Health inspection·July 17, 2023

F 0697 Provide safe, appropriate pain management for a resident who requires such services. Level of Harm - Minimal harm or potential for actual harm Based on observation, interviews and record review, the facility failed to ensure Resident #49's pain medication was administered as ordered. This affected one (Resident #49) of three residents reviewed for receiving medications as ordered. The facility census was 107. Residents Affected - Few Findings include: Review of the medical record for Resident #49 revealed an admission date of 02/18/14 with diagnoses including cellulitis (a skin infection that becomes swollen and inflamed) to the right lower limb, heart failure, diabetes mellitus and chronic pain. Review of the physician's orders for Resident #49 revealed she had an order dated 07/09/23 for Lidocaine Patch to be applied to the right side topically at 9:00 A.M. This was to be left on the resident for 12 hours. Review of the Medication Administration Record (MAR) for July 2023, revealed a nurse had signed off the Lidocaine Patch as administered to Resident #49 at 9:00 A.M. on 07/10/23. Interview and observation on 07/10/23 at 4:33 P.M. with Resident #49 and Resident #49's daughter revealed she did not have the Lidocaine Patch applied to her right side for pain. Resident #49 stated the nursing staff had not applied it to her right hip. Interview on 07/10/23 at 4:38 P.M. with Licensed Practical Nurse (LPN) #202 verified she had not administered the Lidocaine Patch as ordered by the physician. LPN #202 also verified she marked on the MAR that she had applied the patch as she got click happy while checking off her medications. She stated she must have missed the order. Review of the facility policy titled, Medication Administration, undated, revealed staff should administer the medications within the time frame of one hour before and up to one hour after the time ordered. Staff should also chart when the medications were given. This deficiency represents non-compliance investigated under Complaint Number OH00144152. Page 1 of 3 365633 365633 07/17/2023 The Colony Healthcare Center 563 Colony Park Drive Tallmadge, OH 44278

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Based on observation, interview and record review, the facility failed to ensure medications were properly stored and secured. This affected one (Resident #55) of one resident reviewed for medication storage. The facility census was 107. Findings include: Review of the medical record for Resident #55 revealed an admission date of 12/04/20 with diagnoses including bipolar disorder, lack of coordination and cognitive communication deficit. Review of the physician's orders for Resident #55 revealed he had no orders for an antifungal powder. Observation on 07/10/23 at 2:30 P.M. of Resident #55 revealed he was sitting in his doorway in his wheelchair. He was holding a bottle of Tolnaftate Antifungal Powder in his hands. He was noted to have the medicated powder on his hands and pants. He stated he was supposed to put it on his hands. He was unable to state what the medicated powder was for or where he had found it. Interview on 07/10/23 at 2:38 P.M. with Licensed Practical Nurse #202 verified Resident #55 should not have had the Tolnaftate Powder in his room as he did not have an order for that medication. Review of the facility policy titled, Medication Administration, undated, revealed staff should never leave medications unattended or at the bedside. 365633 Page 2 of 3 365633 07/17/2023 The Colony Healthcare Center 563 Colony Park Drive Tallmadge, OH 44278

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on observation and interview, the facility failed to maintain a clean and sanitary kitchen area. This had the potential to affect 106 residents who received meals in the facility. The facility identified Resident #47 as receiving no food from the kitchen. The facility census was 107. Findings include: Observation of the kitchen on 07/11/23 at 10:26 A.M. with Dietary District Manager (DDS) #213 revealed the previous dietary manager had quit without notice approximately two weeks prior. Observation revealed the beverage counter to have coffee grounds spread out on the counter and coffee spilled on the floor. The backsplash behind the beverage counter had a red dried substance which DDS #213 stated was juice. There was food debris, dried spills and brown dirt build-up in the corners and behind the counters in the kitchen. The clean dish area was noted to have dirty plates, pens, staff items including coffee cups and gloves. DDS #213 stated the clean dish cart had become a catch all for staff. Observation of the dry storage pantry revealed food debris including cereal in the corners behind shelves. There were dirty gloves and towels laying on the floors throughout the kitchen. The floor was noted to be sticky with food smashed on it. The gas stove and griddle area showed the last professional cleaning was on 01/30/23. There was a thick layer of dust on the vents and the metal section on the underside of the hood. DDS #213 stated staff was supposed to clean the vents and underside of the hood weekly but he did not think it had been done for a while. Interview on 07/11/23 at 10:38 A.M. with DDS #213 verified all observations and stated staff had not been cleaning the kitchen as they should have been. Review of the facility checklist titled, Dietary Daily Cleaning Assignments, undated, revealed staff should be cleaning the kitchen daily. This deficiency represents non-compliance investigated under Complaint Number OH00144419. 365633 Page 3 of 3