Health inspection·September 13, 2023

F 0677 Provide care and assistance to perform activities of daily living for any resident who is unable. 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 and resident interview and policy review, the facility failed to ensure bathing/showers was provided for residents who were dependent on staff for care. This affected two (#14 and #16) of three residents reviewed for bathing. The census was 48. Residents Affected - Few Findings include: 1. Review of Resident #14's medical record revealed an admission date of 07/17/23, with diagnoses including cerebrovascular attack (CVA), dementia, and multiple sclerosis. Review of care plan dated 07/17/23 revealed Resident #14 had a self-care performance deficit and required assistance with Activities of Daily Living. Interventions on 07/26/23 revealed she preferred her bathing time in the morning and a shower, and she was 1-2-person assistance for the bathing. Review of admission Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #14 was moderately cognitively impaired. Functional status was extensive assistance for bed mobility, transfers, and toileting. She was supervision for eating and total dependence for bathing. Review of showers for Resident #14 revealed from 07/17/23 through 09/12/23, of 18 opportunities the resident only received two showers on 09/04/23 and 09/07/23. The showers were marked non-applicable on 08/03/23 and 08/28/23. 2. Review of Resident #16's medical record revealed an admission date of 08/10/22, with diagnoses including cancer, atrial fibrillation, heart failure, peripheral vascular disease, diabetes, and dementia. Review of care plan dated 03/20/23 revealed Resident #16 had a self-care performance deficit and required assistance with Activities of Daily Living. Interventions on 07/13/23 revealed she preferred her bathing time in the morning and a bed bath. Review of the annual Minimum Data Set (MDS) assessment dated [DATE] revealed the resident was rarely or never understood. She was extensive assistance for bed mobility transfers, toileting and eating. She was total dependence for bathing. Review of bathing for Resident #16 revealed the resident was documented as having a shower on 07/19/23, 07/28/23, 08/22/23, 09/01/23, 09/05/23, 09/08/23. Of 16 opportunities she only received six baths during this time frame. The resident had not been out to the hospital during this time. Page 1 of 4 365773 365773 09/13/2023 The Laurels of Kettering 694 Isaac Prugh Way Kettering, OH 45429

F 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Interview on 09/12/23 at 7:17 A.M., with State Tested Nursing Aide (STNA) #83 revealed there were days when bathing doesn't get completed for the residents due to staffing, but she couldn't provide the day or the resident. Interview on 09/12/23 at 1:48 P.M., with the Administrator revealed she didn't have any more evidence to show Resident #14 and #16 were receiving their showers or baths. Review of the polity titled Routine Resident Care dated 03/07/23, revealed residents will receive the necessary assistance to maintain good grooming and personal/oral hygiene. Steps will be taken to ensure that a resident's capacity for self-performance of these activities does not diminish unless circumstances of the resident's clinical condition demonstrate the decline is unavoidable. Showers, tub baths, and/or shampoos are scheduled according to person centered care or state specific guidelines. Additional bathing will be given as requested. This deficiency represents non-compliance investigated under Complaint Number OH00146189. 365773 Page 2 of 4 365773 09/13/2023 The Laurels of Kettering 694 Isaac Prugh Way Kettering, OH 45429

F 0745 Provide medically-related social services to help each resident achieve the highest possible quality of life. 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 and staff interview, the facility failed to ensure referrals for outside services were made when requested by the family. This affected one (#16) of three residents reviewed for outside services. The census was 48. Residents Affected - Few Findings include: Review of Resident #16's medical record revealed an admission date of 08/10/22, with medical diagnoses including cancer, atrial fibrillation, heart failure, peripheral vascular disease, diabetes, and dementia. Review of the annual Minimum Data Set (MDS) assessment dated [DATE], revealed the resident was rarely or never understood. She was extensive assistance for bed mobility transfers, toileting and eating. Review of the physician referrals for Resident #16 revealed there wasn't any neurology referrals in the folder since 03/01/23. Review of physician notes dated 06/19/23, documented the family wanted a neurology consultation to slow the progression of dementia. Interview on 09/12/23 at 4:00 P.M., with the Director of Nursing (DON) confirmed there was not a neurology consult placed until today. This deficiency represents non-compliance investigated under Complaint Number OH00146189. 365773 Page 3 of 4 365773 09/13/2023 The Laurels of Kettering 694 Isaac Prugh Way Kettering, OH 45429

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm Based on observation, staff interview and policy review, the facility failed to ensure eye protection was worn into COVID-19 positive resident's rooms. This potentially could affect eight (#31, #12, #43, #34, #13, #1, #14, #30) of twelve residents who resided on the 200 hall and did not have COVID-19. The census was 48. Residents Affected - Some Findings include: Observation of the rooms on the 200 halls for Resident #3, #46, #17 and #24 revealed their doors were closed and had a red sign on the door, indicating the resident was in droplet and contact isolation, due to COVID-19 positive. The sign indicated to wear eye protection, gown, gloves, and a N-95 mask. There was a cart observed outside the door with gowns, shields, gloves, and N-95 masks in them. Observation on 09/12/23 from 8:03 A.M. to 8:21 A.M., of breakfast trays being delivered to the 200 halls and lunch trays at 12:09 P.M., revealed State Tested Nursing Aides (STNA) #83 and #90 were going into the COVID-19 isolation rooms without wearing eye protection, coming out of the rooms, and doffing their Personal Protective Equipment (PPE) and then go into a resident's rooms that wasn't positive for COVID-19. Interview on 09/12/23 at 12:15 P.M., with STNA #83 confirmed she went into the isolation rooms without her eye protection, but stated there wasn't any in the carts outside of the room and she didn't ask for any either. Interview on 09/12/23 at 12:20 P.M., with STNA #90 confirmed he didn't wear eye protection into the COVID-19 rooms for breakfast or lunch. Interview on 09/12/23 at 4:00 P.M., with the Director of Nursing (DON) confirmed the expectation of the facility for the staff going into COVID-19 rooms should be wearing eye protection. Review of the policy titled Coronavirus dated 07/27/23, revealed appropriate measures will be utilized for the prevention and control of the Coronavirus (COVID-19). The Coronavirus, also known as COVID-19, is a viral infection that is caused by a distinct Coronavirus. Eye protection (i.e., goggles or a face shield that covers the front and sides of the face) should be worn during all resident care encounters. This deficiency represents non-compliance investigated under Complaint Number OH 00146189. 365773 Page 4 of 4