VERO OF O'FALLON, THE.

PRINTED: 08/26/2025 FORM APPROVED (X3) DATE SURVEY COMPLETED (X2) MULTIPLE CONSTRUCTION A. BUILDING: STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER Cc 08/21/2025 31181 8. WING STREET ADDRESS, CITY, STATE, ZIP CODE 1000 LANDING CIRCLE SAINT CHARLES, MO 63304 NAME OF PROVIDER OR SUPPLIER LANDING OF O'FALLON, THE PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) (Xb! COMPLETE DAIL SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) (X4) 1D PREFIX TAG A4777, 19 CSR 30-86.047(36) Proper Care Per Individual Service Plan Residents shall receive proper care as defined in the individualized service plan. I/II This regulation is not met as evidenced by: Class || Based on observation, interview and record review, the facility failed to provide proper care for residents, as defined in their individualized service plans (ISP, the planning document prepared by an assisted living facility which outlined a resident's needs and preferences, services to be provided, and the goals expected by the resident or the resident's legal representative in partnership with the facility), for two of four sampled residents (Resident #2 and Resident #2) who were not provided with appropriate assistance when transferring. Neither resident could stand without assistance. Staff placed their arms under the residents’ arm pits and grabbed the waistband of the residents' pants to lift the residents during the transfers. This caused pressure on the residents’ shoulders, causing the shoulders to move upward and the residents’ pants to be pulled into their buttocks. The facility census was 100. Review of the facility policy for Transfer and Lift Assistance with a revision date of 3/25 showed: -It is the policy of all managed communities to limit physical assistance with resident transfers and prohibit the lifting of residents: -Transfer Assistance: in accordance with the community's Move In Move Out criteria, a resident may not be impaired to the point where his or her ability to transfer is no longer safe for the resident or individuals who may be assisting with the transfer; Missour! Department of Health and Senior Services LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE STATE FORM ome LS8P 14 If continuation sheet 1 of 12 Bucttoy) Favor? asks PRINTED: 08/26/2025 FORM APPROVED Missouri Department of Health and Senior Services STATEMENT OF DEFICIENCIES {XT} PROVIDER/SUPPLIER/CLIA (X2} MULTIPLE CONSTRUCTION (X3} DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A. BUILDING: COMPLETED Cc 31181 B.WING 08/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 1000 LANDING CIRCLE SAINT CHARLES, MO 63304 SUMMARY STATEMENT OF DEFICIENCIES PROVIDER'S PLAN OF CORRECTION {x5} (EACH DEFICIENCY MUST BE PRECEDED BY FULL (EACH CORRECTIVE ACTION SHOULD BE COMPLETE REGULATORY OR LSC IDENTIFYING INFORMATION) CROSS-REFERENCED TO THE APPROPRIATE DATE DEFICIENCY} LANDING OF O'FALLON, THE A4777 19 CSR 30-86.047(36) Proper Care Per individual Service Plan Residents shall receive proper care as defined in the individualized service plan. I/il This regulation is not met as evidenced by: Class Il Based on observation, interview and record review, the facility failed to provide proper care for residents, as defined in their individualized service plans (ISP, the planning document prepared by an assisted living facility which outlined a resident's needs and preferences, services fo be provided, and the goals expected by the resident or the resident's legal representative in partnership with the facility), for two of four sampled residents (Resident #2 and Resident #2) who were not provided with appropriate assistance when transferring. Neither resident could stand without assistance. Staff placed their arms under the residents’ arm pits and grabbed the waistband of the residents’ pants to lift the residents during the transfers. This caused pressure on the residents’ shoulders, causing the shoulders to move upward and the residents’ pants to be pulled into their buttocks. The facility census was 100. Review of the facility policy for Transfer and Lift Assistance with a revision date of 3/25 showed: -It is the policy of all managed communities to limit physical assistance with resident transfers and prohibit the lifting of residents: -Transfer Assistance: in accordance with the community's Move In Move Out criteria, a resident may not be impaired to the point where his or her ability to transfer is no longer safe for the resident or individuals who may be assisting with the transfer, Missouri Department of Health arid Senior