Health inspection·July 24, 2023

F 0804 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Level of Harm - Minimal harm or potential for actual harm Based on interview, observation and record review, the facility failed to ensure meals served looked appetizing and were served at palatable temperatures. This had the potential to affect all residents receiving meals from the kitchen with the exception of Residents #1 and #10 who received no nutrition by mouth. The facility census was 49. Residents Affected - Many Findings include: Interview on 07/17/23 at 2:08 P.M. with Resident #3 revealed hot foods were served cold upon meal service. Interview on 07/17/23 at 2:21 P.M. with Resident #45's sister revealed while at the facility, Resident #45 did not eat the food because Resident #45 said it did not taste good. Interview on 07/17/23 at 2:32 P.M. with Resident #19 revealed the food was overcooked, soggy and terrible. Observation of a test tray on 07/17/23 at 5:45 P.M. with Dietary Manager (DM) #210 revealed the meal consisted of chicken tenders, french fries, zucchini and mandarin oranges. Temperatures were obtained with the chicken tenders revealing a temperature of 119 degrees Fahrenheit (F) and the zucchini revealing a temperature of 126 degrees F. The french fries were noted to be undercooked and soft. Interview on 07/17/23 at 5:50 P.M. with DM #210 revealed DM #210 stated all hot foods should be served above 140 degrees F. Interview on 07/18/23 at 9:15 A.M. with Resident #46 revealed the food was often cold and tasteless. Review of the facility policy titled Food Temperature Policy dated 08/28/19 revealed hot foods should not fall below 135 degrees while holding after cooking and hot food should be palatable when delivered. Page 1 of 2 365814 365814 07/24/2023 Cortland Center 369 N High Street Cortland, OH 44410

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and facility policy review, the facility failed to ensure proper hand hygiene was completed during medication administration including hand washing and wearing gloves. This affected three Residents (Residents #4, #32, and #101) out of seven residents administered medications. The facility census was 49. Residents Affected - Few Findings include: Observations made on 07/19/23 from 7:59 A.M. to 12:30 P.M. of medication administration by Licensed Practical Nurse (LPN) #223, LPN #234, and LPN #265 of 25 administrations made for seven residents (Residents #4, #14, #16, #32, #35, #101 and #103) revealed LPN #223 did not perform hand hygiene before or after administering medications to Resident #4. LPN #223 was observed dispensing medication into her bare hand then placing them into a medication cup, crushing them, placing in applesauce, and then administered the medications to Resident #4. Additional observation of LPN #223 revealed she did not perform hand hygiene before or after, or wear gloves while administering insulin to Resident #101. Observation during Medication Administration of LPN #265 revealed she did not wear gloves or perform hand hygiene before or after administering insulin to Resident #32. Interview conducted on 07/19/23 at 8:45 A.M. with LPN #223 revealed she did not perform hand hygiene before or after administering medications to Resident #4. Interview conducted on 07/19/23 at 11:30 A.M. with LPN #265 confirmed she did not perform hand hygiene before or after administering insulin to Resident #32. LPN #265 also confirmed she did not wear gloves while administering the insulin to Resident #32. Interview conducted on 07/19/23 at 12:00 PM with LPN #223 confirmed she did not perform hand hygiene before or after administering insulin to Resident #101. LPN #223 also confirmed she did not wear gloves while administering the insulin to Resident #101. Review of facility policy titled General Dose Preparation and Medication Administration, last revised 01/01/22 revealed the facility staff failed to follow their policy for medication administration under Procedure headline, bullet point number two Prior to preparing or administering medications, authorized and competent facility staff should follow facility's infection control policy, including hand hygiene, and under bullet point number 3.4 Facility staff should not touch the medication when opening the bottle or unit dose package. 365814 Page 2 of 2