Health inspection·November 4, 2024

F 0690 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on closed record review and interviews the facility failed to ensure residents received adequate indwelling catheter care, failed to ensure residents received adequate indwelling catheter education upon discharge, failed to ensure urine was obtained per orders, and failed to ensure bladder assessment was accurate on admission. This affected two (Resident #44 and Resident #45) of three reviewed for bladder impairments. Findings included: 1. Closed record review revealed Resident #44 was admitted to the facility on [DATE] and discharged on [DATE]. The residents' diagnoses included metabolic encephalopathy, pneumonia, severe protein-calorie malnutrition, bladder neck obstruction, hydronephrosis, generalized anxiety, malignant neoplasm of prostate, and depression. He had a history of dysphagia, edema, and heart disease. Review of Resident #44's discharge hospital notes dated [DATE] revealed a foley catheter was placed and would need a chronic foley catheter as he was a poor surgical candidate. The resident was alert and oriented. His diagnoses included hydronephrosis, acute retention of urine, bladder outlet obstruction, and malignant tumor of prostate. Review of Resident #44's care plan initiated [DATE] revealed to provide catheter care every shift and as needed. a. Review of Resident #44's admission assessment dated [DATE] revealed the resident was continent of bladder, had no complaints, and did not have a urinary foley catheter. Review of Resident #44's five-day MDS dated [DATE] revealed the resident had cognition impairment. Resident #44 had an indwelling catheter and was frequently incontinent of bowel. Interview on [DATE] at 9:46 A.M., with the Director of Nursing (DON) and Assistant Director of Nursing (ADON) confirmed the admission assessment was inaccurate due to the resident had an indwelling foley catheter on admission. b. Review of Resident #44's orders dated [DATE] revealed to collect a urine for culture and sensitivity due to his urine being tea colored and having an odor to start on [DATE]. Review of Resident #44's laboratory results dated [DATE] to [DATE] revealed no evidence a urine was collected on [DATE]. (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 3 Event ID: 365461 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 365461 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/04/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Muskingum Skilled Nursing & Rehabilitation 501 Pinecrest Drive Beverly, OH 45715 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)