Services LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE STATE FORM 6899 LS8P14 lf continuation sheet 1 of 12 PRINTED: 08/26/2025 FORM APPROVED Missouri Department of Health and Senior Services STATEMENT OF DEFICIENCIES {XT} PROVIDER/SUPPLIER/CLIA (X2} MULTIPLE CONSTRUCTION (X3} DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A. BUILDING: COMPLETED Cc 31181 B.WING 08/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 1000 LANDING CIRCLE LANDING OF O'FALLON, THE SAINT CHARLES, MO 63304 SUMMARY STATEMENT OF DEFICIENCIES PROVIDER'S PLAN OF CORRECTION {x5} (EACH DEFICIENCY MUST BE PRECEDED BY FULL (EACH CORRECTIVE ACTION SHOULD BE COMPLETE REGULATORY OR LSC IDENTIFYING INFORMATION) CROSS-REFERENCED TO THE APPROPRIATE DATE DEFICIENCY} A4777 Continued From page 1 -Designated community staff may provide transfer assistance for residents in licensed apartments in accordance with their service agreements; - Training will be required for all Health and Wellness staff, approved drivers, department supervisors and other staff who may be required/permitted to provide assistance with resident transfers. Review of the facility policy Move In Move Out Criteria Guidelines dated 9/19 showed the following: -Gait belts: a gait/transfer belt is an assistive device that may be used to help an individual who is partially dependent or unsteady and has at least some weight-bearing capacity. A gait belt may help stead the individual who is wearing it and provides a care partner with something to grasp while providing assistance. Review of the Nurse Aide Handbook version 8 dated 2/1/24 showed the following: -The purpose of a gait belt is to provide stability and support to patients with limited mobility during transfers and walking. Patients who are partially dependent on others for their movements, such as the elderly or those with mobility issues, are more in need of a gait belt; -A pivot-transfer of a weight bearing, non-ambulatory resident from a wheelchair to the bed or toilet - Properly place the gait belt around the resident's waist to stabilize the trunk; tighten the gait belt, check the gait belt for tightness; ensure the resident's feet are on the floor; ask the resident to place their hands on the wheelchair armrest; grasp the gait belt with both hands; bring the resident to a standing position using proper body mechanics; assist the resident Missouri Department of Health arid Senior Services STATE FORM B99 LS8P14 if continuation sheet 2 of 12 PRINTED: 08/26/2025 FORM APPROVED Missouri Department of Health and Senior Services STATEMENT OF DEFICIENCIES {XT} PROVIDER/SUPPLIER/CLIA (X2} MULTIPLE CONSTRUCTION (X3} DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A. BUILDING: COMPLETED Cc 31181 B.WING 08/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 1000 LANDING CIRCLE SAINT CHARLES, MO 63304 SUMMARY STATEMENT OF DEFICIENCIES PROVIDER'S PLAN OF CORRECTION {x5} (EACH DEFICIENCY MUST BE PRECEDED BY FULL (EACH CORRECTIVE ACTION SHOULD BE COMPLETE REGULATORY OR LSC IDENTIFYING INFORMATION) CROSS-REFERENCED TO THE APPROPRIATE DATE DEFICIENCY} LANDING OF O'FALLON, THE A4777 Continued From page 2 in pivoting and sitting on the bed in a controlled manner that ensures safety; remove the gait belt. 1. Review of Resident #2's face sheet showed the resident admitted to the facility on 2/20/24 with diagnoses of hypertension (high blood pressure), major depressive disorder, memory loss, and osteoarthritis of the knees. Review of Resident #2's Individual Service Plan (SP-a detailed, written document that outlines the specific supports, activities, and resources needed for an individual to achieve their personal goals) dated 5/31/25 showed: -Toileting: Physical assistance of one staff member; Unlicensed assistive personnel to physically assist resident fo use the toilet, and/or change adult undergarments. May require transfer assistance; -Transfer: physical assistance of one staff member; the resident required physical assist to transfer, set up wheelchair, shower chair before transfer. Unlicensed assistive personnel to physically assist resident through transfer. Observation on 8/21/25 at 10:30 A.M. showed the following: -Care Partner A and Care Partner B pushed Resident #2 in his/her wheelchair into the resident's room to lay the resident down in bed; -Care Partner A was on the resident's left side and Care Partner B was on the resident's right side; -The care partners positioned the resident's wheelchair at the side of the bed. Care PartnerA put his/her left arm under the resident's left arm, and Care Partner B put