Otterbein North Shore

In the surveyor’s words

From the most serious findings on record at Otterbein North Shore, in the surveyor’s own words.

• No harm, potential for more than minimal, widespreadF812Apr 17, 2025

  Based on observation, staff interview, and review of the facility policies, the facility failed to ensure food items were stored, labeled and dated and ensure refrigerators and freezers did not contain expired food items. This had the potential to affect all 17 residents who received food from the facility kitchens. The facility census was 17. Findings include: 1. Observation on [DATE] beginning at 7:37 A.M. of refrigerators and freezers located in the Cornerstone Cottage with Certified Nursing Assistant (CNA) #303 revealed the following findings and CNA #303 verified the below findings: - One unlabeled container of fruit cocktail which expired on [DATE]. - One unlabeled container which contained an unknown white substance and expired on [DATE]. […]

• No harm, potential for more than minimal, widespreadF851Jun 17, 2024

  Based on the review of the facility's Payroll-Based Journal (PBJ) Staffing Data Report, staffing schedule, staff time sheets, and staff interview, the facility failed to submit accurate information in the PBJ in the first quarter of 2024. This had the potential to affect all residents. The facility census was 17. Findings include: Review of the PBJ Staffing Data Report revealed the facility triggered for not having licensed nursing coverage 24 hours a day in the first quarter of 2024. […]

• No harm, potential for more than minimal, patternF880Mar 23, 2023

  Based on observation, medical record review, staff interview, and review of facility policy, the facility failed to ensure a resident who was on contact isolation had proper signage posted and personal protective equipment available. This affected one (Resident #117) of one resident reviewed for transmission based precautions and had the potential to affect the other seven residents (#2, #12, #14, #118, #119, #120, and #121) who resided in the home. The facility census was 18. Findings include: Review of Resident #117's medical record revealed an admitted [DATE]. […]

• No harm, potential for more than minimal, isolatedF578Mar 27, 2026

  Based on medical record review, review of the nurse and staff report sheet, staff interview, and review of the facility policy the facility failed to ensure correct advanced directives were in the medical chart and on the nurse and staff report sheet. This affected one (Resident #7) of one resident reviewed for advanced directives. The facility census was 19.Findings include:Review of the medical record for Resident #7 revealed an admission on [DATE]. Diagnoses included unspecified dementia, hypothyroidism, and major depressive disorder.Review of the quarterly Minimum Data Set (MDS) dated [DATE] revealed Resident #7 had impaired cognition. Further review of the MDS revealed Resident #7 required supervision or touching assistance with activities of daily living (ADL). […]

• No harm, potential for more than minimal, isolatedF580Mar 27, 2026

  Based on review of the medical record, staff interview, and policy review, the facility failed to notify the physician and resident representative of changes in condition. This affected one (#26) of one resident reviewed for change in condition. The facility census was 19.Findings include: Review of the medical record for Resident #26 revealed an admission date of 02/13/26 and a discharge date of 02/23/26. Diagnoses included type two diabetes mellitus with hyperglycemia, chronic kidney disease, hypertension, and hypokalemia. Review of the Minimum Data Set (MDS) assessment dated [DATE] revealed the resident had severe cognitive impairment. The resident was dependent on staff for activities of daily living. Review of the nursing notes dated 02/13/26 at 9:21 P.M. […]