Majestic Care Of Perrysburg

Review of the medical record for Resident #134 revealed he was admitted on [DATE] with diagnoses that included disorder of lipoprotein, myelodysplastic syndrome (disorder affecting bone marrow), and non-pressure chronic ulcer of the right heel and midfoot with the fat layer exposed.

Review of the admission Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #160 was moderately cognitively impaired, and he did not refuse care.

Review of the current care plan for Resident #134 revealed he had impaired skin integrity.

The interventions included wound treatment as ordered.

Review of the physician orders and treatment administration records (TAR) for Resident #134 revealed orders beginning on 06/21/25 for daily wound care to a pressure ulcer on his right foot to cleanse with normal saline, apply collagen, cover with an abdominal dressing, wrap with Kerlix (fluffy gauze), and secure with tape.

Further review of the TARs revealed wound care was not completed on 06/06/25, 06/15/25, 06/16/25, 06/22/25, 06/23/25, 07/01/25, 07/12/25, 07/26/25, 08/01/25, 08/02/25, 08/05/25, and 08/11/25.2.

Review of the medical record for Resident #140 revealed he was admitted on [DATE] with diagnoses that included traumatic brain injury, intracranial abscess and granuloma, tracheostomy, gastrostomy, and acquired absence of part of the head and neck.

Review of the quarterly MDS assessment dated [DATE] revealed Resident #140 was unable to be assessed cognitively due to a traumatic brain injury, and he did not refuse care.

Review of the care plan dated 03/19/25 for Resident #140 revealed he had a pressure injury to his right outer foot.

The interventions included to administer treatments as ordered.

Review of the current care plan for Resident #140 revealed he had a pressure injury to his left foot.

The interventions included to provide wound care per treatment orders.

Review of the physician orders and TARs for Resident #140 revealed orders beginning on 12/17/24 for daily wound care to his left foot to cleanse with normal saline, pat dry, apply skin prep (a protective barrier), and leave open to air.

Further review of the TARs revealed wound care was not completed on 03/03/25, 03/04/25, or 03/22/25.

Review of the physician orders and TARs for Resident #140 revealed orders beginning on 12/18/24 for daily wound care to his right outer foot to cleanse with normal saline, pat dry, apply Medihoney and calcium alginate, cover with abdominal dressing, and wrap with Kerlix.

Further review of the TARs revealed wound care was not completed on 03/03/25.

Review of the physician orders and TARs for Resident #140 revealed orders beginning on 03/21/25 for twice daily wound care to his right outer foot to cleanse with normal saline, pat dry, and apply skin prep.

Further review of the TARs revealed wound care was not completed on 03/22/25 and 03/23/25.

Review of the physician orders and TARs for Resident #140 revealed orders beginning on 09/11/25 for daily wound care to his left foot to cleanse with normal saline, pat dry, apply skin prep, and cover with border gauze.

Further review of the TARs revealed wound care was not completed on 09/12/25.

Interview on 09/11/25 at 4:10 P.M. and 5:20 P.M. with the Director of Nursing (DON) confirmed wound care was not completed for Resident #134's pressure ulcer on 06/06/25, 06/15/25, 06/16/25, 06/22/25, 06/23/25, 07/01/25, 07/12/25, 07/26/25, 08/01/25, 08/02/25, 08/05/25, and 08/11/25, and for Resident #140 on 03/03/25, 03/04/25, 03/22/25, 03/23/25, and 09/12/25.Review of facility policy titled, [NAME] Care Wound Management Policy, dated 05/20/24, revealed the facility would promote the treatment and healing of skin integrity impairment and optimize healing solutions.

This deficiency represents non-compliance investigated under Complaint Number 2575262.

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