his/her right arm under the resident's right arm; -Care Partner B told the resident to stand up. Missouri Department of Health arid Senior Services STATE FORM B99 LS8P14 if continuation sheet 3 of 12 PRINTED: 08/26/2025 FORM APPROVED Missouri Department of Health and Senior Services STATEMENT OF DEFICIENCIES {XT} PROVIDER/SUPPLIER/CLIA (X2} MULTIPLE CONSTRUCTION (X3} DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A. BUILDING: COMPLETED Cc 31181 B.WING 08/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 1000 LANDING CIRCLE SAINT CHARLES, MO 63304 SUMMARY STATEMENT OF DEFICIENCIES PROVIDER'S PLAN OF CORRECTION {x5} (EACH DEFICIENCY MUST BE PRECEDED BY FULL (EACH CORRECTIVE ACTION SHOULD BE COMPLETE REGULATORY OR LSC IDENTIFYING INFORMATION) CROSS-REFERENCED TO THE APPROPRIATE DATE DEFICIENCY} LANDING OF O'FALLON, THE A4777 Continued From page 3 The resident attempted to stand but was unable to come to a standing position. Both Care Partners grabbed the back of the resident's pants and on a count of three lifted the resident out of the wheelchair with both of their arms in the arm pit area of the resident lifting the resident's shoulders up as they lifted. The resident's pants pulled tightly in the groin area. Both care partners lifted the resident to a standing position, pivoted the resident and sat the resident down on the bed. Neither Care Partner utilized a gait belt during the transfer. During an interview on 8/21/25 Care Pariner B said the following: -He/She was a Certified Nurse Aide (CNA), and have been trained on how to use a gait belt; -Care Partners are not allowed to use gait belts fo transfer the residents; -Care Partners had to put their arms under a resident's and pull the resident up by their pants; -It would be easier using a gait belt, but the company did not allow their use; -He/She was aware of the risks to the resident and the care partner if not using a gait belt. 2. Review of Resident #3's face sheet showed the resident admitted to the facility on 9/28/21 with diagnoses of dementia and hypertension. Review of the resident's ISP dated 1/21/25 showed the following: -Transfer: physical assist of one: the resident required one person for assist with transferring. The resident's skin was frail, do not use the resident's hands to transfer.; -Unable to ambulate: the resident was no longer able to ambulate and had a history of falls. Place his/her wheelchair close to the bed and lock the Missouri Department of Health arid Senior Services STATE FORM B99 LS8P14 tf continuation sheet 4 of 12 Missouri STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION NAME OF PROVIDER OR SUPPLIER LANDING AATT? Department of Health and Senior Services {XT} PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: 31181 (X2} MULTIPLE CONSTRUCTION A. BUILDING: B. WING 1000 LANDING CIRCLE SAINT CHARLES, MO 63304 OF O'FALLON, THE SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 4 brakes; -Toileting: physical assist of one staff to assist the resident to use the bathroom, may require transfer assistance. Observation on 8/21/25 at 12:56 P.M. showed the following: -Care Partner C and Care Partner D pushed Resident #3 in his/her wheelchair into the bathroom, positioned the wheelchair in front of the grab bar next to the toilet and removed the resident's foot pedals from the wheelchair; -Care Partner C instructed the resident to put his/her hands on the grab bar and pull him/herself up to come to a standing position; -The resident placed his/her hands on the grab bar then took them off; the care partners placed the resident's hands back on the bar and asked the resident to stand up; -The resident did not stand up. Care Partner C put his/her right arm under the resident's right arm, grabbed the back the resident's pants, and pushed the resident forward so the resident's hands touched the grab bar. Care Partner D grabbed the back of the resident's pants and asked the resident to stand again, the resident did not stand. Both Care Partners pulled on the back of the resident's pants and Care Partner C lifted the resident up with his/her arm under the resident's arm causing the resident's shoulder to elevate, pulled the resident out of the wheelchair, pivoted the resident and sat the resident down on the toilet; -The resident's toes touched the floor during the transfer; the resident did not bear weight during the transfer; -Neither staff used a gait belt during the transfer. During an interview on 8/21/25 at 1:00 P.M. Care Missouri Department of Health arid Senior Services STATE FORM Bag CROSS-REFERENCED TO THE APPROPRIATE