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Slovene Home For The Aged

18621 Neff Rd, Cleveland, OH 44119 · Non profit - Corporation · 104 certified beds · (216) 486-0268 Medicare & Medicaid certified

Call the home — (216) 486-0268 Need help choosing, fast? Free, unbiased: Eldercare Locator 1-800-677-1116
No harm-level citations or fines — but 24 lower-level deficiencies on record (see below)
Insights

The public record raises real questions here. Weigh the concerns below carefully.

In its favor
  • no federal fines or payment denials on record
  • fewer deficiencies at its most recent standard inspection than at the one before — a sign of improvement
Worth asking about
  • a high number of inspection citations overall (24) — worth reading through, though larger and more-often-surveyed homes tend to accrue more lower-severity tags
  • its facility-reported quality-measure score sits well above its independent inspection score
  • its independent health-inspection rating is low (2/5)
  • it did not file the payroll staffing data CMS requires — its 1 of 5 staffing rating is the rating CMS assigns for not reporting, not a measure of how many nurses are on the floor
  • its last standard health inspection was over 2 years ago — the star rating may not reflect current conditions

One thing this read cannot see: what residents and families actually experience day to day. Public data misses the feel of a place — visit unannounced, ideally at a mealtime or on a weekend, talk to staff and families, and ask your tour questions.

A plain-English summary of the public record below — not a rating, ranking, or recommendation. We take no money from any facility.

1/5
CMS overall
1 of 5
Health inspectionSurveyor-assigned, ranked within your stateInspector-verified 2 of 5
StaffingFrom payroll records (PBJ) 1 of 5
Quality measuresSelf-reported by the facility 4 of 5

Worth a closer look. This home's quality-measure rating runs 2 stars above its independent health-inspection score. The inspection is done by state surveyors; the quality-measure score leans on data the facility reports about itself — so a gap this large is worth reading the inspection record for.

Location & what’s nearby

Hospital
★★★★ 4/5 CMS
Urgent care / clinic
25200 Chagrin Blvd Ste 300 · (216) 383-2834 · Call to confirm hours
Pharmacy
725 E 200th St · (216) 531-1700 · Call to confirm hours
Grocery
Save A Lot<0.1 mi
18501 Neff Rd · (216) 692-3571 · Call to confirm hours
Park
Neff Park0.2 mi
19298 Bella Dr · (216) 664-3258 · Typically dawn to dusk
Place of worship

Nearest of each type, straight-line distance. Hospitals come from the CMS Hospital General Information registry; everything else from Overture Maps (public data). Hospital and park hours are typical — call ahead to confirm.

Quality measures — how residents actually fare

Overall quality measures 4 of 5
Long-stay residentspeople who live here 5 of 5
Short-stay residentsrehab / post-hospital 3 of 5

Quality-measure stars summarize outcomes CMS tracks from the assessments each home submits — avoidable hospitalizations and ER visits, falls with injury, pressure ulcers, unplanned weight loss, and long-term antipsychotic use. Because the underlying data is self-reported, weigh a high score against the independent inspection record. Long-stay = permanent residents; short-stay = rehab and post-hospital stays.

Trend — is this home getting better or worse?

Over 2025-02 to 2026-06, this home’s CMS overall rating held steady at 2 stars. From monthly CMS archive snapshots.

Horizontal axis runs 2025-02 to 2026-06. That is where CMS’s monthly archive ends, so the right-hand edge of each line is that month — not today.

Overall rating2★
Inspection scorelower = better
See all quality measures vs. state & national benchmarks
MeasureThis homeState avgTypical statevs typical state
Long-stay residents whose need for help with daily activities increased8.2%5.3%15.4%worse than state — see note marked double-dagger below the table
Long-stay residents who lose too much weight4.8%6.2%5.4%better
Long-stay residents with a catheter left in their bladder0.0%0.2%0.9%better than state — see note marked double-dagger below the table
Long-stay residents with a urinary tract infection0.7%0.4%2.0%worse than state — see note marked double-dagger below the table
Long-stay residents with depressive symptoms6.7%30.1%6.5%typical
Long-stay residents who were physically restrained0.0%0.1%0.1%better
Long-stay residents with falls causing major injury0.4%3.2%3.3%better
Long-stay residents whose ability to walk worsened1.2%6.1%16.1%better than state — see note marked double-dagger below the table
Long-stay residents on antianxiety or hypnotic medication9.4%25.5%18.9%better
Long-stay residents given the seasonal flu vaccine98.7%94.5%95.3%typical
Long-stay residents with pressure ulcers4.8%3.4%4.7%typical
Long-stay residents with worsening bladder/bowel control13.3%21.4%21.2%better
Long-stay residents who got an antipsychotic medication — see the note below the table15.0%8.8%17.1%better
Short-stay residents who newly got an antipsychotic medication1.1%1.2%1.4%better
Short-stay residents given the seasonal flu vaccine80.6%75.6%79.4%typical
Short-stay residents rehospitalized after admission21.0%24.9%22.6%typical
Short-stay residents with an outpatient ER visit14.1%12.9%12.0%worse
Long-stay hospitalizations per 1,000 resident days1.901.731.67worse
Long-stay outpatient ER visits per 1,000 resident days1.701.801.80typical

On this measure the state average is at least twice (or half) the typical state — a gap that size is usually how the state codes and reports the measure, not how its homes actually perform. Against a benchmark this state does not sit on, a “vs typical state” verdict would mostly be measuring the state, so we compare this home with its own state instead and show both averages.

