Health inspection·February 6, 2020

F 0730 Observe each nurse aide's job performance and give regular training. Level of Harm - Minimal harm or potential for actual harm Based on personnel record review and staff interview, the facility failed to ensure three State Tested Nursing Assistants (STNAs) of five reviewed received at least 12 hours of on-going training annually. This had the potential to affect all 42 residents of the facility. Residents Affected - Many Findings include: 1. Review of STNA #223's personnel file revealed the STNA had a hire date of 10/14/16. There was no evidence the STNA received 12 hours of ongoing training annually. 2. Review of STNA #221's personnel file revealed the STNA had a hire date of 01/31/17. There was no evidence the STNA received 12 hours of ongoing training annually. 3. Review of STNA #214's personnel file revealed the STNA had a hire date of 06/28/16. There was no evidence the STNA received 12 hours of ongoing training annually. Interview on 02/04/20 at 1:11 P.M. with Human Resource Supervisor (HR) #217 confirmed STNA #223, #221 and #214 had not completed twelve hours on on-going training and in-services. Page 1 of 2 366445 366445 02/06/2020 Otterbein Loveland 6405 Small House Circle Loveland, OH 45140

F 0757 Ensure each resident’s drug regimen must be free from unnecessary drugs. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review and staff interview, the facility failed to timely respond to pharmacy recommendations. This affected one Resident (#35) of five residents reviewed for unnecessary medications. The facility census was 42. Residents Affected - Few Findings include: Medical record review revealed Resident #35 was admitted to the facility on [DATE] with diagnoses including thrombocytopenia, emphysema, and pulmonary embolism. Review of Resident #35's physician order dated 04/05/19 revealed an order for Diazepam, five milligrams (mg.), one-half tablet, as needed (PRN) every 24 hours for breakthrough muscle spasms and tremors. The physician order additionally directed the order would be evaluated and monitored every 14 days for continued use. Review of Resident #35's pharmacy recommendation dated 06/14/19 revealed the prescriber must provide documentation in the resident's medical record with a rationale and a specific period of time for the Diazepam to continue. There was no evidence the physician reveiwed or responded to the pharmacy recommendation. Interview on 02/04/20 at 12:12 P.M. with Assistant Director of Nursing (ADON) #400 confirmed there was no evidence the physician reviewed the pharmacy recommendation. 366445 Page 2 of 2