on 07/14/23 at 4:24 P.M. with Licensed Practical Nurse (LPN) #209 verified Resident #209's air conditioner vents had a large amount of fuzzy grayish dust occluding the vents on the right side of the panel. Further verified the vents were peeling paint and were blackish and rusty in color. Interview on 07/14/23 at 7:34 P.M. with the Administrator and Regional Registered Nurse #178 verified all 117 resident rooms were affected. The vents had peeling paint, dust, and were discolored. There were two to three rooms that were not as bad but still not acceptable. The Administrator indicated the facility was built in 1960. The moist air from the air conditioning and heat deteriorates the painted vents. The Administrator indicated the vents are cleaned when rooms are deep cleaned. It involves taking the vent panel off and cleaning the filter beneath the vents. The soiled air conditioning vents affected all 137 residents in the facility. The facility did not provide a cleaning schedule. This deficiency represents non-compliance investigated under Complaint Number OH00144368. Page 1 of 3 365272 365272 07/14/2023 Riverview 3710 Olentangy River Road Columbus, OH 43214

F 0695 Provide safe and appropriate respiratory care for a resident when needed. Level of Harm - Minimal harm or potential for actual harm Based on record review, observation, interview, and policy review, the facility failed to ensure oxygen related equipment was ordered and maintained in sanitary condition. This affected two residents (#4 and #103) of three residents reviewed for respiratory issues. The facility identified 18 residents receiving respiratory treatments. Residents Affected - Few Findings include: 1. Review of Resident #4's medical record revealed a 06/26/23 admission with diagnoses including chronic respiratory failure, atherosclerotic heart disease, congestive heart failure, obstructive sleep apnea, chronic respiratory failure, and cardiac pacemaker. Physician orders included a 06/27/23 order for Breztri Aerosphere 160-9-4.8 micrograms(mcg)/ACT Aerosol, Spironolactone 25 milligrams (MG) one time a day for congestive heart failure, change oxygen tubing (i.e. Nasal cannula's, oxygen masks), filters and humidification bottle every week and as needed, oxygen delivery via nasal cannula at 2.5 liters per minute continuous. Resident complains of shortness of breath while lying flat due to chronic obstructive pulmonary disease (COPD). Keep head of bed elevated to resident's preference. There was no order for a continuous positive airway pressure (CPAP) device. Review of the 07/02/23 admission Minimum Data Set Assessment (MDS) included the resident was independent for daily decision making, required extensive assist of one for bed mobility, transfer, walking in room, toilet and personal hygiene. The resident utilized oxygen. Observation on 07/14/23 at 4:32 P.M. revealed Resident #4's nasal cannula was on the floor. The floor was dirty with food and paper debris. There was a CPAP mask face down on the bedside table that was not contained in a bag. There was not a bag hanging on the oxygen condenser to hold the nasal cannula. Interview on 07/14/23 at 4:32 P.M. with the Administrator verified the nasal cannula was on a dirty floor and the CPAP mask on the bedside table, not contained in a bag to keep clean. Interview on 07/14/23 a 5:03 P.M. with Registered Nurse (RN) #215 verified the rooms did not contain bags to store oxygen equipment when not in use. RN #215 verified staff was going around with bags and oxygen tubing to change out cannula's and place bags for use for sanitation. Interview on 07/14/23 at 8:12 P.M. with Regional Registered Nurse #178 verified the resident did not have an order for the CPAP mask and machine at his bedside. Review of the facility's Administration of Oxygen policy (approved 09/25/23) revealed no mention of storage of oxygen equipment. 2. Review of Resident #103's medical record revealed a 06/18/23 admission with diagnoses including chronic obstructive lung disease, and chronic respiratory failure. Review of the resident's 04/14/23 significant change MDS revealed the resident was severely impaired for daily decision making and was utilizing oxygen. 365272 Page 2 of 3 365272 07/14/2023 Riverview 3710 Olentangy River Road Columbus, OH 43214

F 0695 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Physician orders included orders dated 06/12/23 for Ipratropium-Albuterol Inhalation Solution 0.5-2.5 (3) MG/3 ML (Ipratropium-Albuterol) by nebulization every six hours as needed for bronchi muscle spasms resulting from COPD. Resident complains of shortness of breath while lying flat due to chronic obstructive pulmonary disease (COPD). Keep head of bed elevated to resident's preference. Oxygen delivery via nasal cannula at 3 liters per minute. Check for placement and positioning of over the ear oxygen tubing. Monitor skin on ears for signs and symptoms of breakdown. Change Oxygen Tubing (i.e. Nasal cannula's, oxygen masks), filters and humidification bottle every week and as needed. Observation on 07/16/23 at 4:18 P.M. revealed the resident's nebulizer was on the bedside table not contained in a bag or holder to maintain sanitation. There was no evidence of storage bags in the room to contain the equipment he puts in his mouth to inhale. Interview on 07/16/23 at 4:18 P.M. with the Administrator verified the nebulizer was on the bedside table not contained in a sanitary manner. This deficiency was cited as an incidental finding to Complaint Number OH00144368. 365272 Page 3 of 3