§ Antipsychotics carry an FDA boxed warning — they raise the risk of death in older people with dementia-related psychosis, and are not approved for that use. So this measure is partly a read on whether a home sedates residents instead of staffing for them. But read a low rate carefully in both directions: CMS excludes residents coded with schizophrenia (and Tourette's or Huntington's) from this measure, and federal auditors have found implausible increases in schizophrenia coding since the measure was published — so a very low rate can reflect recoding rather than less prescribing. Ask the home what share of its residents carry a schizophrenia diagnosis, and how it handles behavioral symptoms without medication.

CMS quality measures, as Care Compare shows them. For most rows lower is better (fewer falls, ulcers, hospitalizations); vaccination rates are the exception. Not every row is risk-adjusted. CMS adjusts some measures for resident mix, but falls with major injury, antipsychotic use, physical restraints and the vaccination rates are unadjusted rates — so a home caring for heavier or more behaviorally complex residents can look worse on them without providing worse care. The “typical state” column is the median of the 50 state averages — not a national average of all homes. We use it because a plain average across homes is pulled badly off course by a few states’ reporting habits (long-stay depressive symptoms is the clearest case: Illinois codes it several times higher than most states, which alone lifted the all-homes figure to about twice what a typical state records). The median of state averages resists that — but it does weigh every state equally, so a large state counts no more than a small one, and it is a benchmark of our construction rather than a CMS-published figure. better/worse means the home differs from that benchmark by more than 10% of it; closer than that reads typical. CMS does not publish how many residents each measure covers, and the counts are often small — a single resident can move a rate by several points — so treat small gaps as noise. These come from data the facility reports, so weigh them against the independent inspection record above.

Short-stay rehab — if you are coming here from a hospital

Arriving from a hospital right now? Read the discharge guide → — your appeal rights, how to slow a rushed discharge, and what to ask about the numbers below.

49.9% of the Medicare patients who left this home got back to the community and stayed there for at least 31 days — which CMS reads as no different from the national rate. This is CMS’s risk-adjusted rate over 68 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.

49.9%U.S. median 51.5%
Got home and stayed home
12.5%U.S. median 10.7%
Went back to hospital
79.1%U.S. median 56.6%
Met the expected recovery
0.27U.S. median 0.31
Therapy hours / resident / day
0.09hours / resident / day
Physical therapy
0.11hours / resident / day
Occupational therapy
0.07hours / resident / day
Speech therapy

Met the expected recovery: 79.1% of this home’s Medicare short-stay residents left it at or above the ability to care for themselves and move around that CMS predicted for them, across 43 stays in Oct 2024–Sep 2025. The median of the 11,061 homes CMS publishes this for is 56.6%. Read it beside the getting-home figure, not instead of it: unlike the two measures above, CMS makes no better-or-worse call on this one and publishes no confidence interval for it, so this is a comparison and not a verdict — but it is the short-stay measure that separates homes most, and the one to ask about.

Therapy staffing: this home’s payroll records show 0.27 therapist hours per resident per day in 2026Q1 — more than 41% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 24% of this home’s weekday level — it runs some therapy at the weekend, at a lower level than on weekdays. The median home that reports therapy runs 13% — weekday-focused therapy is the industry norm, not a shortfall. But recovery does not pause on a Saturday: ask what the weekend actually looks like here.

This section is about rehab stays, not living here. Most of this page — the stars, the quality measures, the inspection record — describes the home the way a permanent resident experiences it. These figures describe the short Medicare stay after a hospital discharge: a hip, a stroke, a bad infection, six weeks and home. They are different residents, different staff, often a different wing. Therapy hours are per resident in the building, not per rehab patient — the count includes every long-stay resident, and they mostly get no therapy at all. So a home with a small rehab wing inside a large nursing population reads low here even if its rehab patients get plenty of therapy, and a mostly-rehab home reads high. Use it to compare homes doing similar work, ask what a rehab resident actually gets in a day, and remember that CMS does not publish therapy minutes per patient — nobody does.

See every short-stay measure CMS publishes for this home
MeasureThis homeU.S. medianPeriod coveredCMS’s call
Got home and stayed homeRate of successful return to home or community from a SNF49.9%CMS range 40.4–60.151.5%Oct 2022–Sep 2024no different from U.S.
Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNF12.5%CMS range 8.0–16.810.7%Oct 2022–Sep 2024no different from U.S.
Met the expected recoveryPercentage of residents who are at or above an expected ability to care for themselves and move around at discharge79.1%56.6%Oct 2024–Sep 2025CMS makes no comparison for this measure
Self-care at dischargePercentage of residents who are at or above an expected ability to care for themselves at discharge55.8%52.8%Oct 2024–Sep 2025CMS makes no comparison for this measure
Moving around at dischargePercentage of residents who are at or above an expected ability to move around at discharge65.1%50.0%Oct 2024–Sep 2025CMS makes no comparison for this measure
Medication problems followed upPercentage of residents whose medications were reviewed and who received follow-up care when medication issues were identified100.0%98.7%Oct 2024–Sep 2025CMS makes no comparison for this measure
Medication list to the next providerPercentage of residents where the SNF provided a current medication list to the next health care settingnot reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Medication list to the familyPercentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge91.3%98.7%Oct 2024–Sep 2025CMS makes no comparison for this measure
Falls with major injuryPercentage of SNF residents who experience one or more falls with major injury during their SNF stay0.0%0.0%Oct 2024–Sep 2025CMS makes no comparison for this measure
New or worsened pressure ulcersPercentage of residents with pressure ulcers/pressure injuries that are new or worsened1.9%1.9%Oct 2024–Sep 2025CMS makes no comparison for this measure
Infections that led to hospitalPercentage of infections residents got during their SNF stay that resulted in hospitalization6.6%CMS range 3.7–12.37.1%Oct 2023–Sep 2024no different from U.S.
Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs0.771.02Oct 2022–Sep 2024CMS makes no comparison for this measure