LS8P11 PRINTED: 08/26/2025 FORM APPROVED (X3} DATE SURVEY COMPLETED Cc 08/21/2025 STREET ADDRESS, CITY, STATE, ZIP CODE PROVIDER'S PLAN OF CORRECTION {x5} (EACH CORRECTIVE ACTION SHOULD BE COMPLETE DATE DEFICIENCY} tf continuation sheet 5 of 12 PRINTED: 08/26/2025 FORM APPROVED Missouri Department of Health and Senior Services STATEMENT OF DEFICIENCIES {XT} PROVIDER/SUPPLIER/CLIA (X2} MULTIPLE CONSTRUCTION (X3} DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A. BUILDING: COMPLETED Cc 31181 B.WING 08/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 1000 LANDING CIRCLE LANDING OF O'FALLON, THE SAINT CHARLES, MO 63304 SUMMARY STATEMENT OF DEFICIENCIES PROVIDER'S PLAN OF CORRECTION {x5} (EACH DEFICIENCY MUST BE PRECEDED BY FULL (EACH CORRECTIVE ACTION SHOULD BE COMPLETE REGULATORY OR LSC IDENTIFYING INFORMATION) CROSS-REFERENCED TO THE APPROPRIATE DATE DEFICIENCY} A4777 Continued From page 5 Partner C said the following: -Resident #3 would usually stand, but at times will not stand up completely without help; -He/She was a CNA and had been trained on how to use a gait belt; -It was facility policy that care partners could not use gait belts to transfer residents; -He/She had been told the facility was a no lift facility and could not use gait belts; -Have been taught by therapy to put your arm under the resident's arm and use the back of their pants and pull the resident up. During an interview on 8/21/25 at 1:00 P.M. Care Partner D said the following: -He/She was told that they could not use gait belts to transfer the residents; -He/She has been taught not to put your arm under the resident's arm, as this could dislocate a resident's shoulder; -The facility did not allow the use the gait belts. During an interview on 8/21/25 at 9:42 A.M. the Memory Care Director said staff do not utilize gait belts to transfer the residents. They have been trained by therapy on how to transfer a resident without using a gait belts. Review of an email from the contracted therapy department to the Memory Care Director dated 8/21/25 at 9:29 A.M. showed transfer training was provided on July 31st and August 4th. Transfer training with two caregivers without the use of gait belt overview, demonstration, and handout provided to reduce injury and fall risk. Review of the handout provided to the caregivers showed pictures of a one person transfer of a resident from the wheelchair to the bed. The was Missouri Department of Health arid Senior Services STATE FORM B99 LS8P14 if continuation sheet 6 of 12 PRINTED: 08/26/2025 FORM APPROVED Missouri Department of Health and Senior Services STATEMENT OF DEFICIENCIES {XT} PROVIDER/SUPPLIER/CLIA (X2} MULTIPLE CONSTRUCTION (X3} DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A. BUILDING: COMPLETED Cc 31181 B.WING 08/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 1000 LANDING CIRCLE LANDING OF O'FALLON, THE SAINT CHARLES, MO 63304 SUMMARY STATEMENT OF DEFICIENCIES PROVIDER'S PLAN OF CORRECTION {x5} (EACH DEFICIENCY MUST BE PRECEDED BY FULL (EACH CORRECTIVE ACTION SHOULD BE COMPLETE REGULATORY OR LSC IDENTIFYING INFORMATION) CROSS-REFERENCED TO THE APPROPRIATE DATE DEFICIENCY} A4777 Continued From page 6 caregiver positioned in front of the resident with their hands at the resident's waist and not under the resident's arm pits, guiding the resident to turn and sit on the bed. During an interview on 8/21/25 at 1:30 P.M. the Wellness Director said the following: -After reviewing the policy, the staff could be using gait belts; -She had been told by corporate nurses that no gait belts should be used. During an interview on 8/21/25 at 1:30 P.M. the Administrator said the following: -The policy did not specifically say that staff could not use a gait belt to transfer residents, but they had been told by corporate staff that gait belts were not allowed to be used for transfers; -The therapy department had helped with training the staff on how to transfer a resident by not pulling on their arms; -The facility was changing ownership soon, and the new company allowed the use of the gait belt to aid in transferring the residents if needed. During an interview on 8/26/25 at 10:50 A.M. the contracted Therapy Manager said the following: -He/She provided training to the care partner staff at the request of the facility due fo the possibility of some bruising of residents’ hands due to improper transfers; -He/She informed staff and management that if gait belts could not be used, then at least two people should be used to transfer a resident and at times three staff depending upon the resident