Health inspection·August 7, 2024

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 record review, observations, and interviews, the facility failed to provide appropriately sized incontinence briefs for residents who have bariatric needs. This affected three (Residents #48, #66, and #77) of three bariatric residents reviewed. The facility census was 78. Residents Affected - Few Findings include: 1. Record review for Resident #48 revealed this resident was admitted to the facility on [DATE] and had diagnoses including chronic respiratory failure, atrial fibrillation, incontinence, urinary tract infections, anxiety, and depression. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed this resident had minimally impaired cognition evidenced by a Brief Interview for Mental Status (BIMS) assessment score of 13. This resident was assessed to be frequently incontinent of both bowel and bladder. Interviews with Registered Nurse (RN) #30 and Licensed Practical Nurse (LPN) #60 on 08/07/24 at 9:15 A.M. revealed the facility is always out of 3XL incontinence briefs for Resident #48. Both stated they have incontinence pull ups in that size but they do not work for this resident. Both stated they do not have adequate supplies to do their job. Observation of the supply room on 08/07/24 at 9:20 A.M. revealed no available bariatric 3XL incontinence briefs on any of the shelves. This was verified by LPN #40. Interview with State Tested Nursing Assistant (STNA) #50 on 08/07/24 at 9:45 A.M. revealed she always has to take briefs from other residents due to not having the correct size for Resident #48. She stated this resident uses 3 XL bariatric briefs which the facility does not have, and this has been an ongoing problem. Interview with Resident #48 on 08/07/24 at 9:49 A.M. revealed the incontinence brief that she is wearing is extremely uncomfortable and tight fitting. Resident stated she does not think they have the correct size for her needs. 2. Record review for Resident #66 revealed this resident was admitted to the facility on [DATE] and had diagnoses including chronic respiratory failure, chronic obstructive pulmonary disease, and incontinence. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed this resident was cognitively intact evidenced by a Brief Interview for Mental Status (BIMS) assessment score of 15. (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 3 Event ID: 365679 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 365679 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Signature Healthcare of Fayette County 375 Glenn Avenue Washington Court Hou, OH 43160 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)