Health inspection·March 22, 2024

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, policy review, and interview, the facility failed to ensure appropriate care and treatment of Peripherally Inserted Central Catheters (PICC). This affected three residents (#19, #48 and #60) of three residents reviewed for PICC lines. The facility census was 59. Residents Affected - Few Findings include; 1. Review of Resident #48's medical record revealed a 07/13/23 admission with diagnoses including osteomyelitis, methicillin-resistant staphylococcal aureus, type two diabetes, migraines, gastroesophageal reflux disease, fibromyalgia, urinary incontinence and asthma. The resident was admitted with a PICC line. The infection control log revealed the resident had a wound infection 01/10/24 to a coccyx ulcer. Physician orders included to change the PICC line dressing and cap every Tuesday. Review of the treatment sheets for January, February and March 2024 revealed there was no evidence of a weekly dressing change on 01/23/24, 02/27/24, and 03/12/24. There was no evidence of a cap change on 01/16/24, 01/23/24, 01/30/24, 02/27/24 or 03/12/24. Interview on 03/22/24 at 3:54 P.M. with Corporate Quality Assurance #100 verified there was no evidence of dressing and cap changes as ordered. 2. Review of Resident #19's medical record revealed a 02/23/24 admission with diagnoses including muscle wasting and atrophy, lack of coordination, methicillin-resistant staphylococcal aureus, thoracic spine pain, hyperlipidemia, anxiety disorder, heart disease, arthritis, presence of artificial hip, spinal stenosis, obesity, hypokalemia, hypertension, and gastroesophageal reflux disease. She was admitted with a PICC/Midline with orders for an antibiotic due to an infected hip replacement. Physician orders included to change the PICC line dressing within the first 24 hours of insertion or admission and then to change the dressing and cap weekly every Wednesday. Review of the PICC line dressing change revealed the dressing was changed 02/28/24, 03/03/24, 03/10/24, and 03/19/24. There was no evidence of the cap being changed between admission [DATE] and 03/10/23, 19 days after admission. The next cap change was on 03/20/24. Interview on 03/22/24 at 2:54 P.M. with Corporate Quality Assurance #100 verified there was no evidence of dressing and cap changes the day after admission and weekly as ordered. Page 1 of 2 365766 365766 03/22/2024 Parkside Health Care Center 930 East Park Avenue Columbiana, OH 44408

F 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few 3. Review of the closed record for Resident #60 revealed a 12/07/23 admission with diagnoses including hypertension, hyperlipidemia, anxiety disorder, chronic kidney disease, polyarthritis, osteoarthritis, pancreatitis, and malignant neoplasm of pancreas. She was admitted postoperatively with an intra-abdominal abscess, JP drain to the abdomen, midline surgical incision, double lumen line to the right arm and was to receive antibiotic therapy. Physician orders included to change the PICC line dressing within the first 24 hours of admission and then to change the dressing and cap weekly every Friday. Review the treatment sheets revealed the dressing and cap were changed the day after admission on [DATE]. The 12/15/23 signature box was coded 5, refer too progress notes. Review of the progress notes on 12/15/23 included no evidence of a dressing change. There was no evidence of the cap being changed 12/15/23 or 12/22/23. The resident was discharged to the hospital 12/23/23. Interview on 03/22/24 at 2:40 P.M. with Corporate Quality Assurance #100 verified there was no evidence of dressing and cap change 12/15/23 and a cap change 12/22/23. The dressing and cap were not changed weekly as ordered. Review of the facility's undated Midline/PICC catheter dressing changes policy included the dressing was to be changed 24 hours post insertion then every seven days. This deficiency represents non-compliance investigated under Complaint Number OH00151712. 365766 Page 2 of 2