Health inspection·July 21, 2022

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Based on dining observations and staff interview the facility failed to treat 13 residents (#03, #06, #07,#36, #37, #42, #45, #51,#56, #59, #61, #333, and #434) eating in the restorative dining room with dignity during the meal. The facility census was 78. Findings include: Observation on 07/18/22 at 11:20 A.M. revealed State Tested Nursing Assistant (STNA) #123 was in the restorative dinning room standing to the right side behind Resident #37 wheelchair attempting to feed her a spoonful of food. Resident #37 would not open her mouth. Further observation on 07/18/22 at 11:40 A.M. of dining revealed a small room behind the large main dining room. There were 12 residents ( #03, #06, #07,#36, #37, #42, #45, #56, #59, #61, #333, and #434) in the room in wheelchairs sitting at three small square tables. One Resident (#51) was sitting off to the left side of the room with an over bed table in front of her. STNA #123 stood and fed three different residents ( #03, #06, and #37) each one bite at the middle table then left the small dining room. She returned to the dining room and fed Resident #06 one bite of his puree diet. She went to another table and began feeding Resident #03 while standing. Resident #51 was sitting at an over bed table to the left of the tables. She was served a regular diet on the over bed table at 11:50 A.M. There were nine residents ( #03, #06, #36,#37, #45, #59, #61, #333, and #434) requiring staff to feed them and four residents ( #07, #42, #51,and #56 ) requiring cues to feed themselves. Three staff members (STNA #65, #110, #123) were in the dining room feeding nine residents. All three staff members were moving from table to table standing and feeding the residents. Interview with Assistant Director of Nursing (ADON) #74 on 07/18/22 at 12:20 P.M. revealed the small dining room was the restorative dining room. She verified all of the residents currently in the dining room either required staff to feed them or extensive cueing to ensure the residents would feed themselves. She verified it was her expectation the staff sit in a chair at eye level with the resident and feed the resident engaging the residents in the dining process. She stated the restorative dining room was very crowded and there was little room for the staff to sit. She verified staff should not be moving from table to table to feed multiple residents at one time. She verified that Resident #51 was seated at the over bed table due to limited space . Page 1 of 11 365541 365541 07/21/2022 Heritage The 2820 Greenacre Dr Findlay, OH 45840

F 0558 Reasonably accommodate the needs and preferences of each resident. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review , observation, resident and staff interviews and facility policy review the facility failed to provide one resident (#36) of one resident reviewed with an adaptive call light. The facility census was 78. Residents Affected - Few Findings include: Review of the medical record revealed Resident #36 was admitted to the facility on [DATE] with diagnoses including Parkinson's disease, anemia, cervical spine stenosis, hypertension, and contracture of his left wrist. Review of the significant change Minimum Data Set (MDS) assessment dated [DATE] revealed the resident scored a 15 out of 15 on the Brief Interview for Mental Status (BIMS) indicating no cognitive deficits. He requires extensive assistance with all activities of daily living . He was currently receiving hospice care in the facility. Review of the plan of care dated 07/18/22 stated the resident may need adaptations to participate in activities. The only adaptive intervention was for a bingo board . There was no mention of call light use and no mention of checking the resident requiring frequent checks. Observation on 07/18/22 at 10:40 A.M. revealed Resident #36 was in a specialized tilt in space wheelchair sitting in the center of his room. He asked the Surveyor to get a nursing assistant to help him. The call light was hooked to the top of his bed. Resident #36 states he can't use his hands so he can't use his call light even it it was within his reach. The call light is a string attached to a switch and he stated he can't pull it down. Observation on 07/19/22 at 3:20 P.M. revealed Resident #36 was in his room in tilt in space wheelchair. The call light string was attached to the top back of his wheelchair out of the resident's reach. He verified he could not reach his call light . He stated even if he could reach the string he could not pull it as his hands did no work well enough to pull down on the string to activate it. He stated he has end stage Parkinson disease and has really been going down hill physically. He stated staff is to check on him every half hour to see if he needs anything. Interview on 07/19/22 at 3:25 P.M. with Assistant Director of Nursing (ADON) #74 verified Resident #36's call light was out of reach . ADON #74 stated the facility's call light system is not compatible with a soft touch call light. She stated the facility has bells for residents who can't pull down on the call light. Review of the policy Guidelines for Answering Call Lights ,dated 05/11/16 stated adaptive call lights are available if needed. 365541 Page 2 of 11 365541 07/21/2022 Heritage The 2820 Greenacre Dr Findlay, OH 45840

