Health inspection·May 16, 2023

F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, staff interview, and policy review, the facility failed to ensure medications were administered timely and as ordered. This affected one (Resident #100) out of four residents reviewed for change of condition. The facility census was 91. Findings include: Review of Resident #100's medical record revealed Resident #100 was admitted to the facility on [DATE] with diagnoses including cerebral infarction, hemiplegia, hemiparesis (right side), obsessive-compulsive behavior, hypertension, osteoporosis, heart failure, and age-related cataracts. Resident #100 was sent to the hospital on [DATE] and did not return to the facility. Review of Resident #100's Medication Administration Record (MAR) for March 2023 revealed Resident #100 had an order, dated 03/09/22, for Depakote (anticonvulsant medication) tablet delayed release 250 mg, give three tablets by mouth at bedtime for seizures. The Depakote was to be given at 8:00 P.M. Further review of the MAR revealed Resident #100 had an order, dated 02/08/21, for Levetiracetam (anticonvulsant medication) tablet 750 mg, give two tablets by mouth two times a day for seizures. The Levetiracetam was to be given at 8:00 A.M. and 8:00 P.M. The 8:00 P.M. dose of Depakote and Levetiracetam were signed off as administered. Review of the Resident #100's nurses' notes revealed on 03/01/23 at 9:40 P.M. Resident #100 was found in the bathroom, sitting on the toilet, having a mild seizure. Resident #100 was placed in a wheelchair in order to move Resident #100 to bed. Licensed Practical Nurse (LPN) #400 called the on-call and was told to give Resident #100 his oral seizure medication and observe for 15 to 20 minutes. If seizure activity continued, then send Resident #100 to the hospital for evaluation and treatment. Interview on 05/16/23 at 12:40 P.M., with LPN #400 revealed LPN #400 was working on giving Resident #100 his medications when the STNA called her to Resident #100's room to assist with getting Resident #100 back to bed and dealing with his seizure activity. LPN #400 indicated Resident #100's evening dose of antiseizure medication (Levetiracetam and Depakote) was due at 8:00 P.M. on 03/01/23 but LPN #400 had not administered them yet. When LPN #400 called the on-call Certified Nurse Practitioner (CNP) #500 to report his change in condition, the on-call CNP #500 wanted LPN #400 to give Resident #100 his oral seizure medication and observe him for 15 to 20 minutes to see if the seizures stopped. LPN #400 indicated Resident #100 was having a mild seizure that she described as twitching and Resident #100 was alert and able to answer yes/no questions. LPN #400 proceeded to give Resident #100 his 8:00 P.M. dose of anti-seizure medication (Keppra and Depakote) at 9:40 P.M. Resident #100 took the medication with assistance and without difficulty. Page 1 of 2 366481 366481 05/16/2023 Laurels of West Columbus, The 441 Norton Road Columbus, OH 43228

F 0755 Level of Harm - Minimal harm or potential for actual harm Review of the facility policy titled Medication Administration, last reviewed 09/09/22, revealed medications should be administered within 60 minutes of the scheduled administration time. This deficiency represents non-compliance investigated under Complaint Number OH00142816. Residents Affected - Few 366481 Page 2 of 2