Inspection·June 30, 2023

F 0688 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. Based on medical record review, observation, and staff interview, the facility failed to ensure residents received services to prevent ongoing decline in range of motion (ROM). This affected one (#24) of three residents reviewed for contracture management/ROM. The facility census was 87. Findings include: Review of the medical record for Resident #24 revealed an admission date of 10/16/20 with diagnoses including dysphagia, polyarthritis, hemiplegia and hemiparesis, and cerebral infarction affecting left non-dominant side. Review of the Minimum Data Set (MDS) for Resident #24 dated 05/17/23 revealed the resident was cognitively impaired and required extensive assistance with activities of daily living (ADL's). Resident #24 was coded for functional impairment on both sides to upper and lower extremities. Review of the care plan for Resident #24 dated 10/09/20 revealed the resident may require assistance with ADL's, receive staff's extensive assistance to total care in completion of ADL care/functional needs. Mechanical lift was utilized for all transfer needs and resident used a reclining geri chair for out of bed mobility needs. Resident #24's cognition was impaired, and the resident had a history of stroke with left sided weakness and muscle weakness. Interventions included the following: provide assist for ADL's based on residents needs/abilities, provide necessary adaptive equipment to meet daily needs, therapy to screen and provide treatment as ordered, report any changes in ADL self-performance. Review of Restorative Nursing caseload list dated 06/30/23 revealed Resident #24 was not receiving restorative services. Observation on 06/30/23 at 12:19 P.M. of Resident #24 revealed the resident was compliant with peri care per State Tested Nursing Assistants (STNA's) #425 and #555. Resident #24 was compliant with Licensed Practical Nurse (LPN) #275 application of lotion to her feet. Further observation revealed Resident #24's feet appeared to have slight footdrop and bilateral hands appeared to be somewhat contracted. Observations of Resident #24 revealed staff did not perform ROM and there were no splints observed. Interview on 06/30/23 at 12:24 P.M. of STNA's #425 and #555 confirmed Resident #24 was not on a ROM program nor did she have any orders for splints. STNA's #425 and #555 confirmed if resident required ROM services they would be provided by therapy or the facility restorative aides. (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 2 Event ID: 366208 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 366208 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/30/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Residence at Huntington Court 350 Hancock Avenue Hamilton, OH 45011 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)