Health inspection·April 1, 2024

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm Based on record review, review of facility infection control surveillance records, staff interviews, review of facility policies and procedures, review of the Centers for Disease Control and Prevention (CDC) guidance, the facility failed to document and track employee reported illness as part of their infection control and prevention program. This affected 17 (#01, #02, #06, #12, #19, #41, #42, #44, #09, #13, #23, #34 #37, #08, #17, #26 and #25) residents but had the potential to affect all residents at the facility. The facility census was 46. Residents Affected - Some Findings include: Review of the facility's infection control and surveillance logs with Infection Preventionist (IP) Nurse #150 revealed the facility experienced a gastroenteritis illness (GI) including symptoms of nausea, vomiting and/or diarrhea (loose stools) from 03/13/24 through 03/16/23. The facility's infection control and surveillance logs documented 17 residents who were affected by the GI illness. On 03/13/24, Residents' (#01, #02, #06, #12, #19, #41, #42, and #44), on 04/14/24, Residents' (#09, #13, #23, #34 and #37), on 03/15/24 Residents' (#08, #17, and #26), and on 03/16/24, Resident #25 had symptoms of a GI illness. Interview with IP Nurse #150 at the same verified she was tasked with being the facility's Infection Preventionist over the infection control and prevention program. IP Nurse #150 verified the facility had a GI virus outbreak that affected 17 residents from 03/13/24 to 03/16/24. IP Nurse #150 was questioned on whether any staff members were affected by the recent GI virus outbreak and IP #150 indicated she would have to call human resources because she did not track employee call offs and/or illnesses. IP Nurse #150 consulted with the Human Resource (HR) Manager #184 and learned a total of ten employees were affected by the GI virus outbreak from 03/13/24 through 03/16/24. The infection control and surveillance logs revealed no documented evidence of any staff members being identified with the GI illness or employees calling off for illness. Review of a facility document titled Staff GI Virus revealed the following 10 employees were affected by the GI Virus: On 03/13/24, Maintenance Director #181 called off with similar GI illness symptoms. On 03/14/24, Registered Nurse #151 and State Tested Nursing Assistant (STNA) #162 called off with similar GI symptoms. On 03/15/24, the Administrator called off for similar symptoms and the Admissions/Marketing #160 left work near the end of her workday with similar GI symptoms. On 03/16/24, RN #67 and #167 called for similar GI symptoms. On 03/18/24, STNA #73, Housekeepers' #175 and #185 called off for similar GI symptoms. Review of an untitled facility document revealed five additional employees called off with illnesses from 03/11/24 through 03/18/24. On 03/12/24, housekeeper #198 called off due to being ill and on 03/16/24, STNA #60 called off due to being ill. Housekeeper #198 and STNA #60 were not listed on the infection control and prevention surveillance logs. (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: 365592 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 365592 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/01/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Continental Manor Nurs and Rehabilitation Center 820 East Center Street Blanchester, OH 45107 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)