Health inspection·January 22, 2024

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm Based on review of facility infection control records, staff interviews, review of staff schedules, review of time punch records, review of electronic mail (e-mail) correspondence, review of facility policies and procedures, review of the Center for Disease Control and Prevention CDC) guidance, and review of Ohio Department of Health's (ODH) guidance for reporting infectious diseases, the facility failed to develop and implement effective infection control practices including written policies and procedures which included when and to who potentially communicable diseases should be reported, and failed to ensure the local health department was notified in a timely manner of a facility gastrointestinal illness outbreak. This affected 29 residents (#5, #6, #10, #17, #22, #23, #28, #36, #38, #39, #42, #48, #57, #58, #59, #60, #61, #63, #66, #69, #71, #74, #75, #77, #79, #82, #90, #91, and #92), two of which (Resident #58 and #60) Norovirus was detected, who experienced symptoms of gastrointestinal illness. This had the potential to affect all residents residing in the facility. The facility census was 86. Residents Affected - Many Findings include: Review of the facility infection control records for the 2024 gastrointestinal outbreak revealed the onset was 12/30/23 and the reporting date was 01/05/24. The facility had 29 residents who experienced gastrointestinal illness including symptoms of vomiting and/or diarrhea (loose stools) from 12/29/23 through 01/13/24. On 12/29/23, Resident #75 experienced both symptoms. On 12/30/23, Resident #48, #74, #79, and #90 experienced both symptoms. On 01/01/24, Resident #71 experienced both symptoms. On 01/02/24, Resident #10 experienced both symptoms, and Resident #36 experienced loose stools. On 01/03/24, Resident #17 experienced both symptoms. On 01/04/24, Resident #22 experienced vomiting, and Resident #42 and #63 experienced loose stools. On 01/05/24, Resident #23 and #28 experienced loose stools, and Resident #77 experienced vomiting. On 01/06/24, Resident #39, #58, and #66 experienced both symptoms, and Resident #6, #69, #82, and #91 experienced vomiting. On 01/07/24, Resident #60 experienced both symptoms, Resident #38 experienced vomiting, and Resident #59 experienced loose stools. On 01/08/24, Resident #5 experienced both symptoms, and Resident #61 experienced vomiting. On 01/12/24, Resident #57 experienced vomiting. On 01/13/24, Resident #92 experienced vomiting. Further review of the infection control records revealed the facility had 29 staff members (Dietary [NAME] #501, Dietary [NAME] #502, Environmental Services Assistant #503, Resident Care Associate (RCA #504, RCA #505, Licensed Practical Nurse (LPN) #506, LPN #507, LPN #508, RCA #509, LPN #510, LPN #511, LPN #512, RCA #513, Guest Relations Staff Member #514, Registered Nurse (RN) #515, Environmental Services Assistant #516, Environmental Services Assistant #517, RCA #518, Business Office Manager #519, Dining Services Assistant #520, RCA #521, Activities Associate #522, LPN #523, Therapy Staff Member #524, RCA #525, RN #526, Therapy Staff Member #527, Therapy Staff Member #528, and the Assistant Director of Health Services) who experienced gastrointestinal illness including symptoms of vomiting and/or diarrhea (loose stools) from 12/29/23 through 01/11/24. (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 2 Event ID: 365541 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 365541 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/22/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Heritage The 2820 Greenacre Dr Findlay, OH 45840 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)