Inspection·April 3, 2023

F 0602 Protect each resident from the wrongful use of the resident's belongings or money. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, self-reported incident review and interview, the facility failed to ensure all residents were free from incidents of misappropriation of medication. This affected three residents (#58, #90, and #91) of three residents reviewed for misappropriation. The facility census was 89. Residents Affected - Few Findings include: Record review revealed Resident #58 was admitted to the facility on [DATE] with diagnoses including diabetes mellitus type II, hypertension, anxiety, bipolar disorder, anxiety, suicidal ideations, depression and neuropathy. Record review revealed Resident #58 was alert and oriented to person, place, and time with a current Brief Mental Status (BIMS) score of 15 (out of 15 on the most recent Minimum Data Set (MDS) 3.0 assessment completed on [DATE]. Review of physician's orders revealed the resident received the anti-psychotic medication, Abilify 15 milligrams (mg) by mouth once daily at bedtime. Review of Resident #90's closed medical record review revealed the resident was admitted to the facility on [DATE] and was discharged to the hospital on [DATE] and did not return to the facility. The resident had diagnoses including paranoid schizophrenia, anxiety, hypothyroidism, hypertension, delusional disorders, reduced mobility, and muscle weakness. This resident had a BIMS score of 15 (out of 15) on the last MDS 3.0 assessment completed on [DATE]. Review of physician's orders during the resident's stay revealed the resident had an order for the anti-psychotic medication, Risperdal 1 mg by mouth twice daily in the morning and at bedtime. Review of Resident #91's closed medical record revealed the resident was admitted to the facility on [DATE] and expired in the facility on [DATE]. Resident #91 had diagnoses including myocardial infarction, bipolar disorder, hypertension, Alzheimer's disease, anxiety, dysphagia, schizophrenia, atrial fibrillation, and hyperlipidemia. The resident was alert to person and place with a BIMS score of 9 (out of 15) on the last completed MDS 3.0 assessment completed on [DATE]. Review of physician's orders during the resident's stay revealed the resident had an order for the anti-psychotic medication, Seroquel 25 mg by mouth once daily in the morning. Review of facility self-reported incident (SRI), tracking number 233025 revealed on [DATE] the facility became aware of a situation involving a possible misappropriation of property, which involved a former nurse who worked as a contracted agent. Review of the SRI revealed the incidents involved three residents (one current and two discharged ) and was also being investigated by an Ohio Board of Nursing Special Investigator. The report identified Registered Nurse #40 as the person of interest in the investigation. Medications included Seroquel 25 mg, Abilify 15 mg, and Risperdal 1 mg. (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 2 Event ID: 365313 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 365313 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/03/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Bridgeport Health Care Center 2125 Royce Street Portsmouth, OH 45662 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)