From the CMS Skilled Nursing Facility Quality Reporting Program — Medicare short-stay outcomes, which is a different dataset from the long-stay quality measures above and describes a different set of residents. Where CMS risk-adjusts a measure we show its adjusted rate, and the CMS range beside it is the confidence interval CMS publishes: a home whose range is wide is a home with few stays, where one patient moves the number several points. Read the period column. These measures do not share a window — the claims-based ones (getting home, readmission, spending) lag by a year or more, because a stay has to finish and its claims settle before it can be counted. CMS’s call is CMS’s, not ours: it is the only place anyone tests whether this home differs from the national rate at all, and most homes on most measures do not. Two caveats on it. CMS tests only three of these measures — getting home, readmission, and infections that led to hospital; on the other nine it publishes a rate and no comparison, and rather than compute a verdict CMS declined to make, we say so in the column. And on readmission almost every home in the country lands on “no different”, so that row separates homes far less than getting-home does — which is why met the expected recovery, a measure CMS does not test but which spreads across the whole range, is called out above the table rather than left in this list. The U.S. median column is our own, taken across every home CMS publishes that measure for in this same file; it is not a CMS-published benchmark. Homes CMS gives no rate for are left out of it rather than counted as zero. Medicare spending per stay is a ratio, not a percentage — 1.00 means this home’s Medicare spending for a stay matched the national figure CMS compares it against, and it measures cost to Medicare, not quality of care.

Staffing

No payroll-based (PBJ) staffing hours are on file for this home — and the record suggests that is because it did not report them. CMS rates its staffing 1 of 5, which is the rating CMS assigns when a home does not report. Every Medicare-certified nursing home is required to submit its actual payroll data quarterly, and that submission is what makes staffing numbers auditable rather than a claim. A home that does not file is not the same as a home with no data yet: ask this home directly what its nurse-to-resident ratios and weekend RN coverage are, why its payroll data is not filed, and weigh the independent health-inspection score heavily in the meantime.

Inspection trend

6
deficiencies at the latest standard inspection (2024-09-26)
10
at the previous standard inspection (2022-05-19)

Deficiencies are fewer than at the previous inspection — improving. Fewer citations over time suggests a home is fixing problems; a rising count is a warning sign — though two surveys are a short record, and survey teams differ. These counts are from the standard annual health survey only; the full citation list below may also include findings from complaint investigations, so the two won’t always add up.

This trend is not current. The most recent of these two inspections was over 2 years ago; the arrow describes what inspectors found then, not what the home is like now.

Inspection deficiencies

State health-inspection citations, most serious first. Each carries an F-code (the federal rule it cites, e.g. F-684 = quality of care) and a letter A–L marking how serious and how widespread the problem was — we translate that grid into the plain tiers shown here. Wording is the official federal description.

ABCDEFGHIJKL

Each letter is a CMS scope-severity level; highlighted ones are where this home has citations. A–C = no harm found; D–F = potential for harm; G–I = actual harm; J–L = immediate jeopardy. Within each band the later letter is the more widespread finding (an isolated G is one resident; a widespread I is a pattern), so rightward and downward is worse.

24 citations, most serious first. The 10 most serious are shown; the remaining 14 are one tap away and print in full.