and the ability to follow commands and bear weight; -He/She taught staff for one person fo be on each side of the resident and to have the resident's Missouri Department of Health arid Senior Services STATE FORM B99 LS8P14 if continuation sheet 7 of 12 PRINTED: 08/26/2025 FORM APPROVED Missouri Department of Health and Senior Services STATEMENT OF DEFICIENCIES (Xt) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3} DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A. BUILDING: COMPLETED Cc 31181 B.WING 08/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 1000 LANDING CIRCLE SAINT CHARLES, MO 63304 SUMMARY STATEMENT OF DEFICIENCIES PROVIDER'S PLAN OF CORRECTION {x5} (EACH DEFICIENCY MUST BE PRECEDED BY FULL (EACH CORRECTIVE ACTION SHOULD BE COMPLETE REGULATORY OR LSC IDENTIFYING INFORMATION) CROSS-REFERENCED TO THE APPROPRIATE DATE DEFICIENCY} LANDING OF O'FALLON, THE A4777 Continued From page 7 arm cradling in their arm and the staff members other arm and hand on the resident's buttocks to push and lift. If the resident had a belt on their pants, then staff should use that belt to lift; -lf the third person needed to be used for a resident who was having difficulty bearing weight, that third person would be behind the resident lifting on the buttock area; -He/She did not recommend staff place their arms under residents’ arm pits due to the possibility to injury the resident's shoulders; -He/She recommended the use of gait belts for transferring a resident, but understood the company did not allow the use of gait belts. MOQO257862 19 CSR 30-88.010(29) Dignity/Privacy Each resident shall be treated with consideration, respect, and full recognition of his or her dignity and individuality, including privacy in treatment and care of his or her personal needs. All persons, other than the attending physician, the facility personnel necessary for any treatment or personal care, or the department or Department of Mental Health staff, as appropriate, shall be excluded from observing the resident during any time of examination, treatment, or care unless consent has been given by the resident. HAI This regulation is not met as evidenced by: Class Il* Based on observation, interview and record review, the facility failed to ensure one resident, Resident #4, of our sampled residents, was treated with consideration, respect, and full Missouri Department of Health arid Senior Services STATE FORM B99 LS8P14 if continuation sheet 8 of 12 PRINTED: 08/26/2025 FORM APPROVED Missouri Department of Health and Senior Services STATEMENT OF DEFICIENCIES {XT} PROVIDER/SUPPLIER/CLIA (X2} MULTIPLE CONSTRUCTION (X3} DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A. BUILDING: COMPLETED Cc 31181 B.WING 08/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 1000 LANDING CIRCLE SAINT CHARLES, MO 63304 SUMMARY STATEMENT OF DEFICIENCIES PROVIDER'S PLAN OF CORRECTION {x5} (EACH DEFICIENCY MUST BE PRECEDED BY FULL (EACH CORRECTIVE ACTION SHOULD BE COMPLETE REGULATORY OR LSC IDENTIFYING INFORMATION) CROSS-REFERENCED TO THE APPROPRIATE DATE DEFICIENCY} LANDING OF O'FALLON, THE A8030 Continued From page 8 recognition of dignity, when staff had the resident eat his/her meais in a private dining room separate from the main dining room due the resident having a cough. The facility census was 100. Review of the facility policy for Resident Rights dated 11/23 showed the following: - Each resident shall be treated with consideration, respect, and full recognition of his or her dignity and individually, including privacy in treatment and care of his or her personal needs; -Residents shall not have their personal lives regulated or controlled beyond reasonabie adherence to meal schedules. 1. Review of Resident #4's face sheet showed the following: -Admitted to the facility on 11/21/24; -Diagnosis included gastro-esophageal reflux (Occurs when stomach contents flow back into the esophagus. Common symptoms include heartburn, regurgitation of sour liquid, chronic cough, and difficulty swallowing). Review of the resident's Individualized Service Plan (ISP-a personalized document that details a resident's specific care needs, goals, and preferences, developed collaboratively by the resident, their family, and the community's care team) dated 11/21/24 showed the following: -The resident was independent with dining after meal escorts. -The ISP did not address the resident eating meals in a private dining room due to a cough or interventions to address the resident's cough. Review of the resident's Physician Order Sheet (POS) dated August 2025 