Inspection·February 20, 2025

F 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Review of the care plan dated 01/17/25 for Resident #90 revealed the resident was at risk for falls related to bladder and bowel incontinence, decreased strength and endurance, weakness, history of falls, history of self-transfers, and decreased safety awareness. Review of the progress note written by Registered Nurse (RN) #101 dated 01/18/25 at 1:11 P.M. revealed the family was called to inform them of the broken femur and they were dismayed with the facility on the phone and asked why the treatment wasn't given sooner. The nurse explained she wasn't the nurse taking care of Resident #90 on 01/17/25 and the facility was trying to get everything ready for the transfer of the resident. The interview with the Director of Nursing (DON) on 02/20/25 at 11:08 A.M. revealed the X-ray for Resident #80 was ordered and should have been completed within four hours of the time it was ordered. She stated the urine dip wasn't ordered or completed for the resident. She confirmed this was a delay in treatment for the resident. She said the nurse who took care of Resident #90 on 01/17/25 no longer worked at the facility. The nurse resigned to take another job, and it wasn't a result of this episode. Interview with RN #101 on 02/20/25 at 11:40 A.M. revealed she worked on 01/18/25 on day shift and stated the night shift did not tell her in report anything about the fall Resident #90 had on 01/17/25 or that the X-ray company had not been into the facility. She stated a friend came to the nursing station and wanted her to look at Resident #90's leg and she discovered it was swollen, reddened and warm to touch. She stated the resident was in pain, but she medicated her with Tylenol on that morning. She denied the resident was crying out in pain. Review of the policy entitled Falls dated 09/01/21 revealed based on previous evaluations and current data, the staff will identify interventions related to the resident's specific risks and causes to try to prevent the resident from falling and to try to minimize complications from falling. In conjunction with the Physician, staff will identify and implement relevant interventions. 2. Medical record review for Resident #38 revealed an admission date of 09/06/17. Medical diagnoses included diabetes, renal insufficiency, and seizure disorder. Review of the quarterly minimum Data Set (MDS) dated [DATE] revealed Resident #38 was severely cognitively impaired. Her functional status was substantial/maximal assistance for eating and transfers, dependent on toileting, partial/moderate assistance for bed mobility. She was coded on this assessment as being always incontinent for bowel and bladder. Review of the care plan dated 12/07/24 revealed Resident #38 was incontinent for bowel and bladder. Interventions included: assist for toileting needs, monitor for signs and symptoms of urinary tract infection, monitor peri-area for redness and irritation, and provide peri-care after each incontinence episode. During observation of incontinence care for Resident #38 on 02/19/25 at 1:19 P.M. revealed Certified Nursing Aide (CNA) #110 donned gloves and proceeded to provide the care and used a washcloth and wiped up in the labia area once. He proceeded with the care and turned the resident over and wiped the anal area which had feces present in the area. Interview with CNA #110 on 02/19/25 at 1:21 P.M. confirmed he wiped up in the labia area, but stated he was trained to wipe down on the sides of perineum and wipe up in the labia area. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365743 If continuation sheet Page 2 of 7 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 365743 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/20/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wright Rehabilitation and Healthcare Center 829 Yellow Springs - Fairfield Rd Fairborn, OH 45324 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)

F 0684 Review of the policy entitled (Perineal Care) dated 09/01/21 revealed the following: Level of Harm - Minimal harm or potential for actual harm Steps in the Procedure 1. Place the equipment on the bedside stand. Arrange the supplies so they can be easily reached. Residents Affected - Few 2. Wash and dry your hands thoroughly. 3. Fill the wash basin one-half (1/2) full of warm water. Place the wash basin on the bedside stand within easy reach. 4. Put on gloves. 5. Instruct the resident to bend his or her knees and put his or her feet flat on the mattress. Assist as necessary. 6. For a female resident: a. Wet washcloth and apply soap or skin cleansing agent. b. Wash perineal area, wiping from front to back. (l) Separate labia and wash area downward from front to back. (Note: If the resident has an indwelling catheter, gently wash the juncture of the tubing from the urethra down the catheter about 3 inches. Gently rinse and dry the area.) (2) Continue to wash the perineum moving from inside outward to and including thighs, alternating from side to side, and using downward strokes. Do not reuse the same washcloth or water to clean the urethra or labia. (3) Rinse perineum thoroughly in same direction, using fresh water and a clean washcloth. (Note: If the resident has an indwelling catheter, hold the tubing to one side and support the tubing against the leg to avoid traction or unnecessary movement of the catheter.) (4) Gently dry perineum. c. Instruct or assist the resident to turn on her side with her top leg slightly bent, if able. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365743 If continuation sheet Page 3 of 7 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 365743 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/20/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wright Rehabilitation and Healthcare Center 829 Yellow Springs - Fairfield Rd Fairborn, OH 45324 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)

F 0684 c. Rinse wash cloth and apply soap or skin cleansing agent. Level of Harm - Minimal harm or potential for actual harm d. Wash the rectal area thoroughly, wiping from the base of the labia towards and extending over the buttocks. Do not reuse the same washcloth or water to clean the labia. Residents Affected - Few e. Rinse thoroughly using the same technique as described in e above. (5) Remove gloves and discard into designated container. Wash and dry your hands thoroughly. This deficiency represents non-compliance investigated under Complaint Number OH00161840. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365743 If continuation sheet Page 4 of 7 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 365743 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/20/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wright Rehabilitation and Healthcare Center 829 Yellow Springs - Fairfield Rd Fairborn, OH 45324 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)

