Health inspection·November 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 interview, and review of a facility policy, the facility failed to ensure residents received appropriate assistance with bathing. This affected three (#13, #16, and #23) of four residents reviewed for bathing assistance. The census was 54. Residents Affected - Few Findings include: 1. Review of the medical record for Resident #13 revealed an admission date of 10/13/23. Medical diagnoses included diabetes mellitus type II, sleep apnea, and malignant neoplasm of the prostate. Review of the admission Minimum Data Set (MDS) assessment dated [DATE] revealed the resident was assessed as having intact cognition, and required set up assistance for eating, was dependent for toileting, bed mobility, and transfers, and required substantial to maximal assistance for showers and bathing. Record review of shower documentation revealed Resident #13's showers were scheduled twice weekly (on Tuesday and Friday) on the day shift. Further review of the shower documentation between 10/13/23 and 11/03/23 for Resident #13 revealed showers were documented as given on 10/16/23, 10/18/23, 10/26/23, and 11/03/23. 2. Review of the medical record for Resident #23 revealed an admission date of 12/01/21. Medical diagnoses included stroke, hemiparesis, Parkinson's disease, and dementia. Review of the Significant Change MDS assessment dated [DATE] revealed the resident was assessed as cognitively impaired, and required extensive assistance for bed mobility, eating, and toileting, and was dependent for showers. Record review of the shower documentation revealed Resident #23's showers were scheduled twice weekly (on Monday and Thursday) on the day shift. Further review of the shower documentation between 10/05/23 and 10/26/23 revealed Resident #23 was provided a shower on 10/05/23, 10/09/23, 10/12//23, 10/15/23, 10/16/23, and then not again until 10/26/23. 3. Review of the medical record for Resident #16 revealed an admission date of 01/13/23. Medical diagnoses included chronic obstructive pulmonary disease, fracture of the left fibula, diabetes mellitus, and congestive heart failure. Review of the MDS assessment dated [DATE] revealed the resident was assessed with moderate cognitive impairment, and was dependent for bathing and toileting. Page 1 of 3 365773 365773 11/13/2023 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 Record review of the shower documentation revealed Resident #16's showers were scheduled twice weekly (on Tuesday and Friday) on day shift. Further review of the shower documentation between 10/08/23 and 11/07/23 for Resident #16 revealed showers were documented as given on 10/11/23, 10/30/23, 11/02/23, and 11/07/23. Interview on 11/01/23 at 1:26 P.M., with State Tested Nurse Aide (STNA) #30 revealed the facility no longer had a shower aide to help make sure the showers were completed on the day and shift they were scheduled. Interview on 11/07/23 at 10:15 A.M., with Registered Nurse (RN) #45 revealed it was an ongoing issue to ensure STNAs were assisting residents with their showers. Interview on 11/07/23 at 2:33 P.M., with the Director of Nursing verified Resident #13, Resident #23, and Resident #16 did not receive assistance with showers per their schedules, and stated there was no documentation available to indicate showers were provided as scheduled for Resident #13, Resident #16, and Resident #23. 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 were 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 OH00146489. This is an example of continued non-compliance from the survey dated 09/13/23. 365773 Page 2 of 3 365773 11/13/2023 The Laurels of Kettering 694 Isaac Prugh Way Kettering, OH 45429

F 0692 Provide enough food/fluids to maintain a resident's health. 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 obtain weekly weights as ordered. This affected one (#12) of three residents reviewed for nutrition. The census was 54. Residents Affected - Few Findings include: Review of the medical record for Resident #12 revealed an admission date of 10/12/23. Medical diagnoses included diabetes mellitus type two and a wedge compression fracture and fusion of the lumbar spine. Resident #12 was discharged home on [DATE]. Review of Resident #12's admission Minimum Data Set (MDS) assessment dated [DATE] the resident was assessed as cognitively intact, and required set up assistance with eating, moderate assistance for toileting, and was independent with bed mobility. Review of Resident #12's physician orders since the admission date of 10/12/23 revealed an order for weekly weights every Monday for four weeks. Review of the electronic medical record for Resident #12 revealed an admission weight on 10/12/23 of 284.7 pounds, and a weight on 10/16/23 of 268.4 pounds. There were no other recorded weights for Resident #12. Interview on 11/02/23 at 2:20 P.M., with Dietician #43 revealed she had concerns staff did not weigh residents as ordered and often needed to request staff weigh the residents during her assessments. Interview on 11/02/23 at 4:04 P.M., with the Administrator verified no weights had been documented for Resident #12 since 10/16/23. Review of a re-weight of Resident #12's weight on 11/02/23, obtained after the interview on 11/02/23 with the Administrator, revealed Resident #12 weighed 268.0 pounds. Interview on 11/07/23 at 2:33 P.M., with the Director of Nursing verified weekly weights had not been taken on Resident #12. This deficiency represents non-compliance investigated under Complaint Number OH00147562. 365773 Page 3 of 3