F 0561 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, resident and facility staff interviews, the facility failed to honor choices of two of 12 sampled residents (Resident #32 and Resident #75), regarding showers. The facility census was 78. Findings include: 1. Interview with Resident #32 occurred on 07/18/22 at 12:52 P.M., Resident #32 identified she is getting a shower about once a month. Resident #32 confirmed she is receiving bed baths, but actually wants showered. Resident #32 appeared clean and odor free at the time of the interview and observation. Interview with Resident #32 occurred again on 07/19/22 at 9:58 A.M. Resident #32 confirmed there is an issue with residents not getting showers and getting bed baths. Resident #32 identified she is the resident council president and wants to speak for other residents whom can not speak for themselves. Review of Resident #32's medical record identified admission to the facility occurred on 08/04/16 with medical diagnoses including; COPD (Chronic obstructive pulmonary disease), diabetes mellitus with diabetic neuropathy, chronic kidney disease, ;major depressive disorder, anemia, hypothyroidism, gout, anxiety disorder, hypertension, gastro-esophageal reflux disease without esophagitis, nausea with vomiting; constipation, presence of urogenital implants; tachycardia and personal history of COVID-19. Review of Resident #32 most recent annual Minimum Date Assessment (MDS) assessment, dated 04/26/22 identified Resident #32 is cognitively intact. The assessment identified Resident #32 is dependent on one staff member for personal care. Review of the facilities grievance logs identified Resident #32 had voiced concerns on 04/27/22, 05/05/22, 05/16/22, 06/17/22 and 07/07/22 for lack of getting showers. The notes identified when the resident complains then she is noted to have received on that date; however then has to voice another concern to get a shower. Interview with the facility Administrator on 07/19/22 at 1:21 P.M. confirmed Resident #32 had filed grievance on 04/27/22, 05/05/22, 05/16/22, 017/22 and 07/07/22 for lack of getting showers. The notes identified when Resident #32 voices her concerns a shower is given at that time, but the same thing is continuing to occur. Review of Resident #32 point of care history (where staff document showers/bed bathing) was completed from 06/20/22 through 07/19/22. The forms identified Resident #32 is schedule for showers on twice a week on Mondays and Fridays. The information confirmed Resident #32's most recent shower occurred on 07/03/22 and bed baths occurred on 07/19, 07/18, 07/15, 07/13, 07/12, 07/10, 07/07 and 07/05/22. 2. Interview with Resident #75 occurred on 07/18/22 at 1:08 P.M. Resident #75 identified he has not been getting showers three times a week as scheduled. Resident #75 identified most of the time he is getting a bed bath instead and prefers a shower. Resident #75 identified he is scheduled on 365541 Page 3 of 11 365541 07/21/2022 Heritage The 2820 Greenacre Dr Findlay, OH 45840

F 0561 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Monday, Wednesday and Friday's which are the days he attends Dialysis. Resident #75 was observed during the interview to be clean and odor free and was shaven. Review of Resident #75's medical record identified admission to the facility occurred on 06/17/13, with medical diagnoses including; fracture of the right fibula/tibia, end stage renal disease, diabetes, morbid obesity, anxiety, major depression, anemia and poor circulation. Review of the most recent MDS assessment dated [DATE] identified he is cognitively intact. Resident #75 is legally blind, dependent on staff for bathing, and required dialysis treatment three time a week. Review of the facility Point of Care history from 06/20/22 through 07/19/22 was completed. The history identified Resident #75 received bed bathing on 07/19, 07/13, 07/06, 07/01, 06/27, 06/25, 06/21 and 06/20/22. Interview with Registered Nurse (RN) #74 was completed on 07/20/22 at 10:44 A.M. and confirmed Resident #75 is not getting showers, as he desires three times a week and instead has been receiving bed baths. 365541 Page 4 of 11 365541 07/21/2022 Heritage The 2820 Greenacre Dr Findlay, OH 45840

