Health inspection·September 12, 2024

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 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, staff interview, and review of the facility policy, the facility failed to ensure residents were treated for constipation. This affected one (#6) of one resident reviewed for bowel movements. The facility census was 52. Residents Affected - Few Findings include: Review of the medical record for Resident #6 revealed an admission date of 06/19/24 with diagnoses of dementia, heart disease, and heart failure. Review of the comprehensive admission Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #6 had impaired cognition and was occasionally incontinent of stool and was dependent for toileting hygiene. Review of the current care plan revealed Resident #6 was frequently incontinent of bowel and bladder. Interventions included documenting bowel movements. Further review revealed Resident #6 was at risk for developing pressure ulcers related to bowel and bladder incontinence. Interventions included providing assistance with toilet use and incontinence care to keep skin clean and dry. Review of Resident #6's medical record revealed no documented bowel movement between 07/02/24 and 07/06/24 and between 07/21/24 and 07/25/24. Review of the Medication Administration Record (MAR) and Treatment Administration Record (TAR) for July 2024 revealed Resident #6 received one treatment for constipation on 07/17/24. Interview on 09/12/24 at 8:40 A.M. with Unit Manager (UM) #505 confirmed Resident #6 had no documented bowel movement for five days between 07/02/24 and 07/06/24, and for five days between 07/21/24 and 07/25/24. UM #505 further confirmed Resident #6 received no treatment for constipation for either occurrence. Continued interview with UM #505 revealed nurses should receive alerts through the electronic medical record system when a resident has no bowel movement for 72 hours and nurses have authority to implement physician orders for constipation. UM #505 further confirmed Resident #6 should have received an intervention for constipation on 07/05/24 and on 07/24/24. Review of the policy, Bowel Program, revised 04/07/15, revealed standing physician orders should be implemented when residents do not have a bowel movement in 72 hours. Additionally, standing laxative orders could include Milk of Magnesia, Dulcolax suppository and/or Fleets enema. 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: 366184 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 366184 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/12/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Elizabeth Scott Community 2720 Albon Rd Maumee, OH 43537 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)