  • Potential for harm · Fcited before2025-08-20 · tag F0804 — failed to serve food at safe, palatable temperature — widespread
    Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interviews and record review the facility failed to provide food at appetizing temperatures. This had the potential to affect 189 of 196 facility residents. The facility identified seven residents (Residents #119, #120, #126, #149, #155, #166, #186) as receiving nothing by mouth (NPO). The facility census was 196.Findings include:An observation on 08/18/25 at 08:20 A.M. of tray line revealed a test tray was prepared and placed on the food cart at 8:23 A.M. and transported by dietary staff to the [NAME] North unit where it arrived at 8:26 A.M. The test tray remained on the cart in view of the surveyor, until all other trays were distributed to residents. The test tray was removed from the cart at 8:42 A.M. by Kitchen Manager (KM) #354 who used a facility thermometer that revealed all foods were not at appetizing temperature. The waffle was 92.4 degrees Fahrenheit (F), the cream of wheat was 135.6 degrees F, and the ham was 92.4 degrees F KM #354 verified at the time of the observation that…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2025-05-23 · tag F0842 — failed to keep accurate, complete medical records — isolated
    Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY THE FOLLOWING DEFICIENCY REPRESENTS AN INCIDENT OF PAST NON-COMPLIANCE THAT WAS SUBSEQUENTLY CORRECTED PRIOR TO THIS SURVEY. Based on record review and interview, the facility failed to ensure medical records were accurate and complete. This finding affected one (Resident #42) of nine resident records reviewed for accuracy. The facility census was 74. Findings include: Review of Resident #42's medical record revealed the resident was admitted on [DATE] with diagnoses including malignant neoplasm of the breast, neoplasm of the lung and primary osteoarthritis. Review of Resident #42's Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed the resident exhibited severe cognitive impairment. Review of Resident #42's physician orders revealed an order dated 02/25/25 for oxycodone instant release (IR) 5 mg (milligrams) narcotic pain medication administer one tablet every two hours as needed for shortness of breath. Review of Resident #42's medication administration records (MAR) and narcotic flow records (NFR)…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Assessment and Care Planning Deficiencies · Past Non-Compliance
  • Potential for harm · Fcited before2024-09-26 · tag F0804 — failed to serve food at safe, palatable temperature — widespread
    Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation and interviews, and facility policy, the facility failed to serve hot and palatable foods. This had the potential to affect all residents, except resident #54 and #56 who received no food by mouth (NPO). The facility census was 83. Findings include: Interview on 09/23/24 at 9:46 A.M. with Resident #21 revealed food from the kitchen was not good and was always served late. Interview on 09/23/24 at 9:49 A.M. with Resident #179 revealed food from the kitchen was very cold and always had to be warmed up by staff. Interview on 09/23/24 at 10:45 A.M. with Resident #47 revealed food from the kitchen was bland and had no seasoning. Interview on 09/23/24 at 12:17 P.M. with Resident #44 revealed food from the kitchen was not good and had no taste and/or flavor. Interview on 09/23/24 at 3:47 P.M. with Resident #69 revealed the taste and appearance of food from the kitchen was unappetizing. Observation on 09/23/24 at 12:36 P.M. with Kitchen Aide (KA) #602 of the lunch meal tray line revealed the meal…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Fcited before2024-09-26 · tag F0812 — failed to store, cook, and serve food safely — widespread
    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, interviews, and facility policies, the facility failed to ensure food was prepared and served under sanitary conditions. This had the potential to affect all residents, except resident #54 and #56 who received no food by mouth (NPO). The facility census was 83. Findings include: Observation and interview on 09/23/24 at 8:30 A.M. during the tour of the kitchen revealed a box of hairnets available at the entrance of the kitchen. Observation revealed Kitchen Aide (KA) #603 was observed to be without a hairnet in place while preparing the breakfast meal. KA #603 confirmed and verified she was without a hairnet. Observation and interview on 09/23/24 at 12:30 P.M. with Licensed Practical Nurse (LPN) #814 during the Westpark Unit lunch meal, revealed Resident #28's uncovered breakfast tray was on top of the microwave, adjacent to the dining room. LPN #814 confirmed and verified the findings. Observation and interview on 09/24/24 at 8:12 A.M. with Dietary Manager (DM) #604 during tour of the three…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · E2024-09-26 · tag F0802 — failed to prepare enough nourishing food — pattern
    Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on record review, observation and interview, the facility failed to ensure meals were served in a timely manner. This had the potential to affect all residents residing on the Westpark Unit (#1, #2, #5, #6, #7, #8, #9, #10, #12, #14, #15, #17, #18, #19, #20, #21, #22, #23, #24, #27, #28, #31, #32, #33, #34, #35, #36, #39, #40, #41, #42, #47, #48, #50, #51, #52, #55, #56, #58, #60, #61, #67, #68, #71, #73, #74, #179, #180, #181, #182, #229), except resident #54 and #56 who received no food by mouth (NPO). The facility census was 83. Findings include: Review of the facility document titled Meal Times undated, revealed the facility served breakfast between 7:30 A.M. and 8:30 A.M., lunch between 12:15 P.M. and 1:15 P.M., and dinner between 5:15 P.M. and 6:15 P.M. Observation and interview on 09/23/24 at 12:30 P.M. with Kitchen Aide (KA) #602 of the Westpark Unit dining room, revealed the lunch meal service had not started yet and she could not start until she received help. Observation and interview on 09/23/24 at 1:06 P.M. with Licensed Practical Nurse (LPN) #814 revealed the…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-09-26 · tag F0550 — failed to protect resident dignity and rights — isolated
    Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review, staff interview, and facility policy review, the facility failed to ensure urinary drainage bags were covered with privacy bags. This affected one resident (#68) of three reviewed for urinary catheters. The facility census was 83. Findings include: Review of the medical record for Resident #68 revealed an admission date of 02/03/24 with diagnoses that included chronic respiratory failure with hypoxia, type two diabetes mellitus, and chronic obstructive pulmonary disease. Review of the Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed Resident #68 was alert and oriented and was dependent on staff for Activities of Daily Living (ADLs). Review of the care plan dated 02/13/24 revealed Resident #68 required a suprapubic urinary catheter related to obstructive and reflux uropathy with interventions that included to store collection bag inside a protective dignity pouch. Review of the physician orders dated 05/01/24 revealed an order to maintain privacy bag and suprapubic…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-09-26 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolated
    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, record review, and policy review, the facility failed to ensure all fall interventions were in place for one resident (Resident #51) of five residents reviewed for accidents. The facility census was 83. Findings Include: Resident #51 was admitted to the facility on [DATE] with diagnoses including multiple fractures of the left sided ribs, diabetes, high blood pressure, hyperlipidemia, gastric reflux, insomnia, over active bladder, major depressive disorder, Alzheimer's, dementia without behavioral disturbance, osteoarthritis, urge incontinence and cataracts. Review of the quarterly comprehensive Minimum Data Set Assessment (MDS) 3.0 dated 06/30/24 revealed the resident was severely cognitively impaired, needed assistance for all personal care, and had fallen once since the previous assessment dated [DATE]. Review of the medical record revealed Resident #51 had fallen on 04/03/24 when she attempted to transfer herself from her bed to her wheelchair. The resident was dependent on…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-09-26 · tag F0692 — failed to prevent malnutrition and dehydration — isolated
    Provide enough food/fluids to maintain a resident's health.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review, staff interview, and facility policy review, the facility failed to ensure weekly weights were taken and documented per physician orders for a resident that was at risk for weight loss. This affected one resident (#68) of eight residents reviewed for nutrition. The facility census was 83. Findings include: Review of the medical record for Resident #68 revealed an admission date of 02/03/24 with diagnoses including chronic respiratory failure with hypoxia, type two diabetes mellitus, and chronic obstructive pulmonary disease. Review of the Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #68 was alert and oriented and was dependent on staff for Activities of Daily Living (ADLs). Review of the care plan dated 02/16/24 revealed Resident #68 was at risk nutritionally and the care plan dated 07/25/24 revealed Resident #68 had a weight loss with interventions including to monitor weights weekly as ordered and monitor weights as ordered per policy. Review of the…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Fcited before2022-05-19 · tag F0812 — failed to store, cook, and serve food safely — widespread
    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation and staff interview, the facility failed to ensure the kitchen area was maintained in a clean and sanitary condition. This had the potential to affect 70 of 71 residents receiving food from the kitchen (the facility identified Resident #53 as receiving no food from the facility kitchen). The facility census was 71. Findings include: Initial kitchen tour conducted on 05/16/22 between 8:35 A.M. and 8:55 A.M. revealed the following: 1. Observation of the hood suppression system above the stove area in the kitchen revealed a considerable amount of dust, dirt, and other unknown debris above the stove top area where food was prepared. 2. Observation of the walk-in freezer revealed one open box of bread left open to air. The bread was very hard and showed signs of freezer burn. 3. Observation of the walk-in cooler revealed dust, dirt, and various debris located on the floor and within the cooling fan. Fresh strawberries stored in the walk in cooler had a moderate amount of green mold. 4. Observation of the dry storage area revealed honey barbeque sauce had a label…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · F2022-05-19 · tag F0814 — failed to dispose of garbage properly — widespread
    Dispose of garbage and refuse properly.
    What the surveyor found here — the official record, unedited, may be distressing

