Health inspection·September 10, 2024

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, review of staff statements, observation of a video recording, interviews, and review of the Ohio Nursing Home Residents [NAME] of Rights, the facility failed to ensure a resident was treated with dignity and respect. This affected one (#26) of three residents reviewed for dignity and respect. The facility census was 48. Findings include: Review of the medical record for Resident #26 revealed an admission date of 08/25/23. Diagnoses included dementia, pulmonary fibrosis, and chronic obstructive pulmonary disease. Review of the quarter Minimum Data Set (MDS) assessment dated [DATE] revealed the resident had impaired cognition. The resident was always incontinent of bladder and occasionally incontinent of bowel. Review of an undated and unsigned statement by Registered Nurse (RN) #600 revealed on 08/13/24 Resident #26's daughters called and expressed after reviewing a video from their father's room, they saw and heard a nursing assistant yelling at their father and scolding him for urinating on himself. The daughter explained the nursing assistant's behavior appeared to be aggressive as she was in their fathers face yelling at him and again scolding him for urinating on himself. The daughter requested the nursing assistant to no longer be allowed in the resident's room and to no longer take care of the resident. RN #600 identified the nursing assistant and notified the Director of Nursing. RN #600 then spoke with the nursing assistant who denied yelling or scolding the resident. The nursing assistant stated the resident was hard of hearing and she had to speak loudly into his ear so he could hear her. The nursing assistant explained she was just telling the resident he should not pee on himself and he needed to call for assistance so he was not sitting in urine and for safety so he would not fall taking himself to the bathroom without assistance. RN #600 told the nursing assistant she could no longer go into the residents room or provide care for the resident. The nursing assistant was also educated on the importance of offering incontinent residents assistance to the bathroom every two hours and the proper way to approach and talk to a resident who was hard of hearing. Review of an undated and unsigned statement by State Tested Nursing Assistant (STNA) #210 revealed she walked into Resident #26's room and told him he was wet. The resident put his hand to his ear and stated he could not hear. STNA #210 took her hands up and down trying to explain to the resident that he was wet. STNA #210 went to closet and got a clean pair of pants and took the resident to the bathroom. STNA #210 stated there was urine on the floor and she helped the resident change. When STNA #210 walked out of the room, the nurse stopped her and told her the resident's daughter did not Page 1 of 3 365571 365571 09/10/2024 Otterbein Portage Valley 20311 Pemberville Rd Pemberville, OH 43450

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few want her in the room again. STNA #210 stated she was louder because the resident can't hear and was showing him pants. Observation of a video dated 08/13/24 at 11:41 A.M. revealed Resident #26 was in his room seated in his wheelchair watching television. State Tested Nursing Assistant (STNA) #210 entered the room and treated the resident without dignity and respect for being incontinent of urine. STNA #210 while raising her hands in the air had spoken very loudly to the resident and stated, Why do you do this? The resident stated What? STNA #210 then pointing to the resident's pants stated This, you peed yourself, you wet yourself, while moving her right hand and then she walked away from the resident. Interview on 09/09/24 at 1:48 P.M., after reviewing the video, STNA #210 verified the interaction between herself and Resident #26. STNA #210 revealed she had not treated the resident with dignity and respect. STNA #210 revealed she should not have talked to the resident like that. Interview on 09/09/24 at 1:50 P.M., Director of Nursing (DON) reviewed the video and revealed the resident was not treated with respect and dignity. The DON revealed STNA #210 should have just cleaned up the resident and not questioned the resident why he was wet. The DON revealed if STNA #210 was frustrated she could have got someone else to help. The DON further revealed STNA #210 does not realize how she comes off to the residents. Interview on 09/09/24 at 2:28 P.M., the Administrator viewed the video then revealed there was a lack of customer service. Review of the undated, Ohio Nursing Home Residents [NAME] of Rights, revealed residents had the right to be free from physical, verbal, mental and emotional abuse and be treated at all times with courtesy, respect with full recognition of dignity and individuality. This deficiency represents non-compliance investigated under Master Complaint Number OH00156903. 365571 Page 2 of 3 365571 09/10/2024 Otterbein Portage Valley 20311 Pemberville Rd Pemberville, OH 43450

F 0607 Develop and implement policies and procedures to prevent abuse, neglect, and theft. Level of Harm - Potential for minimal harm Based on review of personnel records, staff interview, and policy review, the facility failed to ensure employee reference checks were completed. This had the potential to affect all residents. The facility census was 48. Residents Affected - Many Findings include: Review of the personnel record for State Tested Nursing Assistant (STNA) #210 revealed a hire date of 04/11/23. Further review of the personnel record revealed reference checks had not been completed. Interview on 09/10/24 at 11:56 A.M., the Administrator revealed the facility was unable to find any documentation of completed reference checks for STNA #210. Review of the policy, Abuse, Mistreatment, Neglect, Exploitation and Misappropriation of Resident Property, last revised 10/25/22 revealed prior to hiring a new employee the facility would attempt to obtain information from previous employers or current employers. 365571 Page 3 of 3