Health inspection·May 5, 2023

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, staff and resident interviews, and policy review, the facility staff failed to report a resident's alleged abuse by a staff. This affected one (#2) of six residents reviewed for potential abuse. The facility census was 74. Findings include: Review of Resident #2's medical record revealed an admission date of 01/30/23, with diagnoses including anoxic brain damage from drug overdose, spastic paraplegia, and impaired vision. Review of the Minimum Data Set (MDS) assessment dated [DATE], revealed the resident had intact cognition and was usually understood. He required the assistance of two staff for transfers, dressing and toilet use, and did not ambulate. Review of the care plan with a target date of 07/26/23, revealed the resident had poor safety awareness and attention seeking behaviors including sliding from this chair or bed to the floor. He was easily agitated yelling at the staff, throwing items such as his urinal, food tray or the bed headboard. Interview with the Administrator on 05/05/23 at 8:50 A.M., revealed she recently spoke to Resident #2 about safety concerns in the threshold of her office doorway. She advised him to lock his wheelchair before standing up by himself to prevent falls and not throw objects at others. The resident flipped her off, stated I don't give a (expletive word) and attempted to leave. The Administrator revealed she sternly told the resident this conversation was not finished, and he needed to understand if his behavior continued, he would receive a 30-day discharge notice because he could hurt himself and others. Interview with Scheduler #12 on 05/05/23 at 10:06 A.M., revealed she heard the conversation between Resident #2 and the Administrator. The resident was very agitated. She heard the Administrator tell him he needed to listen to this conversation. She did not hear the Administrator curse or yell at the resident. Interview with State Tested Nursing Assistant (STNA) #48 on 05/05/23 at 10:50 A.M., revealed on 04/21/23, she was present when the Administrator spoke to Resident #2 in her office. The Administrator was near the resident's face, and discussed when he stood up in his wheelchair, safety, and falls. The resident said he locked his wheelchair when standing, denied that he fell, was very upset, did not want to listen to the Administrator and flipped her off. The resident kicked up his wheelchair foot pedal and tried to leave the area when the Administrator told him this conversation was not over, Page 1 of 2 365374 365374 05/05/2023 Beavercreek Post Acute 1974 North Fairfield Road Dayton, OH 45432

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few she was the boss and offered him alternate placement or to return home with his father. After this conversation, the resident told STNA #48 he felt the Administrator was verbally abusive. STNA #48 verified she did not report the verbal abuse allegation to the Administrator or Director of Nursing (DON) Interview with Resident #2 on 05/05/23 at 11:05 A.M., revealed he told STNA #48 the Administrator talked to him in a mean way and felt verbally abused a few weeks ago. Interview with Activities #40 on 05/05/23 at 11:20 A.M., revealed on 04/21/23, Resident #2 reported to her the Administrator attached him in her office. Activities #40 verified she did not report the abuse allegation to the Administrator or Director of Nursing (DON). Interview with the Director of Nursing (DON) on 05/05/23 at 11:35 A.M., verified she received no abuse allegations from the staff regarding the Administrator. The DON stated she was present for the end of the conversation with Resident #2 who was in his wheelchair on 04/21/23 and observed the Administrator at his eye level offering alternate placement. Resident #2 flipped the Administrator off and said (expletive word) you to her. Review of the policy titled Abuse, Neglect, Exploitation and Misappropriation dated 06/08/22 revealed any abuse allegation was immediately reported to the Administrator or designee. The Administrator was responsible for notifying the state agency of the allegation within 24 hours. This deficiency represents non-compliance investigated under Master Complaint Number OH00142413 and Complaint Number OH00142355. 365374 Page 2 of 2