F 0676 Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, medical record reviews, therapy, family and staff interviews, the facility failed to maintain ambulation for one (Resident #55) of one residents reviewed for activities of daily living (ADL) decline, in a total sample of 18 residents. The facility census was 78. Residents Affected - Few Findings include: Review of Resident #55's medical record identified she was admitted to the facility on [DATE]. Resident #55 has medical diagnoses that include: dementia, atrial-fibrillation, anxiety and chronic pain. Review of Resident #55's admission assessment dated [DATE] identified severe impairment with cognition and under section G- requires extensive assistant of one, for ambulation, in the room and corridor. The quarterly assessment dated [DATE] identified continued severe cognitive impairment and ambulation in room with supervision only. The assessment identified Resident #55 was not walking in the corridor. Interview with Resident #55's husband occurred on 07/19/22 09:29 A.M. The interview identified two weeks prior to Resident #55's admission she was walking without any assistance. The interview confirmed she received therapy at the facility and since that has stopped they are not walking her very much. Observations of Resident #55 occurred on 07/18/22 at 10:12 A.M.; 11:25 A.M.; and on 07/19/22 at 12:07 P.M. Resident #55 was observed to be an in wheelchair at each observation. Observations on 07/20/22 at 8:30 A.M. and 11:06 A.M. of Resident #55's room and the secured unit identified no evidence Resident #55 had a walker for the staff to ambulate the resident. Interview with Licensed Practical Nurse (LPN) #340 was completed on 07/19/22 at 12:17 P.M. LPN #340 confirmed Resident #55 could ambulate with contact guard assistance when she was discharged from therapy and is almost non-ambulatory at this time. The interview confirmed there is not a walker in Resident #55's room for her to use with the staff. Review of the physical therapy Discharge summary dated [DATE]; identified Resident #55 was discharged because she has reached highest practical level achievement. The discharge notes identified Resident #55 can ambulate 120 feet with a front wheeled walker (FWW) with contact guard minimal assistance. The summary identified Resident #55 transfers with contact guard minimal assistance. The discharged therapy recommendation was for Resident #55 patient complete functional transfers and ambulation with FWW. Observation and interview with STNA (State Tested Nursing Assistant) #109 on 07/20/22 at 8:53 A.M. identified the resident leans forward and does not have a walker on the unit. STNA #109 confirmed she has not been instructed Resident #55 should walk and or has a walker. Review of the point of care forms (utilized by STNA for ambulation times) identified the following days; 05/28/22, 05/31/22, 06/02/22, 06/09/22, 06/11/22, 06/20/22, 07/15/22, and on 07/17/22, Resident #55 was ambulated since 05/24/22, when she was discharged from therapy. The documentation 365541 Page 5 of 11 365541 07/21/2022 Heritage The 2820 Greenacre Dr Findlay, OH 45840

F 0676 identified staff walked Resident #55 in her room with extensive assistance of one person. Level of Harm - Minimal harm or potential for actual harm Interview with Occupational Therapist (OT) #320 occurred on 07/21/22 at 9:46 A.M. The interview confirmed the therapy department can not recommend restorative programs when residents are discharged from therapy as this facility does not have a program. The interview confirmed there was no written program to ambulate Resident #55 upon discharge from therapy. The interview confirmed there is no plan of care to ambulate Resident #55. OT #320 confirmed she had worked with Resident #55 when she was in services through them. The interview confirmed Resident #55 was able to ambulate with contact guard assistance only. Residents Affected - Few Observation on 07/21/22 at 10:10 A.M. with OT #320 working with Resident #55 was completed. The observation identified OT #320 was able to ambulate with a walker approximately 120 feet. The interview confirmed she was contacted yesterday to look at Resident #55 for a decline in ambulation. 365541 Page 6 of 11 365541 07/21/2022 Heritage The 2820 Greenacre Dr Findlay, OH 45840

