Inspection·January 2, 2025

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. 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 and interview, the facility failed to ensure wound care was completed as ordered for Residents #43, #51 and #77 and timely wound assessments were completed for Resident #77. This finding affected three (Residents #43, #51 and #77) of four residents reviewed for wounds. Residents Affected - Few Findings include: 1. Review of #51's medical record revealed the resident was admitted on [DATE] with diagnoses including other acute osteomyelitis of the right ankle and foot, encounter for other orthopedic aftercare and end stage renal disease. Review of Resident #51's hospital report dated 12/09/24 revealed the resident had a right lower extremity non healing wound with osteomyelitis related to advanced peripheral vascular disease and insulin dependent diabetes. Review of Resident #51's care plans revealed an intervention dated 12/10/24 indicated to note amount and characteristics of any wound drainage, and observe effectiveness of ordered treatments. Notify the physician as needed. Review of Resident ##51's physician orders revealed an order dated 12/10/24 for Ceftazidime 2 grams intravenous (IV) during dialysis for six weeks once a day on Tuesday, Thursday and Saturday; an order dated 12/10/24 for Vancomycin 750 milligrams (mg) IV during dialysis on Tuesday, Thursday and Saturdays for osteomyelitis; and an order dated 12/30/24 to cleanse the right foot wound with wound cleanser, pat dry, apply black foam and secure and place negative pressure wound therapy (NPWT or a special type of wound dressing that was used in a therapy system to help the wound heal) at 125 mmHg (millimeters of mercury or a unit of pressure that measures how high a column of mercury rises). Change every Monday, Wednesday and Friday and as needed. Review of Resident #51's Quarterly Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed the resident exhibited intact cognition. Review of Resident #51's Wound Information Observation History dated 12/30/24 at 2:18 P.M. revealed the resident had a right heel surgical incision which measured 6 cm (centimeters) length by 2 cm width. Interview on 01/02/25 at 5:59 A.M. with Resident #51 indicated she had a wound vac on her left foot and denied concerns with the treatments on her left foot wound. She did not report any other concerns. Observation at the time of the interview revealed the wound vac settings was noted at 135 mmHg. (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 6 Event ID: 365482 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 365482 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/02/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Altercare of Navarre Ctr for Rehab & Nrsg Care 517 Park Street NW Navarre, OH 44662 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)