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Hickory Creek Of Athens

51 East 4th Street, The Plains, OH 45780 · For profit - Corporation · 90 certified beds · (740) 797-4561 Medicare & Medicaid certified

Call the home — (740) 797-4561 Need help choosing, fast? Free, unbiased: Eldercare Locator 1-800-677-1116
Behavioral-health or dementia-care citations — no harm found (F0740, F0758)1 actual-harm citation
Insights

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

In its favor
  • a strong health-inspection score (4/5) — the hardest rating to game (though it’s ranked within its own state, not nationally)
  • 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
  • it has 1 actual-harm citation
  • 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

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.

4/5
CMS overall
4 of 5
Health inspectionSurveyor-assigned, ranked within your stateInspector-verified 4 of 5
StaffingFrom payroll records (PBJ) 3 of 5
Quality measuresSelf-reported by the facility 3 of 5

Location & what’s nearby

Urgent care / clinic
88 North Plains Road
Pharmacy
Supervalu1.0 mi
70 N Plains Rd Ste F · (740) 797-4526 · Call to confirm hours
Grocery
Foodland1.0 mi
70 S Plains Rd · (740) 797-4526 · Call to confirm hours
Park
4 Beech Rd · (740) 797-4085 · Typically dawn to dusk
Place of worship
9322 Johnson Rd · (740) 594-3700

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 3 of 5
Long-stay residentspeople who live here 5 of 5
Short-stay residentsrehab / post-hospital 1 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 improved from 3 to 4 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 rating4★
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 increased5.8%5.3%15.4%typical for the state — see note marked double-dagger below the table
Long-stay residents who lose too much weight9.0%6.2%5.4%worse
Long-stay residents with a catheter left in their bladder0.3%0.2%0.9%worse than state — see note marked double-dagger below the table
Long-stay residents with a urinary tract infection0.0%0.4%2.0%better than state — see note marked double-dagger below the table
Long-stay residents with depressive symptoms27.4%30.1%6.5%typical for the state — see note marked double-dagger below the table
Long-stay residents who were physically restrained0.0%0.1%0.1%better
Long-stay residents with falls causing major injury1.8%3.2%3.3%better
Long-stay residents whose ability to walk worsened8.4%6.1%16.1%worse than state — see note marked double-dagger below the table
Long-stay residents on antianxiety or hypnotic medication39.4%25.5%18.9%worse
Long-stay residents given the seasonal flu vaccine75.7%94.5%95.3%worse
Long-stay residents with pressure ulcers2.2%3.4%4.7%better
Long-stay residents with worsening bladder/bowel control20.0%21.4%21.2%typical
Long-stay residents who got an antipsychotic medication — see the note below the table15.8%8.8%17.1%typical
Short-stay residents who newly got an antipsychotic medication0.0%1.2%1.4%better
Short-stay residents given the seasonal flu vaccine80.5%75.6%79.4%typical
Short-stay residents rehospitalized after admission25.0%24.9%22.6%worse
Short-stay residents with an outpatient ER visit19.1%12.9%12.0%worse
Long-stay hospitalizations per 1,000 resident days3.391.731.67worse
Long-stay outpatient ER visits per 1,000 resident days2.271.801.80worse

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.

11.4%U.S. median 10.7%
Went back to hospital
37.0%U.S. median 56.6%
Met the expected recovery
0.15U.S. median 0.31
Therapy hours / resident / day
0.09hours / resident / day
Physical therapy
0.04hours / resident / day
Occupational therapy
0.02hours / resident / day
Speech therapy

Met the expected recovery: 37.0% 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 27 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 0.15 therapist hours per resident per day in 2026Q1 — more than 12% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 5% of this home’s weekday level — it runs therapy on weekdays, with essentially none at the weekend. 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 SNFnot reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNF11.4%CMS range 7.6–17.810.7%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 discharge37.0%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 discharge33.3%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 discharge22.2%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 identified97.2%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 dischargenot reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality 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 worsened11.1%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 hospitalizationnot reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs1.101.02Oct 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

