Health inspection·July 6, 2023

F 0679 Provide activities to meet all resident's needs. Level of Harm - Minimal harm or potential for actual harm Based on observation, resident interview, staff interview, record review and review of facility policy, the facility failed to ensure group activities were offered and provided per the resident's preferences and the activity calendar. This had the potential to affect all residents residing in the facility except for residents (#2, #6, #7, #8, #9, #11, #14, #20, #21, #23, #31, #34, and #43) who the facility identified as residents who did not participate in any group activities. The facility census was 42. Residents Affected - Some Findings include: Review of the facility activity participation records for 06/01/23 to 07/06/23, revealed there was no record of activities from 06/13/23 to 07/06/23. Review of a copy from a text message Activities Director (AD) #245 sent to the facility's management dated 06/16/23 revealed the staff member was resigning her position effective immediately. Review of the facility activity calendar dated June 2023, revealed the calendar featured a variety of activities seven days per week. There was no calendar available for July 2023. Random observations of the resident care environment on 07/05/23 from 8:35 A.M. to 4:49 P.M. and on 07/06/23 from 6:20 A.M. to 12:00 P.M., revealed the June 2023 activity calendar was posted in the common area, and there were no activity programs observed taking place. Interview on 07/05/23 at 8:48 A.M. with the Director of Nursing (DON) indicated former AD #245 had resigned without notice a couple weeks ago, and they had no activities since AD #245 left. DON confirmed the facility had hired a new AD; however, she was not going to start work till 07/07/23. Interview on 07/05/23 at 11:15 A.M. with Housekeeper #235, confirmed the facility had not had any activity programs since AD #245 resigned a couple weeks ago. Housekeeper #235 confirmed she worked on the fourth of July 2023, and there were no activities related to the holiday. Interview on 07/05/23 at 11:17 A.M. with residents (#1, #10, and #38), confirmed AD #245 quit without notice a couple weeks ago and they would not have any activities until the new AD started. Residents confirmed they were particularly bothered that the facility had not offered any activities to celebrate the fourth of July 2023. Interview on 07/05/23 at 11:20 A.M. with the DON, confirmed AD #245 was the only activity staff person and the facility had not appointed anyone to carry out the activities in her absence. Page 1 of 3 365934 365934 07/06/2023 Crestwood Ridge Skilled Nursing and Rehab 141 Willettsville Pike Hillsboro, OH 45133

F 0679 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Interview on 07/05/23 at 2:35 P.M. with Regional Quality Assurance Nurse (RQAN) #250 confirmed AD #245 had resigned her position without notice via text message dated 06/16/23. RQAN #250 confirmed AD #245's last day worked was 06/15/23. Interview on 07/06/23 at 9:35 A.M. with the DON, confirmed former AD #245 recorded activity participation in the facility electronic medical record. DON confirmed the facility had no documentation of resident activities from 06/13/23 to 07/07/23. DON confirmed the facility identified 13 residents who did not participate in any group activities related to preference, behaviors, medical or cognitive status. DON further confirmed AD #245 had prepared the June 2023 activity calendar. Review of facility list dated 07/06/23, revealed there were 13 residents (#2, #6, #7, #8, #9, #11, #14, #20, #21, #23, #31, #34, and #43) identified by the facility who did not participate in group activities: Review of the facility policy titled Activity Programming undated revealed the Activities Director shall and organize a program of activities for residents on a group level and for individuals to meet the resident's interests and preferences. This deficiency represents non-compliance investigated under Complaint Number OH00144137. 365934 Page 2 of 3 365934 07/06/2023 Crestwood Ridge Skilled Nursing and Rehab 141 Willettsville Pike Hillsboro, OH 45133

F 0727 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. Based on document review, staff interview, and review of the facility policy, the facility failed to ensure a Registered Nurse (RN) worked in the facility for eight consecutive hours daily. This had the potential to affect all residents residing in the facility. The census was 42 residents. Findings include: Review of the staffing schedules revealed the facility did not have an RN working on 06/17/23, 06/18/23, and 07/01/23. Interview on 07/05/23 at 3:15 A.M. with the Director of Nursing (DON) confirmed the facility did not have a RN working on 06/17/23, 06/18/23, and 07/01/23. Review of the facility policy titled Nursing Staffing Services undated revealed the facility would ensure licensed registered nursing and licensed nursing staff are available to provide and monitor the delivery of resident care services. 365934 Page 3 of 3