Health inspection·December 28, 2019

F 0557 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, resident interview, and staff interview, the facility failed to ensure residents were treated with dignity and respect. This affected four residents (#6, #16, #32 and #33) out of 64 residents interviewed for dignity and respect. The facility census was 64. Findings include: 1. A review of Resident #33's medical record revealed an admission date of 03/05/19 and the diagnoses of multiple sclerosis (MS), depression and high blood pressure. A Minimum Data Set (MDS) assessment, dated 11/26/19, revealed the resident was cognitively intact, and required extensive assistance of one staff for bed mobility, transfers, dressing, toileting and personal hygiene. A care plan, dated 03/25/19 revealed the resident had a self care deficit related to MS, weakness and limited mobility. Interventions included extensive assistance as needed and showers per schedule and as needed. An interview on 12/26/19 at 9:34 A.M. with Resident #33 revealed she was unhappy with the attitude of State Tested Nurse Assistant (STNA) #47 during her care on 12/24/19. She stated she requested to receive showers on Tuesdays and Fridays before dinner, and on the afternoon of 12/24/19 at 4:00 P.M. she had asked STNA #47 when she would be getting her shower. STNA #47 stated to her that she would get a shower when she said she could get a shower. 2. A review of Resident #16's medical record revealed an admission date of 02/15/15 and the diagnoses of morbid obesity and congestive heart failure. An MDS assessment, dated 10/24/19, revealed the resident had intact cognition. 3. A review of Resident #6's medical record revealed an admission date of 10/30/17 and the diagnoses of major depression, rheumatoid arthritis and chronic pain. An MDS assessment, dated 12/12/19 revealed the resident had intact cognition. 4. A review of Resident #32's medical record revealed an admission date of 12/08/17 and the diagnoses of major depression. An MDS assessment dated [DATE] revealed the resident had intact cognition. A resident council meeting on 12/27/19 at 3:00 P.M. revealed Resident #6 and Resident #16 complained about the attitudes and demeanor of STNA #13 and STNA #47. They stated the two staff were short with the residents, they yelled at times and the residents feared retaliation if the facility punished the two STNAs. An interview on 12/28/19 at 12:29 P.M. with the Administrator verified she completed interviews Page 1 of 4 366155 366155 12/28/2019 New Albany Care Center 5691 Thompson Road Columbus, OH 43230

F 0557 with residents between 12/27/19 and 12/28/19, and Residents #16, #32 and #33 complained about STNA #13 and STNA #47 not treating them in a respectful manner. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 366155 Page 2 of 4 366155 12/28/2019 New Albany Care Center 5691 Thompson Road Columbus, OH 43230

F 0561 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. Based on medical record review, resident interview and staff interview, the facility failed to complete resident showers per resident preference. This affected one resident (Resident #33) out of three residents reviewed for choices. The facility census was 64. Findings include: A review of Resident #33's medical record revealed an admission date of 03/05/19 and the diagnoses of multiple sclerosis (MS), depression and high blood pressure. A Minimum Data Set (MDS) assessment, dated 11/26/19, revealed the resident had a Brief Interview of Mental Status (BIMS) of 15, indicative of intact cognition, and required extensive assistance of one staff for bed mobility, transfers, dressing, toileting and personal hygiene. A care plan, dated 03/25/19 revealed the resident had a self care deficit related to MS, weakness and limited mobility. Interventions included extensive assistance as needed and showers per schedule and as needed. A review of Resident #33's undated shower preference form revealed she requested showers on Tuesdays and Fridays in the evenings before dinner. A review of the shower sheets revealed the resident didn't receive showers for the following weeks: 11/23/19 through 11/30/19, 12/07/19 through 12/14/19, and 12/17/19 through 12/25/19. An interview on 12/26/19 at 9:34 A.M. with Resident #33 revealed she had requested her showers be completed between noon and five in the evenings, before dinner. She stated that on 12/24/19 State Tested Nurse Aide (STNA) #47 came in at 8:45 P.M. to give her the shower, and she refused because it was too late. An interview on 12/18/19 at 3:35 P.M. with the Director of Nursing (DON) confirmed the resident didn't receive her showers per her preference. 366155 Page 3 of 4 366155 12/28/2019 New Albany Care Center 5691 Thompson Road Columbus, OH 43230

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm Based on observation, record review and staff interview, the facility failed to provide physician ordered care for a resident with lymphedema. This affected one of one resident reviewed for edema. Residents Affected - Few Findings included: Review of the medical record for Resident #32 revealed an admission date of 12/08/17 with diagnoses to include lower extremity cellulitis, lymphedema and major depressive disorder. Review of the physician's orders for 12/2019 revealed orders for double ace wraps to bilateral legs during the day. Review of the treatment administration record for 12/2019 revealed there were several days that were not signed by the nurses indicating the ace wraps were applied. Days that were not signed off included, 12/02/19, 12/03/19, 12/05/19, 12/15/19, 12/17/19, 12/19/19, 12/23/19, 12/25/19, 12/27/19 and 12/28/19. On 12/26/19 the nurse had signed the ace wraps were applied but observations on that date revealed the resident did not have the ace wraps on as ordered. Observation on 12/26/19 at 10:35 A.M. revealed the resident was lying in bed with the head of the bed up. Interview with the resident at the time of the observation revealed she had lymphedema to bilateral lower extremities. Her legs and feet were observed to be extremely large and edematous. She stated the nurses don't wrap them like they should. She stated they used to do it, but those nurses quit and the new nurses don't seem to have the time. She stated she needed to have her legs wrapped because it helped her to stand which enhanced her ability to do her therapy. She stated her goal was to go home and she needed therapy to accomplish this. She'd had many setbacks to this goal and became tearful stating she missed her cats. Observations on 12/27/19 between 9:00 A.M. and 4:30 A.M. revealed the resident did not have ace wraps applied to her legs. On 12/28/19 observations from 8:00 A.M. until 2:30 P.M. revealed no ace wraps were applied to the resident's legs. Staff were questioned about the ace wraps and then she was observed with ace wraps on after this time. Interview with the Director of Nursing on 12/28/19 at 2:30 P.M. confirmed the ace wraps were not signed off on the treatment administration record. She attempted to provide progress notes stating the resident was wearing the ace wraps as ordered but on further questioning she agreed the progress notes did not specifically state she was wearing the ace wraps. Interview on 12/28/19 with Licensed Practical Nurse #101 at 2:45 P.M. confirmed the resident had not been wearing the ace wraps on this date. 366155 Page 4 of 4