Health inspection·October 27, 2023

F 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, staff, resident and resident representative interviews and policy review, the facility failed to notify the resident's representative when their was a change of condition. This affected one (#1) of three reviewed for change of condition. The census was 71. Findings included: Medical record review for Resident #1 revealed an admission date of 08/18/23. Medical diagnoses included history of fractures and atrial fibrillation. Review of admission Minimum Data Set, dated [DATE] revealed she was cognitively intact. Her functional status was extensive assistance for bed mobility, transfers, and toilet use. She was independent for eating. She was occasionally incontinent for bowel and bladder. Review of physician progress note dated 09/26/23 revealed Resident #1 was being seen for red, painful, and warm thumb noted by the therapy department. Review of the progress note dated 09/26/23 revealed there wasn't any evidence Resident #1's Representative was notified of this skin condition. Interview with Resident #1 on 10/25/23 at 10:00 A.M. revealed she couldn't remember if she had a blister on her thumb. Interview with Resident #1's Representative on 10/25/23 at 1:19 P.M. revealed she was not contacted about Resident #'1's thumb on 09/26/23 and was quite surprised by the call. Interview with Assistant Director of Nursing (ADON) #9 on 10/26/23 at 2:15 P.M. revealed Resident #1 wasn't quite herself after she had COVID-19 on 09/09/23 and had periods of confusion and her cognitively status fluctuated. ADON #9 stated there were times they would call the resident's representative if the resident didn't seem alert and oriented. ADON #9 confirmed there wasn't any evidence in the chart the representative as contacted concerning her blister on her thumb. Review of the policy entitled Change in Condition dated 06/01/15 revealed the facility staff will report identified significant changes in resident's status. Documentation of the condition will be noted in the nurses charting or interdisciplinary charting as indicated. The resident's physicians/clinicians and responsible party will be notified of significant changes in resident's conditions. If a resident specified on admission they do want family members notified of a significant change the facility will respect that. If the resident is incapable of making decision, the responsible party will make any decisions that have to be made, but the resident should be up dated on his/her condition. Page 1 of 2 366040 366040 10/27/2023 Doverwood Village 4195 Hamilton Mason Road Hamilton, OH 45011

F 0580 This deficiency represents non-compliance investigated under Complaint Number OH00146641. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few 366040 Page 2 of 2