Health inspection·April 7, 2022

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on observation, facility policy and procedure review and interview the facility failed to ensure altered textured food items were prepared in accordance with professional standards for food service safety to prevent contamination and/or food borne illness. This affected 16 residents (#2, #4, #5, #9, #21, #23, #28, #30, #31, #32, #36, #40, #44, #51, #115 and #210) of 16 residents identified to receive altered textured diets in the facility. The facility census was 56. Findings include: On 04/06/22 from 10:00 A.M. to 10:10 A.M. [NAME] #142 was observed during preparation of the lunch meal. [NAME] #142 was observed preparing altered texture food items. The cook was wearing gloves and placed turkey ala king into the blender. After blending one pan to a puree texture and three pans to a ground texture, [NAME] #142 gave the blender container to Dining Services Director #263 to be washed. [NAME] #142 then grabbed the sanitizing bucket, put her hand in the sanitizer to grab a wash cloth, wiped the blender base with the sanitizing cloth, threw a piece of turkey from the counter into the trash can, and changed the page on the food preparation manual. This was all done wearing the same gloves. [NAME] #142 did not change gloves or perform any hand hygiene during this process. Dining Services Director #263 then brought the blender container back to [NAME] #142 to prepare pureed texture minestrone soup. Wearing the same gloves as above, [NAME] #142 placed the soup in the blender, prepared it to the proper texture and poured it into a clean pan. While pouring the pureed soup into the clean plan, she placed a gloved hand on the top of the blending blade. After pouring all the soup into the clean pan, she cleaned the blender base with the sanitizing cloth. After doing this, [NAME] #142 then removed her gloves. On 04/06/22 at 10:13 A.M. interview with [NAME] #142 confirmed she did not change her gloves between preparing the altered food texture of the turkey ala king and minestrone soup. [NAME] #142 revealed staff typically do not change their gloves when preparing food textures until they change food types; so she did not change her gloves (perform hand hygiene) between the turkey ala king and minestrone soup because both foods contained turkey in them even though they were completely different food items. [NAME] #142 confirmed she did use the sanitizing cloth, threw a piece of turkey in the trash, touched the top of the blending blade, and changed pages in the food preparation manual prior to starting the process of blending the minestrone soup wearing the same gloves. The facility identified 16 residents, Resident #2, #4, #5, #9, #21, #23, #28, #30, #31, #32, #36, #40, #44, #51, #115 and #210 who received altered textured diets in the facility. Review of the undated facility Kitchen Hand Hygiene Policy revealed dietary employees shall clean Page 1 of 3 365399 365399 04/07/2022 Westerwood Rehabilitation 5757 Ponderosa Drive Columbus, OH 43231

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some their hands and exposed portions of their arms immediately before engaging in food preparation including working with exposed food, clean equipment and utensils and unwrapped single service and single use articles and also in the following situations: after hands had touched anything unsanitary, after handling chemicals and before beginning to work with food, while preparing food, as often as necessary to remove soil and contamination and to prevent cross contamination when changing tasks, before applying (donning) gloves for working with food and after removing gloves. The policy indicated for use of gloves- gloves should be changed when handling soiled trays and dishes, during food preparation, as often as necessary to remove soil and contamination and to prevent cross contamination when changing tasks and anytime a contaminated surface was touched. 365399 Page 2 of 3 365399 04/07/2022 Westerwood Rehabilitation 5757 Ponderosa Drive Columbus, OH 43231

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm Based on observation, facility policy and procedure review, facility Infection Control Program review and interview the facility failed to maintain adequate infection control practices when checking resident blood sugars using a shared glucose meter (glucometer) including proper handwashing and disinfecting of the glucometer to prevent the spread of infection. This affected one resident (#31) and had the potential to affect one additional resident (#18) who received blood glucose monitoring using the shared glucometer on the unit. Residents Affected - Few Findings include: On 04/06/22 at 11:40 A.M. Licensed Practical Nurse (LPN) #141 was observed checking Resident #31's blood sugar using a shared glucometer. LPN #141 applied gloves and gathered the necessary equipment. After repositioning Resident #31 in the chair, the LPN removed her gloves and applied new gloves without first washing her hands. LPN #141 then obtained a blood sample and removed her gloves. However, the LPN had to obtain a new test strip for the glucometer as the first test did not register. LPN #141 applied a new pair of gloves without first washing her hands/performing hand hygiene and obtained another blood specimen from the resident. Following the procedure, LPN #141 was observed to place the glucometer in a cup that contained a disinfectant wipe but failed to properly clean the meter. On 04/06/22 at 11:57 A.M. interview with LPN #141 verified she had not washed her hands between glove changes and verified she had not properly disinfected the glucometer after use with Resident #31. The facility identified two residents, Resident #18 and Resident #31 who resided on the unit who required blood glucose monitoring using the shared glucometer. Review of the Glucometer Disinfection policy, dated 09/07/17 revealed all external surfaces of the glucometer must be cleaned and disinfected with the facility validated disinfectant after each patient use, whenever it was visibly soiled or contaminated and prior to docking. Staff were to reapply gloves, retrieve disinfectant wipe from the container and cleanse the glucometer with a disinfectant wipe by ensuring a four minute dwell time. Review of the facility Infection Prevention and Control Program, dated 08/2017 revealed the hand hygiene protocol included staff to use hand hygiene when coming on duty, between resident contacts, after handling contaminated objects, after personal protective equipment (PPE) removal, before/after eating, before/after toileting and before going off duty. Staff should use hand hygiene before and after performing resident care procedures and hands shall be washed in accordance with the facilities established hand washing procedure. 365399 Page 3 of 3