    Based on observation and staff interview the facility failed to ensure the dumpster area was maintained in a clean and sanitary condition. This had the potential to affect all residents. The facility census was 71. Findings include: Observation of the dumpster area on 05/16/22 between 8:45 A.M. and 9:00 A.M. revealed the following: 1. Numerous bags of garbage outside and around the dumpster. 2. Numerous loose articles on the ground including food scraps, personal protective equipment (gloves and masks) and other debris. 3. A trash cart filled with approximately ten to twelve red bio-hazard bags was noted outside the dumpster in the area directly behind the dumpster. Cook #421 verified the condition of the dumpster area in an interview on 05/19/22 at 9:00 A.M.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
Show the remaining 14 citations
  • Potential for harm · F2022-05-19 · tag F0880 — failed to prevent and control infections — widespread
    Provide and implement an infection prevention and control program.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, record review, and interview the facility failed to properly dispose of red biohazard bags. This had the potential to affect all residents. The facility census was 71. Findings include: Observation 05/16/22 at 9:20 A.M. of the outside dumpster area revealed a gray colored trash cart overflowing with red biohazard bags and biohazard bags on the ground around it. Interview on 05/16/22 at 9:20 A.M. with Infection Control Preventionist (ICP) #385 verified the observation and stated there was a process for biohazard bag disposal. ICP #385 explained they had a contracted company that picked up the biohazard bags. The biohazard bags were normally boxed up and locked in a shed; ICP #385 pointed to the area the biohazard bags were to be stored. The area ICP #385 pointed to was a large garage with a garage door that was closed located next to the dumpster area. Review of the facility policy titled The Policy of Disposal of Hazardous Waste for Slovene Home dated January 2022 revealed waste would be collected daily by maintenance staff, placed in transport biohazard waste…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Infection Control Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Ecited before2022-05-19 · tag F0803 — failed to meet residents' dietary needs — pattern
    Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review, and interview, the facility failed to ensure the menu was followed and appropriate food substitutions were provided. This affected five residents (#18, #42, #37, #55, and #67) of five residents observed during a breakfast meal and had the potential to affect all residents except Resident #53 who received nothing by mouth. The facility also failed to ensure therapeutic diets were followed as prescribed. This affected one resident (#42) of four residents (#37, #42, #50, and #67) reviewed for food concerns. The facility census was 71. Findings include: Review of the facility menu for breakfast on 05/18/22 revealed oatmeal, scrambled eggs, and cranberry muffin. 1. Observation on 05/18/22 at 8:58 A.M. of Resident #67's breakfast tray revealed a plain bagel with mandarin oranges on the same plate, a container of cream cheese, an eight-ounce container of fat free milk, a four-ounce container of grape juice, and a bowl of oatmeal. Interview with Resident #67 at the time of the…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2022-05-19 · tag F0623 — isolated
    Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and interview the facility failed to ensure the Long-Term Care (LTC) Ombudsman was notified of residents discharged to hospital. This affected two residents (#27 and #73) of two residents reviewed for hospitalization. The facility census was 71. Findings include: Review of the medical record for Resident #27 revealed an admission date of 09/12/18. Diagnoses included hypertension, delirium due to known physiological condition, asthma, and chronic obstructive pulmonary disease. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #27 had severely impaired cognition, required supervision of one staff for bed mobility and transfers, and limited assistance of one staff for toilet use. Review of the Notice of Transfer or Discharge forms dated 11/04/21 and 03/03/22 revealed Resident #27 was transferred to the hospital on [DATE] and 03/03/22. Review of the closed medical record for Resident #73 revealed an admission date of 03/30/18 and a discharge date of…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2022-05-19 · tag F0625 — isolated
    Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and interview the facility failed to ensure written bed hold notices were provided to residents or the resident representative when transferred to the hospital. This affected two residents (#27 and #73) of two residents reviewed for hospitalization. The facility census was 71. Findings include: Review of the medical record for Resident #27 revealed an admission date of 09/12/18. Diagnoses included hypertension, delirium due to known physiological condition, asthma, and chronic obstructive pulmonary disease. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #27 had severely impaired cognition, required supervision of one staff for bed mobility, transfers, and limited assistance of one staff for toilet use. Review of the Notice of Transfer or Discharge forms dated 11/04/21 and 03/03/22 revealed Resident #27 was transferred to the hospital on [DATE] and 03/03/22. Review of the closed medical record for Resident #73 revealed an admission date of 03/30/18…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2022-05-19 · tag F0690 — failed to manage incontinence, catheters, and urinary infections — isolated
    Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review the facility failed to ensure the proper use of incontinence briefs and liners to prevent potential skin breakdown and infection. This affected three (#6, #31 and #68) of three residents observed for incontinence care. Findings include: 1. Review of Resident #6's medical records revealed an admission date of 10/15/19 with diagnoses that included Parkinson's disease, dementia and incontinence. Review of the care plan dated 04/20/22 revealed Resident #6 had self care deficits related to limited mobility. Review of the Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #6 had intact cognition and required total dependence with toileting. Observation of incontinence care on 05/16/22 at 9:38 A.M. with State Tested Nursing Assistant (STNA) #344 revealed Resident #6 was wearing two incontinence briefs. Interview with STNA #344 at time of observation revealed she had not provided care to Resident #6 previously on this shift and was not aware the resident…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2022-05-19 · tag F0755 — failed to provide safe pharmacy services — isolated
    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
    What the surveyor found here — the official record, unedited, may be distressing