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 observations, medical record review and staff interviews, the facility failed to prevent a delay in treatment of surgical wound and suture (stitches) removal for one (Resident #75) of two residents reviewed for hospitalization. The facility census was 78. Residents Affected - Few Findings include: Observation and Interview with Resident #75 occurred on 07/18/22 01:19 P.M. Resident #75 was observed with an ace wrap and bandage on the right calf, stopping below the knee. Resident #75 was observed with sutures (stitches) located on the top of the knee and just below the knee. Resident #75 was asked about the stitches and confirmed they should have been out weeks ago; however he missed his appointment on 06/30/22 and it has never been rescheduled. Review of Resident #75's medical record identified admission to the facility occurred on 06/17/13, with medical diagnoses including; fracture of the right fibula/tibia, end stage renal disease, diabetes, morbid obesity, anxiety, major depression, anemia and poor circulation. The most recent Minimum Data Set (MDS) assessment dated [DATE] identified he is cognitively intact. Resident #75 is legally blind and required dialysis treatment three time a week. Review of Resident #75's progress notes identified on 06/05/22 revealed Resident #75 had a fall and suffered a fractured right leg, which required surgical repair on 06/07/22. Review of Resident #75's hospital discharge records dated 06/09/22 identified Resident #75 should return to the orthopedic physician office in 3 weeks for a check up and suture removal. Review of the facilities records identified an appointment was for 06/30/22, but Resident #75 did not make the appointment for transportation issues. Review of the progress notes dated 06/30/22 identified no entries were made regarding the missed appointment, rescheduling or suture removal. Interview with Licensed Practical Nurse (LPN) #181 occurred on 07/19/22 at 12:35 P.M., confirmed Resident #75 should have had an appointment with the orthopedic surgeon on 06/30/22 and missed the appointment, for lack of facility transport. The interview confirmed Resident #75's stitches were still in place and she is going to call the Orthopedic surgeon or Medical Director and ask them about what to do. The interview confirmed Resident #75 has had the sutures in for the past 6 weeks; and should have had them removed after 3 weeks, on 06/30/22. Observation of LPN #181 on 07/19/22 at 3:16 P.M. identified she had a physician order from the facility Medical Director to remove Resident #75's stitches. LPN #181 entered Resident #75's room and started the removal of the stitches. Resident #75's right leg was observed with two sutures above the knee, three sutures just below the knee, had skin growing over the sutures and were difficult to remove. LPN #181 confirmed Resident #75 sutures were difficult to remove due to the extended time they were in place. LPN #181 continued the suture removal with approximately seven sutures removed from Resident #75's right ankle, some of which were observed with crusty skin growing over the sutures. Resident #75 expressed slight discomfort at the time of removal but no pain. 365541 Page 7 of 11 365541 07/21/2022 Heritage The 2820 Greenacre Dr Findlay, OH 45840