F 0770 Provide timely, quality laboratory services/tests to meet the needs of residents. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, staff interview and policy review the facility failed to ensure an X-ray was ordered and implemented in a timely manner. This affected one (#90) of three residents reviewed for X-rays. The census was 89. Residents Affected - Few Findings included: Medical record review for Resident #90 revealed an admission date of 12/20/24. Admitting diagnoses were multiple fractures of ribs with routine healing, ulcerative colitis, non-Alzheimer's dementia, anxiety, and depression. Review of admission Minimum Data Set (MDS) dated [DATE] revealed Resident #90 was moderately cognitively impaired. Her functional status was set up or clean-up assistance for eating, toileting, bed mobility, and transfers were partial/moderate assistance. She was frequently incontinent with her bowel and bladder. Review of the physician orders dated 01/17/25 revealed a Stat X-ray of left knee, left femur, left hip, and unilateral with pelvis when performed. Review of the progress notes from 01/17/25 at 4:45 P.M. to 01/18/25 11:48 A.M. there wasn't any evidence the X-ray company had been called about the X-ray for Resident #90. Review of the dispatch record on 01/17/25 revealed they were informed of an X-ray at 5:50 P.M. and a technician was assigned to the order, but the x-ray wasn't completed until 01/18/25 at 11:48 A.M The interview with the Director of Nursing (DON) on 02/20/25 at 11:08 A.M. revealed the X-ray for Resident #80 was ordered and should have been completed within four hours of the time it was ordered. She confirmed the Stat X-ray was not completed within the four hours and confirmed the X-ray didn't get completed until 01/18/25 at 11:48 A.M. Review of the policy entitled Request for Diagnostic Services undated revealed orders for diagnostic services will be carried out as instructed by the physician's order. This deficiency represents non-compliance investigated under Complaint Number OH 00160894. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365743 If continuation sheet Page 5 of 7 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 365743 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/20/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wright Rehabilitation and Healthcare Center 829 Yellow Springs - Fairfield Rd Fairborn, OH 45324 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)

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, observations, staff interview and policy review the facility failed to ensure proper infection control was maintained during incontinence care. This affected one (#38) of three residents reviewed for incontinence. The facility identified there were 58 residents who were incontinent. The census was 89. Residents Affected - Few Findings included: Medical record review for Resident #38 revealed an admission date of 09/06/17. Medical diagnoses included diabetes, renal insufficiency, and seizure disorder. Review of the quarterly minimum Data Set (MDS) dated [DATE] revealed Resident #38 was severely cognitively impaired. Her functional status was substantial/maximal assistance for eating and transfers, dependent on toileting, partial/moderate assistance for bed mobility. She was coded on this assessment as being always incontinent for bowel and bladder. Review of the care plan dated 12/07/24 revealed Resident #38 was incontinent for bowel and bladder. Interventions included: assist for toileting needs, monitor for signs and symptoms of urinary tract infection, monitor peri-area for redness and irritation, and provide peri-care after each incontinence episode. During observation of incontinence care for Resident #38 on 02/19/25 at 1:19 P.M. revealed Certified Nursing Aide (CNA) #110 donned gloves and proceeded to provide the care and used a washcloth and wiped up in the labia area once. He proceeded with the care and turned the resident over and wiped the anal area which had feces present in the area. He retrieved some lotion and applied the lotion to the bottom of the resident. The CNA did not change his gloves prior to applying the lotion to the resident skin. Interview with CNA #110 on 02/19/25 at 1:21 P.M. confirmed he didn't change his gloves prior to putting on the lotion to the resident's bottom and stated he was never told to change his gloves in between a dirty to clean task. Review of the policy entitled (Perineal Care) dated 09/01/21 revealed the following: Steps in the Procedure 1. Place the equipment on the bedside stand. Arrange the supplies so they can be easily reached. 2. Wash and dry your hands thoroughly. 3. Fill the wash basin one-half (1/2) full of warm water. Place the wash basin on the bedside stand within easy reach. 4. Put on gloves. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365743 If continuation sheet Page 6 of 7 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 365743 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/20/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wright Rehabilitation and Healthcare Center 829 Yellow Springs - Fairfield Rd Fairborn, OH 45324 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)

F 0880 5. Instruct the resident to bend his or her knees and put his or her feet flat on the mattress. Level of Harm - Minimal harm or potential for actual harm Assist as necessary. 6. For a female resident: Residents Affected - Few a. Wet washcloth and apply soap or skin cleansing agent. b. Wash perineal area, wiping from front to back. (l) Separate labia and wash area downward from front to back. (Note: If the resident has an indwelling catheter, gently wash the juncture of the tubing from the urethra down the catheter about 3 inches. Gently rinse and dry the area.) (2) Continue to wash the perineum moving from inside outward to and including thighs, alternating from side to side, and using downward strokes. Do not reuse the same washcloth or water to clean the urethra or labia. (3) Rinse perineum thoroughly in same direction, using fresh water and a clean washcloth. (Note: If the resident has an indwelling catheter, hold the tubing to one side and support the tubing against the leg to avoid traction or unnecessary movement of the catheter.) (4) Gently dry perineum. c. Instruct or assist the resident to turn on her side with her top leg slightly bent, if able. c. Rinse wash cloth and apply soap or skin cleansing agent. d. Wash the rectal area thoroughly, wiping from the base of the labia towards and extending over the buttocks. Do not reuse the same washcloth or water to clean the labia. e. Rinse thoroughly using the same technique as described in e above. (5) Remove gloves and discard into designated container. Wash and dry your hands thoroughly. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365743 If continuation sheet Page 7 of 7