Health inspection·August 17, 2023

F 0600 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Level of Harm - Actual harm Residents Affected - Few **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** THE FOLLOWING DEFICIENCY REPRESENTS AN INCIDENT OF PAST NONCOMPLIANCE THAT WAS SUBSEQUENTLY CORRECTED PRIOR TO THIS SURVEY. Based on medical record review, observation, review of the hospital records, staff, family, and resident interviews, review of a Self- Reported Incident (SRI), review of the facility investigation, and review of the facility's abuse policy, the facility failed to ensure a resident was free from neglect. This resulted in Actual Harm when Resident #01 went five hours lying on the floor, crying for help, vomiting several times, suffered pain, and did not receive medical attention for approximately five hours. Subsequently, Resident #01 required an emergency transfer to the hospital, an inpatient hospital stay for seven days, and treatment for multiple fractures of the clavicle, medial and lateral left elbow, and left humerus. This affected one (Resident #01) of three residents reviewed for abuse. The facility census was 32. Findings include: Clinical record review revealed Resident #01 was admitted to the facility on [DATE] from the assisted living area of the facility due to a cognitive decline. Diagnoses included Alzheimer's dementia, osteoarthritis, and heart disease. Resident #01 used a walker and gait belt for ambulation with staff supervision when admitted . Review of a progress note dated 08/04/23 revealed at 5:30 A.M., Licensed Practical Nurse (LPN) #43 was rounding and found Resident #01 on her back on the floor by her bed. The resident stated she hurt really badly all over with no deformities. Range of motion to the right arm was good but the left arm was extremely painful. A small emesis was noted on the floor next to the resident. Vital signs were stable except for an elevated blood pressure. State Tested Nursing Assistant (STNA) #70 stayed with the resident while the nurse contacted the physician; she was sent out with emergency services. Resident #01 stated she did not know what happened. Review of the hospital documentation revealed Resident #01 was admitted to the hospital on [DATE] and discharged back to the facility on [DATE] with injuries including a fractured clavicle, fractured medial and lateral left elbow, and fractured left humerus. The resident's medications included Compazine injections and orally at five milligrams (mg) as needed every six hours for nausea, and pain medications included Acetaminophen 975 mg every eight hours and 650 mg every four hours, Oxycodone 2.5 mg every three hours as needed, and a one-time dose on 08/04/23 of Morphine two mg intravenously, and Dilaudid 0.2 mg as needed every three hours intravenously. The resident's power of attorney/daughter elected hospice services with no surgical intervention for the fractures. (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 4 Event ID: 365416 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 365416 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/17/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Ohio Living Westminster-Thurber 717 Neil Avenue Columbus, OH 43215 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)