F 0685 Assist a resident in gaining access to vision and hearing services. Level of Harm - Minimal harm or potential for actual harm Based on record review, staff and resident interview, and observations the facility failed to ensure one resident ( #43) of 18 sampled residents received her hearing aids on a consistent basis. The facility census is 78. Residents Affected - Few Findings Include: Review of the medical record for Resident #43 revealed an admission date of 12/01/21. Diagnoses included, unspecified dementia without behavioral disturbance, anxiety disorder, hypokalemia, essential hypertension, and insomnia. Review of the quarterly Minimum Data Set (MDS) assessment, dated 05/13/22, revealed she was moderate cognitive impairment. The assessment, section B (Hearing) revealed moderate difficulty - speaker has to increase volume and speak distinctly, and indicated hearing appliance used. There were no behaviors indicated. Review of the Plan of Care dated 05/21/22 revealed interventions included putting hearing aids in medication cart each night. Review of the progress notes dated 05/18/22 revealed Resident #43 had hearing aid on. Review of notes dated 06/08/22 revealed daughter, came in today and brought in left hearing aid, and placed in Resident #43's ear. Review of the progress notes dated 06/08/22 through 07/17/22 revealed no further mention of hearing aid. Interview on 07/19/22 at 1:45 P.M. with Licensed Practical Nurse (LPN) #157, indicated Resident #43 states she doesn't want the hearing aids and throws them when she does have them. Interview on 07/20/22 at 9:43 A.M. with Registered Nurse (RN) #300 stated there is no record used for nurses to sign off that hearing aids are put in place, we only record hearing aids placed in med cart each night. Interview on 07/21/22 at 10:31 A.M. with Resident #43 stated, Yes, I would like to have my hearing aides in everyday. Interview on 07/21/22 at 11:22 A.M. with Executive Director (ED) stated a staff education was given about two months ago because Resident # 43's daughter asked to have hearing aids placed every day. Observation on 07/18/22 at 11:29 A.M. and 1:02 P.M. revealed Resident #43 in room awake no hearing aids in place. Observation on 07/19/22 at 12:27 P.M. revealed Resident #43 sitting up in recliner, in her room eating lunch. Resident #43 stated she doesn't know where her hearing aids are. Resident #43 pointed to her ears and shook her head. Observation on 7/19/22 at 1:50 P.M. revealed LPN #57 removed the hearing aids from her medication cart and placed then in Resident #43's ears. Resident #43 did not object to having the hearing aids in place. 365541 Page 8 of 11 365541 07/21/2022 Heritage The 2820 Greenacre Dr Findlay, OH 45840

F 0756 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, review of pharmacy recommendations and interview the facility failed to timely respond to pharmacy recommendations. This affected one resident (#05) of five residents reviewed for unnecessary medications. The facility census was 78. Findings include: Review of the medical record for Resident #05 revealed an admission date of 03/25/22. Diagnoses included Parkinson's Disease, Alzheimer's Disease, dementia, unspecified psychosis not due to a substance or known physiological condition, major depressive disorder, single episode, and anxiety. Review of the pharmacy recommendations dated 03/29/22 revealed resident has an order for Celexa 40 milligrams (mg) daily. Food and Drug Administration (FDA) says citalopram doses should not exceed 20 mg/day for most patients over age [AGE]. Higher doses of citalopram (Celexa, etc.) increases risk of QT prolongation (a heart rhythm that can potentially cause fast, chaotic heartbeats) and torsades (a specific type of ventricular tachycardia, or fast heart rhythm that begins in your heart ventricles). Please review to determine if patient would benefit from a decrease to Celexa 20 mg daily, or alternative therapy. If no change is to be made, please comment. There was no documentation to indicate the physician had addressed the recommendation. Review of the pharmacy recommendation dated 04/25/22 revealed a repeat recommendation related to Celexa 40 mg daily. Review of physician response dated 05/03/22 revealed discontinue Celexa 40 mg, start Celexa 20 mg daily. Interview on 07/21/22 at 9:05 A.M. with Registered Nurse (RN) #300 verified the physician did not document a response to the recommendation dated 03/29/22. Review of facility policy titled, Medication Regimen Review, revised date 11/2018, revealed recommendations are acted upon and documented by the facility personnel and/or the prescriber. Prescriber accepts and acts upon suggestion or rejects and provides an explanation for disagreeing. 365541 Page 9 of 11 365541 07/21/2022 Heritage The 2820 Greenacre Dr Findlay, OH 45840