showed the following: Missouri Department of Health arid Senior Services STATE FORM B99 LS8P14 tf continuation sheet 9 of 12 PRINTED: 08/26/2025 FORM APPROVED Missouri Department of Health and Senior Services STATEMENT OF DEFICIENCIES {XT} PROVIDER/SUPPLIER/CLIA (X2} MULTIPLE CONSTRUCTION (X3} DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A. BUILDING: COMPLETED Cc 31181 B.WING 08/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 1000 LANDING CIRCLE SAINT CHARLES, MO 63304 SUMMARY STATEMENT OF DEFICIENCIES PROVIDER'S PLAN OF CORRECTION {x5} (EACH DEFICIENCY MUST BE PRECEDED BY FULL (EACH CORRECTIVE ACTION SHOULD BE COMPLETE REGULATORY OR LSC IDENTIFYING INFORMATION) CROSS-REFERENCED TO THE APPROPRIATE DATE DEFICIENCY} LANDING OF O'FALLON, THE A8030 Continued From page 9 -Pantroprazole Sodium DR ( medication used to treat conditions caused by too much stomach acid) 40 milligrams daily before breakfast; -Mucus relief DM ER (medication to treat coughs and chest congestion) one tablet two times a day and as needed for coughing. During an interview on 8/21/25 at 11:30 A.M. Resident #4 said the following: -The General Manager told him/her since his/her cough disrupted other residents in the main dining room, he/she was going to eat in the private dining room; -He/She would prefer to eat in the main dining room; -He/She was seeing a physician about the cough and could not help he/she had the cough; -He/She did not want to cause any problems. Observation on 8/21/25 at 12:03 P.M. to 12:45 P.M. showed the following: -Resident #4 sat by him/herself at a table by him/herself in the main dining room; (staff had placed the inspector in the private dining room to work on 8/21/25); -The resident would occasionally cough, and at times the cough would be considered loud, the resident cleared his/her throat loudly. During an interview on 8/21/25 at 12:03 P.M. to 12:45 P.M. several residents who were eating in the main dining room said the following: -Resident #4 will cough loudly at times and it could be disruptive to their dining experience. The resident could not help that he/she had a cough; -They did not think that it was right for the resident to eat alone in the private dining room. Missouri Department of Health arid Senior Services STATE FORM B99 LS8P14 if continuation sheet 10 of 12 PRINTED: 08/26/2025 FORM APPROVED Missouri Department of Health and Senior Services STATEMENT OF DEFICIENCIES {XT} PROVIDER/SUPPLIER/CLIA (X2} MULTIPLE CONSTRUCTION (X3} DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A. BUILDING: COMPLETED Cc 31181 B.WING 08/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 1000 LANDING CIRCLE SAINT CHARLES, MO 63304 SUMMARY STATEMENT OF DEFICIENCIES PROVIDER'S PLAN OF CORRECTION (x5) (EACH DEFICIENCY MUST BE PRECEDED BY FULL (EACH CORRECTIVE ACTION SHOULD BE COMPLETE REGULATORY OR LSC IDENTIFYING INFORMATION) CROSS-REFERENCED TO THE APPROPRIATE DATE DEFICIENCY} LANDING OF O'FALLON, THE A8030 Continued From page 10 During an interview on 8/22/25 at 9:30 A.M. Family Member A said the following: -He/She and the resident were approached by the facility General Manager about the resident's cough disrupting other residents in the dining room. The General Manager gave the option of either eating in the private dining room or in the resident's apartment; -He/She did not like the idea of the resident eating in the apartment as the only time the resident goes out of his/her room was to eat the noon meal in the dining room. He/She did not want the resident to be further isolated in his/her room; -The resident was not happy about having to move, and would prefer to eat with other people; -He/She took the resident to the physician fo see if here was anything medically wrong or if medication could be ordered to help with the cough. The resident has had the cough for some time; -He/She and the resident did not think they had any other options but to move fo the private dining room. During an interview on 8/21/25 at 10:00 A.M. the Wellness Director said the following: -Resident #4 coughed a lot in the dining room, and other residents had complained about this; -The General Manager had a talk with the resident and his/her family member about moving to the private dining room for meals and they were both okay with moving there; -The resident had been seen by speech therapy for the cough, but found no issues. The family member was currently taking the resident to the physician to treat the cough. During an interview on 8/21/25 at 1:15 P.M. the Missouri Department of Health arid Senior Services STATE FORM B99 