Health inspection·February 22, 2024

F 0554 Allow residents to self-administer drugs if determined clinically appropriate. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, record review, and facility policy review the facility failed to obtain a physician order for medication at the bedside, assess and document self-medication administration for Resident #45. This affected one resident (#45) out of seven residents reviewed for medication administration. The facility census was 97. Residents Affected - Few Findings Include: Review of the medical record for Resident #45 revealed an admission date of 11/18/22. Diagnoses included psoriasis, other pruritus, intrinsic allergic eczema, and chronic kidney disease stage 3. Review of the physician order dated 11/14/23 indicated Triamcinolone Acetonide External Cream 0.5 % (Triamcinolone Acetonide (Topical)), apply to arms, chest, trunk, legs topically every shift on Monday, Tuesday, Wednesday and Thursday for eczema. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed no cognitive impairment, and application of ointments/medications were applied other than to the feet during the assessment period. There was no medication self-administration skills assessment. Review of the Treatment Administration Records (TARs) from December 2023 through February 2024 indicated Triamcinolone was signed as administered by the nurses twice daily with no indication Resident #45 was self-administering the medication. Observation on 02/20/24 at 1:44 P.M. revealed one jar of Triamcinolone cream (used to treat eczema) on Resident #45's bedside tray table. Interview at the time of the observation with Resident #45 indicated he applied it for itchy skin when needed. Observation on 02/21/24 at 11:03 A.M. revealed one jar of Triamcinolone cream on Resident #45's bedside tray table. The prescription directions stated to apply to affected areas Monday through Thursday and to take a break on the weekends. Interview at the time of the observation with Resident #45 reported the prescription was from a non-facility pharmacy which he ordered independently and applied it when his skin itched but followed the prescription instructions. Resident #45 stated the dermatologist educated him on how and when to apply the medication but denied facility staff provided any instruction or oversight. Interview on 02/21/24 at 11:05 A.M. with Registered Nurse (RN) #380 verified Resident #45 had a current order for Triamcinolone cream and indicated it was kept at the bedside because Resident #45 applied it himself. RN #380 explained the medication was kept at the bedside and Resident #45 was asked (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: 366455 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 366455 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/22/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mentor Ridge Health and Rehabilitation 8151 Norton Parkway Mentor, OH 44060 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)