Above average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Respiratory And Nursing Center Of Dayton during CMS and state inspections, most recent first.
The facility failed to complete quarterly MDS assessments within the required timeframe for four residents, as per the RAI Manual guidelines. These residents, who had significant medical conditions and were dependent on staff for all ADLs, had their assessments completed beyond the 14-day limit after the ARD. This deficiency was confirmed by the Regional MDS Nurse.
A facility failed to provide adequate daily activities, including late afternoon and evening options, affecting a resident with multiple health conditions and potentially impacting others. Interviews and calendar reviews confirmed the lack of activities after early afternoon and on certain weekends, with no policies in place to address scheduling.
The facility failed to maintain food safety and sanitation, affecting 63 residents. Observations included uncovered food near debris, improper hand hygiene by staff, and an ice scoop stored directly in ice. These deficiencies were confirmed by staff interviews.
The facility failed to ensure proper infection control during tracheostomy care for a resident, as a respiratory therapist used a soiled dressing without changing gloves or performing hand hygiene. Additionally, staff did not wear appropriate PPE, including N-95 masks and eye protection, when entering the room of a COVID-19 positive resident, contrary to the facility's policy.
The facility failed to honor the preferences of a resident's representative for ADL assistance, as the resident was not transferred to a chair on the requested days. Additionally, another resident was unable to use the commode in his room due to a toilet riser, forcing him to use a different restroom. Staff interviews confirmed the lack of awareness and documentation of these preferences and needs.
A facility failed to complete a comprehensive admission MDS assessment within the required timeframe for a resident with severe medical conditions. The assessment, which should have been completed within 14 days of admission, was delayed by 25 days. This was confirmed by the Regional MDS Nurse, who stated that the facility adheres to the RAI manual guidelines.
A resident with chronic respiratory failure and dependence on a respirator pulled out her tracheostomy tube, leading to an emergency situation. Despite this known behavior, the care plan was not updated to include interventions. The oversight was confirmed by the MDS Coordinator and DON, highlighting a lack of policy on care planning.
The facility failed to provide adequate ADL care for two residents, leading to deficiencies. A resident with severe cognitive impairment was found with long, jagged fingernails and debris in her contracted hands, indicating a lack of nail care. Another resident, requiring extensive assistance for toileting, experienced a significant delay in receiving incontinence care, waiting approximately 49 minutes after activating her call light. Staff interviews revealed communication and coordination issues, and the facility lacked a written policy on call light response times.
A facility failed to properly position a dependent resident with severe medical conditions, including chronic respiratory failure and dependence on a ventilator. Despite a physician's order to place a pillow between the resident's hands and face to offload pressure, observations revealed the absence of the pillow, with the resident's chin pressed against her oxygen tubing. An LPN confirmed the non-compliance with the physician's order.
A resident with severe cognitive impairment and multiple medical conditions did not receive adequate care to prevent worsening contractures and limited ROM. Despite recommendations for a splint program, observations and staff interviews revealed the absence of splint application and documentation. The facility's restorative nursing policy was not effectively implemented, resulting in a deficiency in care.
A facility failed to provide trauma-informed care for a resident with PTSD. The care plan lacked interventions to manage PTSD triggers, and staff were not informed about appropriate responses. The resident's trauma history included military service and past abuse, with loud noises identified as triggers. Staff interviews confirmed a lack of knowledge and policy on trauma-informed care, resulting in the resident frequently becoming upset during care.
The facility failed to date opened vials of insulin and TB testing solution, affecting medication safety for two residents and potentially all residents. An LPN confirmed the vials were not dated, and the facility's policy requires proper dating and disposal of outdated medications.
The facility did not update the daily staffing information, as the posting dated 08/20/24 was still displayed on 08/25/24. The Administrator confirmed the posting should be updated daily, and there was no written policy for staffing postings.
Untimely Completion of Quarterly MDS Assessments
Penalty
Summary
The facility failed to ensure that quarterly Minimum Data Set (MDS) assessments were completed in a timely manner for four residents, as required by the Resident Assessment Instrument (RAI) User's Manual 3.0. The manual stipulates that the completion date for quarterly MDS assessments must be no later than 14 days after the assessment reference date (ARD). However, the assessments for Residents #06, #08, #22, and #50 were completed beyond this timeframe. For instance, Resident #06's assessment with an ARD of 07/03/24 was completed on 08/05/24, and Resident #08's assessment with an ARD of 05/31/24 was completed on 06/24/24. The residents affected by this deficiency had significant medical conditions and dependencies. Resident #06 had diagnoses including chronic respiratory failure and multiple sclerosis, and was dependent on staff for all activities of daily living (ADLs). Similarly, Resident #08 had chronic respiratory failure and was also dependent on staff for all ADLs. The delay in completing the MDS assessments was confirmed by Regional MDS Nurse #110, who acknowledged that the facility used the RAI Manual for guidelines on completing these assessments. This deficiency affected four out of 23 residents reviewed for timely MDS assessments, with the facility having a total census of 75 residents.
