Inspection·February 20, 2025

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 review of the medical record, staff interviews, and policy review, the facility failed to adequately monitor weights and implement appropriate interventions in a timely manner. This affected one Resident (#64) of the three resident reviewed for significant weight changes. The facility census was 60. Residents Affected - Few Findings include: Review of the closed medical record for Resident #64 revealed an admission date of 06/06/24 with a discharge date of 01/15/25. Diagnoses included epilepsy, major depressive disorder, anxiety disorder, and cerebral infarction. Review of the Quarterly Minimum Data Set (MDS) assessment dated [DATE], revealed Resident #64 had intact cognition as evidenced by a Brief Interview for Mental Status (BIMS) score of 13. This resident was assessed to require setup with eating, dependent with toileting, substantial assistance with bathing and dressing, and partial assistance with transfers. Review of the care plan dated 01/14/25, revealed Resident #64 had increased nutrition/hydration risk related to seizures, cerebral infarction, and weight gain for three months. Interventions included monitor laboratory (lab) values per order, review preferences per routine and as needed (PRN), respect dietary choices, monitor weight per protocol, and monitor dietary intake. Review of the weight records for Resident #64 revealed the following dates and weights: a) On 06/07/24 a weight of 193.4 pounds (lbs.) was recorded. b) on 07/09/24 the resident was 193 lbs. c) On 08/06/24 the resident was 215.8 lbs. d) On 09/04/24 the resident was 242.4 lbs. e) On 10/21/24 the resident was 265.8 lbs. f) On 11/04/24 the resident was 267.4 lbs. g) On 12/2024, there was no weight recorded h) On 01/01/25 the resident was 283.6 lbs. (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 3 Event ID: 366157 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 366157 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/20/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Dunbar Health & Rehab Center 320 Albany Street Dayton, OH 45417 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)