Health inspection·February 6, 2020

F 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and staff interview, the facility failed to develop care plans addressing behaviors and the use of an enclosed walker (Merry Walker). This affected one Resident (#20) of 18 sampled residents. The facility census was 79 residents. Findings include: Record review revealed Resident #20 was admitted to the facility on [DATE]. Diagnoses included dementia with behavioral disturbance, protein-calorie malnutrition, anxiety disorder, insomnia, chronic pain syndrome, constipation, and repeated falls. Review of the admission Minimum Data Set (MDS) dated [DATE], revealed the cognitively impaired resident experienced delusions and had a behavior of wandering. The assessment also revealed the resident required extensive assistance of staff with bed mobility, transferring, dressing, toilet use, and personal hygiene tasks. Review of the care plans, revealed there was no care plan in place for the use of the Merry Walker, the resident's behaviors of unlatching the cross bar and seat belt, and crawling out of the bottom or side of the walker. In addition the care plan had not addressed the use of routine and as needed anti-anxiety medications nor any non pharmacological interventions. Behavior note on 01/16/20 at around 9:00 P.M., the resident's personal alarm was sounding. The nurse and nurse aide responded. The resident was observed trying to get out of her Merry Walker. Her head was under the crossbar, her seatbelt was on the side, and her legs were bent in a squat position. The nurse opened the crossbar and and assisted the resident back into her seat. Behavior note on 01/26/20 at 6:06 P.M., the resident was observed on her knees in the lounge area with both hands holding onto the front crossbar of the Merry Walker. Resident assisted to a sitting position in the Merry Walker. The resident removed her personal alarm sensor prior to being found on her knees. Resident educated on proper use of Merry Walker. Behavior note on 02/04/20 at 6:00 A.M., the nurse documented the resident was attempting to get out of the Merry Walker, sat down on her knees, and crawled out under the front of the walker. She was assisted back into the walker. There were no documented injuries to the resident. In addition, the resident had orders in place dated 11/22/19 to administer an anti-anxiety medication, Clonazepam 1.0 milligrams (mg) twice daily. She also had orders in place dated 01/31/20 and (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 5 Event ID: 366167 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 366167 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/06/2020 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Anderson, The 8139 Beechmont Ave Cincinnati, OH 45255 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)