LS8P14 lf continuation sheet 11 of 12 PRINTED: 08/26/2025 FORM APPROVED Missouri Department of Health and Senior Services STATEMENT OF DEFICIENCIES (Xt) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3} DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A. BUILDING: COMPLETED Cc 31181 B.WING 08/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 1000 LANDING CIRCLE SAINT CHARLES, MO 63304 (x4) ID SUMMARY STATEMENT OF DEFICIENCIES ID PROVIDER'S PLAN OF CORRECTION (x5) PREFIX (EACH DEFICIENCY MUST BE PRECEDED BY FULL PREFIX (EACH CORRECTIVE ACTION SHOULD BE COMPLETE TAG REGULATORY OR LSC IDENTIFYING INFORMATION) TAG CROSS-REFERENCED TO THE APPROPRIATE DATE DEFICIENCY} LANDING OF O'FALLON, THE A8030 Continued From page 11 General Manager said the following: -Resident #4 has a overwhelming guttural cough in the dining room and it was upsetting to the other residents who ate there; -He had talked with the resident and the resident's family member and they both consented to be moved to the private dining room; -He thought that by moving the resident it would preserve the resident's dignity and enhance the other residents’ dining experience. *The higher classification merited due to the violation’s effect on the resident. MO29/667 Missouri Department of Health arid Senior Services STATE FORM B99 LS8P14 if continuation sheet 12 of 12 Provider/Supplier Name: | The Vero of O'Fallon (formerly The Landing of O'Fallon) Street Address, City, Zip: | 1000 Landing Circle St. Charles, MO 63304 PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER The facility, with a census of 100 residents and a survey sample of four residents, failed to provide proper care as outlined in individualized service plans (ISPs). Specifically, staff did not consistently provide appropriate assistance during transfers for Residents #2 and #3, which may also impact other residents requiring transfer assistance per their ISPs. On September 03, 2025, the individualized service plans for Residents #2 and #3 were reviewed and confirmed to reflect their continued need for assistance with transfers. Staff were re- educated on the residents’ care needs, and transfer assistance IS NOW being provided in accordance with their ISPs. Current resident ISP review conducted to identify other residents with transfer assistance needs. Residents requiring transfer support were confirmed, and staff were instructed to follow ISP requirements consistently. By 09/08/2025, current clinical staff will receive education on safe transfers. including gait belt use and proper body mechanics. Staff who are not scheduled on that date will receive the same education prior to working their next scheduled shift. Training will be documented and maintained in personnel files. Beginning 09/08/2025, the Health Care Director, or designee, will complete five transfer audits weekly for four weeks to ensure Staff compliance with ISPs and safe transfer practices. Results will be reviewed by the QMPI (Quality Management and Performance Improvement) Committee at the end of the four- week period. The committee will determine if Ongoing or modified monitoring is recommended, based on findings. Based on observation, interview, and record review, the facility failed to ensure one resident (R4) of the sampled residents was treated with consideration, respect, and full recognition of dignity. The facility census at the time of survey was 100 residents, with a sample of four. On August 21, 2025, Resident R4 was informed that does not have to eat in a private dining room during meals. R4 was given the choice to remain in the main dining room during all meal services, and staff were instructed to honor preference. Current residents were interviewed to ensure no other residents had been asked to eat outside the main dining room. No additional concerns were identified. On 09/08/2025, the Residence Director was reeducated by the Regional Health Care Director of Operations that asking a resident to eat outsice of the main dining room violates dignity and privacy standards. By 09/08/2025, current staff shall be reeducated on Resident Rights and Dignity, or before working their next scheduled shift. Education will be documented and maintained in personnel files. Beginning 09/08/2025, the Resident Director or designee will conduct three resident interviews per week for four weeks to ensure resident rights and dignity are respected and maintained. Findings will be reported to the QMP! Committee, which will review results and determine if additional or extended monitoring is recommended, based on findings.