    Based on observation and interview the facility failed to ensure expired medications were discarded timely. This affected two (Residents #35 and #65) of 32 residents whose medications were stored in the first floor medication cart. The facility census was 71. Findings include: Observation on 05/16/22 at 10:52 A.M. with Licensed Practical Nurse (LPN) #305 revealed the medication cart located on the first floor contained a bottle of Timolol (eye drops used to treat glaucoma) belonging to Resident #35 that had an open date of 04/10/22, and a vial of Humalog (insulin) belonging to Resident #65 with an open date of 04/05/22. Interview with LPN #305 at time of observation revealed eye drops were to be discarded 30 days after opening, and insulin should be discarded after 28 days. Review of the manufacturer guidelines dated 01/2020 revealed You can use Timolol for 28 days after first opening the bottle. Discard the opened bottle with any remaining solution after that time. Review of www.humalog.com revealed once opened Humalog vials should be thrown away after 28 days.

    Pharmacy Service Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2022-05-19 · tag F0804 — failed to serve food at safe, palatable temperature — isolated
    Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, interview, and record review, the facility failed to serve food at a palatable temperature. This affected one (#55) of five residents reviewed for food concerns and had the potential to affect 70 of 71 residents (the facility identified Resident #53 as receiving no food from the kitchen). The facility census was 71. Findings include: Review of the Resident Council Meeting Notes dated 02/15/22 revealed the residents had questions and comments about the food. The residents indicated the food could be hotter. In response to the residents, it was suggested to ask a staff member to warm their meals in the microwave. Interview with Resident #67 on 05/16/22 at 10:41 A.M. revealed sometimes the items on her food tray were cold when received. Interview with Resident #37 on 05/16/22 at 1:14 P.M. revealed mashed potatoes were served cold. Interview with Resident #50 on 05/17/22 at 11:17 A.M. revealed her breakfast tray arrived late and the food was cold. Observation on 05/18/22 at 9:35 A.M. revealed Resident #55's hot super cereal was recorded at 100 degrees Fahrenheit…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2022-05-19 · tag F0806 — failed to honor food preferences — isolated
    Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review, and interview the facility failed to ensure resident food preferences were honored. This affected one resident (#67) of four residents (#37, #42, #50, and #67) reviewed for food concerns. The facility census was 71. Findings include: Review of the medical record for Resident #67 revealed an admission date of 03/28/16. Diagnoses included multiple sclerosis, Type two diabetes mellitus, and hypertension. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #67 had intact cognition and required supervision of one staff for eating. Review of the quarterly nutrition assessment dated [DATE] and timed 10:57 A.M. revealed Registered Dietitian (RD) #423 suggested liberalizing Resident #67's diet to make food more enjoyable for her and to promote better intakes of nutrient-dense foods and balanced meals the resident was willing to try. The resident would like yogurt, milk, and coffee at all meals and would update preferences. RD #423 indicated she…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Fcited before2019-04-25 · tag F0803 — failed to meet residents' dietary needs — widespread
    Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review and staff interview the facility failed to provide the appropriate portion of the planned menu items during the lunch meal on 04/22/19 according to the dietary spreadsheet. This had the potential to affect all 125 residents who received meal trays from the kitchen. The facility identified two residents (Resident #31 and #73) who received nothing by mouth. The facility census was 127. Findings include: Observations during the lunch meal service on 04/22/19 from 12:23 P.M. through 12:41 P.M. revealed residents were served either one or two meatballs with their spaghetti. Observations on the [NAME] Park dining room on 4/22/19 at 12:30 P.M. revealed residents were served one meatball with the spaghetti. Observations on the [NAME] dining room revealed residents were served two meatballs with their spaghetti Observations on the St [NAME] dining room revealed residents were served one meatball. Interview with Dietary Aide #279 on 04/22/19 at 12:41 P.M. revealed she had earlier how…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Fcited before2019-04-25 · tag F0812 — failed to store, cook, and serve food safely — widespread
    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, record review and interview the facility failed to ensure the kitchen was maintained in a clean and sanitary manner, food transportation carts were cleaned, food products were dated when opened and food/beverages were served in a manner to prevent contamination and/or food borne illness. This had the potential to affect all 125 residents who received meal trays from the kitchen. The facility identified two residents (Resident #31 and #73) who received nothing by mouth. The facility census was 127. Findings include: 1. Observations during the initial tour of the kitchen on 04/22/19 from 8:00 A.M. through 8:25 A.M. revealed the following: There were four of four garbage cans with trash in them were not covered with lids. The slicer had dried food on the blade and slicer guard, the floor mixer had food splatter on it and dried food was inside the mixing bowl, the table top mixer had food splatter on it, the wall behind the food processor had food splatter on it, the reach-in refrigerator had food splatter on the outside and inside of the door and there was a food…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2019-04-25 · tag F0641 — isolated
    Ensure each resident receives an accurate assessment.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and staff interview the facility failed to ensure Minimum Data Set (MDS) 3.0 assessments were accurately completed. This affected two residents (Resident #69 and #114) of 30 residents whose MDS assessments were reviewed. Findings Include: 1. Review of medical record for Resident #114 the resident was admitted to the facility on [DATE] with diagnoses including unspecified dementia with behavioral disturbances, retention of urine and benign prostatic hyperplasia with lower urinary tract symptoms. Record review revealed the resident had an indwelling urinary (Foley) catheter due to diagnoses of retention of urine. Resident #114 also had a care plan in place for the indwelling catheter related to a mass of bladder. A review of MDS 3.0 assessment, dated 03/17/19 revealed no indication of an indwelling catheter in Section H of the MDS 3.0 assessment. An interview with the MDS Nurse on 04/25/19 at 8:26 A.M. revealed there was an error in the documentation. The MDS Nurse verified that Resident…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2019-04-25 · tag F0684 — failed to provide proper treatment and quality of care — isolated
    Provide appropriate treatment and care according to orders, resident’s preferences and goals.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review and interview the facility failed to ensure indwelling urinary catheter tubing was secured per Resident #19 and Resident #114's plan of care to prevent the catheter from pulling and/or causing irritation or pain. This affected two residents (Resident #19 and #114) of three residents reviewed for urinary catheters. Findings Include: 1. Review of the medical record for Resident #114 revealed the resident was admitted to the facility on [DATE] with diagnoses including unspecified dementia with behavioral disturbances, retention of urine and benign prostatic hyperplasia with lower urinary tract symptoms. Record review revealed the resident had an indwelling catheter due to the diagnosis of retention of urine. Resident #114 had a care plan in place to have the catheter tubing secured to her leg every morning. Review of physician's order, dated 02/24/19 revealed to change Foley catheter holding (bag) to opposite leg every day at 6:00 A.M Observation and interview with Resident #114…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2019-04-25 · tag F0807 — failed to offer suitable drinks — isolated
    Ensure each resident receives and the facility provides drinks consistent with resident needs and preferences and sufficient to maintain resident hydration.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review and interview the facility failed to ensure Resident #324's liquids were properly thickened as ordered by the physician. This affected one resident (Resident #324) of four residents reviewed for thickened liquids. Findings Include: Review of Resident #324's medical record revealed an admission date of 04/07/19 with diagnoses including Parkinson's disease, dementia with behavioral disturbance, heart failure, chronic pulmonary disease and major depressive disorder. Review of a physician's orders revealed Resident #324 was ordered a dysphagia II carbohydrate controlled no added salt diet with nectar thick liquids. Review of Resident #324's baseline care plan dated 04/07/19 revealed the resident was on dysphagia II no added salt diet with nectar thick liquids with a goal to maintain adequate nutrition. Review of Resident #324's Minimum Data Set (MDS) 3.0 assessment dated [DATE] indicated the resident exhibited severe cognitive impairment and required extensive assistance from…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2019-04-25 · tag F0808 — failed to follow doctor-ordered diets — isolated
    Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review and staff interview the facility failed to ensure a therapeutic diet was provided to Resident #324 as ordered by the physician. This affected one resident (Resident #324) of five residents who received therapeutic a dysphagia II diet. Findings include: Review of Resident #324's medical record revealed an admission date of 04/07/19 with diagnoses including Parkinson's disease, dementia with behavioral disturbance, heart failure, chronic pulmonary disease and major depressive disorder. Review of the physician's orders revealed Resident #324 was ordered a dysphagia II carbohydrate controlled no added salt diet with nectar thick liquids. Review of Resident #324's Minimum Data Set (MDS) 3.0 assessment dated [DATE] indicated the resident exhibited severe cognitive impairment and required extensive assistance from staff for eating. Review of Resident #324's baseline care plan dated 04/07/19 revealed the resident was on dysphagia II no added salt diet with nectar thick liquids with a…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction

“Cited before” means this same F-tag appears on at least one other survey date in the record we hold — counting complaint investigations as well as standard surveys, with no time limit. It is our own read of the data, not CMS’s: CMS uses repeat deficiency as a formal term tied to consecutive standard surveys, and that is a narrower test than this one. A tag marked here may or may not meet it.