Deficiency in Activity Scheduling for Residents
Penalty
Summary
The facility failed to provide daily activities throughout the day, including late afternoon and evening activities, affecting one resident directly and potentially impacting nine additional residents. The medical record for one resident revealed a history of conditions such as an unspecified fracture of the left femur, diabetes, anxiety, atrial fibrillation, and vascular disease. The resident's care plan indicated a preference for social activities, yet the facility did not meet these needs, as confirmed by the resident's interview, which highlighted a lack of weekend activities and early cessation of daily activities. Interviews with facility staff, including an Activity Aide and the Activity Director, confirmed the absence of activities after early afternoon and the lack of weekend activities every other weekend. The activity calendar for July and August 2024 corroborated these findings, showing no scheduled activities after 2:00 P.M., except for a weekly bible study, and no activities on certain Saturdays. The facility administrator confirmed the absence of policies regarding the scheduling of activities, contributing to the deficiency.
Food Safety and Sanitation Deficiencies
Penalty
Summary
The facility failed to maintain food service safety and a sanitary environment, potentially affecting 63 residents who received food from the facility kitchen. During an observation, a Dietary Supervisor placed a small bin of cooked carrots on a prep table without covering them. The area above the carrots was covered with crumbs and debris, and an air conditioner nearby had a casing covered with dust and black specks. Additionally, there was a four-inch opening in the window next to the air conditioner, exposing the food to the outside environment. The Dietary Supervisor confirmed these observations during an interview. Further observations revealed lapses in hand hygiene practices. A staff member removed gloves, discarded them, and donned new gloves without performing hand hygiene. Another instance involved a Dietary Supervisor who, after removing gloves and lifting a garbage can lid, proceeded to stir gravy without washing hands. These actions were confirmed by interviews with the staff involved. Additionally, an ice machine in the dining room was found with a scoop stored directly in the ice, which was confirmed as improper by the Regional Dietitian.
Infection Control Deficiencies in Tracheostomy Care and COVID-19 Precautions
Penalty
Summary
The facility failed to ensure proper hand hygiene and infection control practices during tracheostomy care for a resident with severe cognitive impairment and multiple diagnoses, including chronic respiratory failure and a tracheostomy. During an observation, a respiratory therapist was seen using a soiled dressing to wipe around the tracheostomy site and did not change gloves or perform hand hygiene before inserting a new disposable inner cannula. This action was confirmed by the respiratory therapist, who acknowledged not following the facility's infection control policy, which requires hand hygiene and glove changes when moving from a contaminated to a clean body site. Additionally, the facility did not ensure that staff donned appropriate personal protective equipment (PPE) when entering the room of a COVID-19 positive resident. Despite the resident being under droplet isolation precautions, staff members entered the room wearing only surgical masks, gowns, and gloves, without the required N-95 masks and eye protection. Interviews with the involved staff and the infection preventionist confirmed the failure to adhere to the facility's COVID-19 prevention policy, which mandates the use of N-95 masks and eye protection in such situations.
Failure to Honor Resident Preferences and Needs
Penalty
Summary
The facility failed to honor the preferences of Resident #54's representative regarding the resident's activities of daily living (ADL) assistance. Despite a care conference where the representative requested that Resident #54 be transferred out of bed to a chair on Tuesdays and Thursdays, the facility did not comply. The ADL records showed that the resident was only transferred on three occasions, none of which were on the requested days. Interviews with staff, including a State Tested Nursing Assistant (STNA) and a Licensed Practical Nurse (LPN), revealed that they were unaware of the representative's request, and the Director of Nursing (DON) confirmed the lack of documentation for the requested transfers. Additionally, the facility did not accommodate Resident #49's needs regarding bathroom facilities. After returning from the hospital, Resident #49 was placed in a room with a toilet riser on the commode, which he was unable to use. As a result, he had to use the restroom in the shower room instead. Interviews with the resident and staff confirmed the presence of the toilet riser and the resident's inability to use the commode in his room independently.
Delayed Completion of Admission MDS Assessment
Penalty
Summary
The facility failed to ensure that comprehensive admission Minimum Data Set (MDS) assessments were completed in a timely manner, as required by the Resident Assessment Instrument (RAI) Manual. This deficiency affected one resident, who was admitted with multiple serious medical conditions, including chronic respiratory failure with hypoxia, sepsis, end-stage renal disease, anoxic brain injury, and a tracheostomy. The resident's admission MDS assessment, which should have been completed by the end of day 14 following admission, was not completed until 25 days after the assessment reference date. This delay was confirmed by the Regional MDS Nurse, who acknowledged that the facility follows the RAI manual guidelines for completing MDS assessments.
Failure to Update Care Plan for Resident with Tracheostomy
Penalty
Summary
The facility failed to update the care plan for a resident who had a history of pulling out her tracheostomy tube, which was a significant change in her condition. The resident, who had been admitted with chronic respiratory failure, dependence on a respirator, and other serious diagnoses, was found unresponsive after pulling out her tracheostomy tube. This incident was discovered by a respiratory therapist responding to a pulse oximetry alarm. Despite the resident's known behavior, the care plan had not been updated since April to include this behavior or any interventions for staff to follow. Interviews with the MDS Coordinator and the Director of Nursing confirmed the oversight and acknowledged the absence of a facility policy regarding care planning.