F 0920 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Provide at least one room set aside to use as a resident dining room and for activities, that is a good size, with good lighting, air flow and furniture. Based on dining observations and staff interview the facility failed to ensure there was adequate space in the restorative dining room for 13 residents (#03, #06, #07,#36, #37, #42, #45, #51, #56, #59, #61,#333, and #434) requiring extensive assistance with eating. The facility census was 78. Findings include: Observation on 07/18/22 at 11:20 A.M. revealed State Tested Nursing Assistant (STNA) #123 was in the restorative dinning room standing to the right side behind Resident #37 wheelchair attempting to feed her a spoonful of food. Resident #37 would not open her mouth. Further observation on 07/18/22 at 11:40 A.M. revealed a small room behind the large main dining room. There were 12 residents ( #03, #06, #07,#36, #37, #42, #45, #56, #59, #61,#333, and #434) in the room in wheelchairs sitting at three small square tables. One resident (#51) was sitting off to the left side of the room with an over bed table in front of her. STNA #123 stood and fed three different residents ( #03, #06, #37) each one bite at the middle table then left the small dining room. In order to leave the middle table STNA # 123 had to move two resident's ( #03 and #59) wheelchairs away from two different tables to exit the dining room. She returned to the dining room and fed Resident #06 one bite of his puree diet. She went to another table moving Resident #59 wheelchair out of the way and began feeding Resident #03 while standing. There were nine residents ( #03, #06, #36,#37, #45, #59, #61, #333, and #434) requiring staff to feed them and four residents ( #07, #42, #51,and #56 ) requiring cues to feed themselves. Three staff members (STNA #65, #110, #123) were in the dining room feeding nine residents. All three staff members were moving from table to table standing and feeding the residents. As staff moved throughout the restorative dining room they would move resident's wheelchairs so they could to get to a different table. Interview with Assistant Director of Nursing (ADON) #74 on 07/18/22 at 12:20 P.M. verified the small dining room was the restorative dining room. She verified all of the residents currently in the dining room were in wheelchairs and either required staff to feed them or extensive cueing to ensure the residents would feed themselves. She verified all of the residents currently in the restorative dining room were dependent on staff for mobility in a wheelchair. She stated the restorative dining room was very crowded and there was little room for the staff to sit. She verified Resident # 51 was seated off to the left side of the tables and was eating off an over bed table due to limited space in the restorative dining room. 365541 Page 10 of 11 365541 07/21/2022 Heritage The 2820 Greenacre Dr Findlay, OH 45840

F 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review,observations, family and staff interviews the facility failed to ensure a clean sanitary environment was maintained for one resident (#07) in a total sample of 18 residents. The facility census was 78. Findings include: Review of the medical record revealed Resident #07 was admitted to the facility on [DATE] with diagnoses including Alzheimer's dementia and generalized anxiety. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed the resident had short and long term memory deficits and was unable to complete the Brief Interview for Mental Status. She requires extensive assistance of one staff member for all activities of daily living including toileting. She was assessed as always incontinent of bowel and bladder. Review of the plan of care dated 05/25/22 revealed the resident is incontinent of bowel and bladder. Interventions included providing incontinent care following incontinence. Observation on 07/18/22 at 10:30 A.M. revealed the trash in Resident 's #07 bathroom was overflowing with two wet incontinent briefs. There was a strong smell of urine in the bathroom. Observation on 07/19/22 at 8:30 A.M. revealed one wet incontinent brief in Resident #07 bathroom trash. Interview with Resident #07's family member on 07/19/22 at 9:20 A.M. revealed she stated she usually visits Resident #07 on Saturday evenings and does not leave until she is in bed for the night. She stated generally there is an wet incontinent brief in the waste basket when she visits which she feels if left from the last time the resident was changed. Observation on 07/19/22 at 5:30 P.M. revealed a wet incontinent brief was in the resident's bathroom trash . Assistant Director of Nursing (ADON) #74 verified there was a wet incontinent brief in the trash can in Resident #07's bathroom. She stated it is the expectation for staff is to take the soiled briefs in a sealed trash liner to the dirty utility room and dispose of them immediately. She verified soiled incontinent briefs are never to be left in a trash can in resident's rooms or bathrooms. . 365541 Page 11 of 11