Worried about a resident here? There are three different people you can turn to, and they do different jobs:
  • Long-Term Care Ombudsman — a free, confidential advocate for the resident. They act only with the resident’s consent and work to resolve the problem. Find yours at theconsumervoice.org/get_help.
  • Adult Protective Services — the state agency that investigates suspected abuse, neglect, or exploitation of a vulnerable adult. Not sure of your state’s APS number? The federal Eldercare Locator will route you: 1-800-677-1116 or eldercare.acl.gov.
  • State survey agency — the regulator that licenses and inspects the home. Every state has an official nursing-home complaint line and most take complaints online; the Ombudsman or Eldercare Locator can connect you.
Not sure where to start, or need other help? Dial 2-1-1 for local resources — and if a call is hard or impossible for you, many local 211s also take a text (send your ZIP code to 898-211) or a web chat at 211.org; both vary by area, and 211.org will show what yours offers. Deaf or hard of hearing: dial 711 for the telecommunications relay service, then any number above. In an emergency, call 911.
It is illegal for a facility to retaliate against a resident or family for reporting a concern: federal law gives a resident the right to voice grievances — to the home or to any outside agency — without discrimination or reprisal (42 CFR §483.10(j)(1)). You may report anonymously.

Fines & penalties

No federal fines in the current CMS record.

Who owns this facility

Owner / managerTypeRoleSince
SAS, JEFFREYIndividualW-2 MANAGING EMPLOYEE; CORPORATE OFFICERsince 11/14/2002
HITI, ANTHONYIndividualCORPORATE OFFICERsince 05/27/2018
HRVATIN, PHILIPIndividualCORPORATE OFFICERsince 07/29/2014
ZELE, SCOTTIndividualCORPORATE OFFICERsince 05/27/2017

CMS files one row per role, so the 5 rows in the source record cover these 4 parties — each is shown once here with every role it holds. Nothing is omitted. The source lists no ownership percentage for any of them — PECOS records a share only for equity interests, not for board or management roles.

Follow the money — this home’s finances

Where a nursing home’s revenue comes from and where it goes — including money paid to companies under the same ownership. Most consumer sites never show this; we reproduce it straight from the Medicare cost report.

$6.6M
Net patient revenuemost recent cost report
-38.6%
Operating marginrevenue minus expenses
Who pays — share of resident-days
Medicaid 13%Medicare 7%Other / private 80%

A reported operating loss is common in this industry and is not by itself a sign of trouble — but paired with large related-party payments it can mean profit is being taken elsewhere in the ownership structure.

Source: CMS Healthcare Provider Cost Reporting Information System (HCRIS), Medicare cost report Form CMS-2540 · fiscal year 2023. Facilities self-file these reports; figures are unaudited and a year or two behind. A home with no Medicare cost report on file shows no figures here.

Cost & finances

$369per resident / day
operating cost
$11,204per month
≈ monthly operating cost
$266per day
avg. revenue, all payers

Straight from this home’s Medicare cost report (CMS, FY2023). These are its operating economics — what it costs to run per resident-day and what it collects on average across Medicare, Medicaid, and private pay — not a private-pay quote. Your out-of-pocket cost depends on payer and room type, so ask the facility directly; a higher operating cost can reflect richer staffing or a sicker population. The cost-of-care planner shows regional benchmarks by care type.

What families pay in OH

Paying with Medicaid

This is a Medicare- and Medicaid-certified nursing home, so it can accept Medicaid for long-term care — like nearly all U.S. nursing homes. The private-pay figures below are what families without Medicaid pay; once a resident qualifies for Medicaid, out-of-pocket cost for covered nursing-home care is typically close to $0 (almost all of their income goes to the home as their share of the cost; they keep a small personal needs allowance — for clothing, haircuts, a phone — and Medicaid pays the rest). The amount of that allowance is set by each state. Confirm Medicaid-bed availability with the home, and see the Ohio Medicaid page.

Typical monthly cost in Ohio
$9,186/mo
Nursing home (semi-private)
$10,389/mo
Nursing home (private)
$6,103/mo
Assisted living

Median private-pay cost, CareScout (Genworth) 2025 Cost of Care Survey — a regional midpoint, not any single community’s rate. Private rooms and higher care levels cost more; ask for a current quote. Project your own in the cost-of-care planner.

Every figure above is reproduced from the CMS Provider Data Catalog (a public record), from the CMS extract processed 2026-08-01 — CMS provider number 365567. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2024-09-26, which can lag current conditions. Staffing hours are CMS PBJ CY2026Q1 (Jan–Mar 2026). Check this record against the government’s own page for it: this home on Medicare Care Compare ↗ — the authoritative source, and the place to confirm anything here before you act on it. How we present it →

Not a government site. Eldercare Lens is not affiliated with, endorsed by, or authorized by the Centers for Medicare & Medicaid Services (CMS), Medicare, or any government agency. The star ratings, citations, and inspection wording on this page are reproduced from the public CMS record; the plain-English summaries, tiers, and comparisons around them are ours. We do not speak for CMS, and CMS has not reviewed this page. For the official record, go to Medicare Care Compare. How we’re funded →

Are you this operator? If the record here is out of date, or misses what you have since fixed, tell us and we will look: hello@eldercarelens.com. We reproduce the public CMS record and cannot change what it says — corrections to the underlying data go through CMS and your state survey agency — but we will correct anything we have got wrong about it, and we will say so on the page.

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