Deficiencies in ADL Care and Call Light Response
Penalty
Summary
The facility failed to provide adequate activities of daily living (ADL) care for two residents, leading to deficiencies in their care. Resident #50, who has chronic respiratory failure, dependence on a ventilator, and severely impaired cognition, was observed with long, jagged fingernails and debris in her contracted hands, indicating a lack of nail care despite regular bathing. This was confirmed by a Licensed Practical Nurse (LPN) who noted the resident's hands were contracted and dirty, highlighting a failure in maintaining proper hygiene for the resident. Resident #46, who requires extensive assistance for toileting due to conditions such as acute respiratory failure and heart failure, experienced delays in receiving incontinence care. Despite activating her call light, the resident waited approximately 49 minutes for assistance, during which time she was incontinent. Interviews with staff revealed a lack of communication and coordination, as one State Tested Nursing Aide (STNA) turned off the call light without providing care and another was unaware of the resident's needs. The facility lacked a written policy on call light response times, contributing to the delay in care.
Failure to Properly Position Dependent Resident
Penalty
Summary
The facility failed to ensure proper positioning of a dependent resident, which was identified during a survey. Resident #50, who has chronic respiratory failure, dependence on a ventilator, a tracheostomy, anoxic brain injury, and hypertension, was observed without a pillow placed between her hands and face as per the physician's order. This order, dated 10/17/22, was intended to offload pressure. Observations on two separate occasions revealed that the resident was lying in bed without the required pillow, and her chin was pressed against her oxygen tubing. An interview with an LPN confirmed the absence of the pillow, acknowledging the resident's contracted body and the existing physician's order.
Failure to Prevent Worsening of Contractures and Limited ROM
Penalty
Summary
The facility failed to provide adequate care and services to prevent the worsening of contractures and limited range of motion (ROM) for Resident #50. The resident, who was admitted with chronic respiratory failure, dependence on a ventilator, tracheostomy, anoxic brain injury, and hypertension, had severely impaired cognition and was dependent on staff for all activities of daily living. The resident's care plan identified risks related to impaired mobility and joint contractures. Despite receiving occupational therapy to maximize functional ROM and reduce the risk of contractures, the facility did not maintain a consistent splint program as recommended by therapy. Observations revealed that Resident #50 was not wearing splints, and interviews with staff confirmed the absence of documentation and application of splints to the resident's hands. The restorative flow records lacked specific instructions on splint application, and staff interviews indicated a lack of adherence to the recommended splint schedule. The facility's policy on restorative nursing, which aimed to maintain or improve residents' highest practicable level, was not effectively implemented for Resident #50, leading to the deficiency in care.
Failure to Provide Trauma-Informed Care for Resident with PTSD
Penalty
Summary
The facility failed to provide trauma-informed care for a resident diagnosed with Post Traumatic Stress Disorder (PTSD). The medical record review and staff interviews revealed that the care plan for the resident did not include interventions to eliminate or mitigate triggers of PTSD. The trauma assessment completed by the Social Services Designee noted the resident's military service, history of physical punishment, and unwanted sexual contact, with loud noises and music identified as potential triggers. However, the assessment lacked detailed information on how staff should manage these triggers. Interviews with staff, including the Social Services Designee, Minimum Data Set Nurse, Regional MDS Coordinator, Licensed Practical Nurse, and State Tested Nurse Aide, confirmed the absence of a policy on trauma-informed care and a lack of knowledge about interventions for the resident's PTSD. Staff members were unaware of the symptoms or appropriate responses if the resident experienced PTSD triggers, leading to routine incidents of the resident becoming upset and angry during incontinence care.
Failure to Date Opened Medication Vials
Penalty
Summary
The facility failed to ensure that open vials of insulin and tuberculin (TB) testing solution were properly dated after being opened, which is a requirement for safe medication administration. During an observation, it was found that the vials of Admelog insulin for Resident #44 and Insulin Lispro for Resident #60 were opened but not marked with the date of opening. This oversight was confirmed by an LPN, who was unable to determine when the vials had been opened. The manufacturer's instructions for both types of insulin indicated that the vials should be discarded 31 days after opening, but without the date of opening, compliance with this guideline could not be ensured. Additionally, the facility failed to date the Mantoux TB skin test solution vials after opening. Observations in the medication storage rooms on both the South and Central Units revealed that the TB skin test solution vials were opened but not dated. The LPN confirmed the lack of dating and was unable to ascertain when the vials had been opened. The facility's policy on medication storage required that medications and biologicals be stored according to the manufacturer's recommendations, and outdated items should be removed and disposed of properly. However, the failure to date these vials indicates non-compliance with this policy.
Failure to Update Daily Staffing Information
Penalty
Summary
The facility failed to ensure that daily staffing information was posted, including the date, census, and total numbers of actual hours worked per staff. This deficiency was observed when the daily staffing posting, dated 08/20/24, was still displayed on 08/25/24. An interview with the Administrator confirmed that the staffing posting at the front desk was outdated and should be updated daily. Additionally, the facility lacked a written policy regarding the staffing posting.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
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