HEARTLAND OF UPTOWN WESTERVILLE
LOCATED: 140 OLD COUNTY LINE ROAD, WESTERVILLE, OH 43081

HEARTLAND OF UPTOWN WESTERVILLE was cited by the DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES for the following deficiencies:

PLEASE NOTE: The following highlighted quoted text is only a portion of the full report/survey submitted by DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES. The full report/survey can be found here.

FACILITY FAILED TO GIVE RESIDENTS PROPER TREATMENT TO PREVENT NEW BED (PRESSURE) SORES OR HEAL EXISTING BED SORES.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on review of the medical record, observation and staff interview, the facility failed to ensure a resident was monitored and received necessary treatment to prevent and treat in a timely manner two unstageable pressure ulcers. Actual Harm occurred when Resident #59 developed two unstageable pressure ulcers on the heels that were not discovered until they had necrotic tissue present. This affected one (Resident #59) of two residents reviewed for pressure ulcers.

Interview with the Director of Nursing (DON) on 07/26/17 at 3:20 P.M. stated they had determined the resident used his heels to propel his wheelchair causing the pressure ulcers to the heels. She was unable to explain how they became so large and had advanced to necrotic tissue before anyone reported this. She stated they should have been found when the nurses completed the weekly body audits.

Interview with the DON on 07/26/17 at 4:06 P.M. confirmed the wounds were staged wrong initially. She confirmed the laboratory testing ordered by the wound clinic was never completed. She confirmed the Prevalon boots were documented in the record to be worn when in bed and not 24 hours/day as ordered by the wound clinic physician. She stated they started the use of the Prevalon boots before he went to the wound clinic and the order was not updated when the wound clinic ordered them to be worn 24 hours. She confirmed the wound clinic notes from 07/19/17 were not in the record but stated he did go to the appointment. She called the wound clinic and had the 07/19/17 wound clinic notes faxed to the facility. The DON confirmed there were new orders to change the wound treatment to the left heel orders but this did not occur. The new order included to apply Santyl ointment ([MEDICATION NAME] agent) nickel thick, only to the wound bed on the left heel, apply around wound edges, between good skin and eschar, use the [MEDICATION NAME] on the eschar, cover with dry dressing; the resident will continue use of offloading to prevent further irritation to the heels; follow up in roughly three weeks for further evaluation and treatment. She confirmed the above treatments and orders were delayed from 07/19/17 to 07/26/17.

Observation on 07/27/17 at 8:55 A.M. revealed Resident #59 was in bed. The resident was sitting in the bed with the head of the bed at about 45 degrees. The resident was not wearing the Prevalon boots on either heel and there were no other positioning devices, such as pillows to offload his heels.

Interview on 07/27/17 at 8:55 A.M. with State tested Nurse Aide (STNA) #20 confirmed the resident was not wearing the Prevalon boots.

This deficiency substantiates Complaint Number OH 381.

Personal Note from NHA–Advocates: NHAA shares with all the families of loved ones who are confined to nursing homes the pain and anguish of putting them in the care of someone else. We expect our loved ones to be treated with dignity and honor in the homes we place them. We cannot emphasize enough to family members of nursing home residents; frequent visits are essential to our loved ones’ well-being and safety. This nursing home and many others across the country are cited for abuse and neglect.