0.56
RN hours/ resident / day
0.98
LPN hours/ resident / day
2.14
Aide hours/ resident / day
3.69
Total nurse hours/ resident / day
0.29
RN hoursweekends
42.4%
Total nursing turnover
28.6%
RN turnover

How full it usually is: this home is certified for 90 beds and averages 71.2 residents a day — about 79% occupied, or roughly 19 beds typically open. It usually has some room. This is a CMS average, not live availability — no public source publishes real-time vacancies, and a home can be full the day you call. Confirm with the home, and if you need a Medicaid bed specifically, ask about that separately: a home with open beds may still not have an open Medicaid bed.

Against a benchmark — not a legal minimum. In May 2024 CMS finalized the first federal staffing floor for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 RN hours and 2.45 nurse-aide hours. Its hour requirements never took effect and are no longer on the books. Homes had until 2026 (2027 if rural) to comply, and that deadline never arrived: a federal court vacated the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026. This home is not required to meet these numbers, and is not violating anything by missing them. We still show the comparison because the figures are CMS’s own published estimate of adequate staffing, which makes them a useful yardstick — but they are our benchmark, not federal law: this home’s total nurse staffing of 3.69 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.56 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.14 is below the 2.45-hour aide benchmark. What federal law does require today is unchanged: “sufficient” nursing staff for residents’ needs and an RN on duty at least 8 consecutive hours a day, 7 days a week (42 CFR 483.35). Those are judged by inspectors on site, not by these averages, so read this comparison alongside the inspection record rather than as a pass/fail.

Weekend coverage: total nurse staffing is 3.32 hrs/resident/day on weekends vs 3.84 on weekdays — 13% thinner on weekends. RN hours go from 0.67 to 0.29 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 42% is about the same as the national median of 45%. 2 administrators have left in the past year — frequent leadership churn is a warning sign families often miss.

Payroll-based (PBJ) staffing hours, as reported for Jan–Mar 2026 (CMS PBJ CY2026Q1) — the most recent quarter CMS has published, so they can lag a change of operator or staffing agency. Higher is generally better. Registered-nurse coverage and weekend staffing are the numbers families most often overlook — an RN on site matters most when something goes wrong, and coverage usually thins on weekends. High turnover means residents rarely see the same caregiver twice. One caveat: these are hours as reported, not adjusted for how sick or heavy-care this home’s residents are. CMS separately publishes a case-mix-adjusted view; we show the reported hours. A home caring for higher-acuity residents needs more hours to deliver the same care, so compare these figures against homes doing similar work, and read them next to the inspection record rather than alone.

Inspection trend

3
deficiencies at the latest standard inspection (2025-08-11)
8
at the previous standard inspection (2024-06-06)

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.

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 11 most serious are shown; the remaining 13 are one tap away and print in full.

  • Actual harm · Gcited before2025-08-11 · 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 record review, review of on-call physician contact procedures, and staff interview, the facility failed to ensure a resident, who had a significant change in condition, received appropriate and timely consultation with the on-call advanced level provider for a transfer to the hospital for an evaluation. This affected one (Resident #36) of two residents reviewed for hospitalization. Actual Harm occurred when Resident #36 displayed a significant change in condition consistent with a cerebrovascular accident (CVA) and did not receive a timely transfer to the hospital for evaluation and treatment. Resident #36 suffered an ischemic stroke but could not be given tissue plasminogen activator (a medication used to break down blood clots) due to being outside the treatment window for optimal results. Resident #36 was hospitalized for several days before returning to the facility with residual effects from his stroke. The facility census was 78. Findings Include: Review of Resident #36's medical record revealed…

    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 · D2025-08-11 · tag F0757 — failed to avoid unnecessary drugs — isolated
    Ensure each resident’s drug regimen must be free from unnecessary drugs.
    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 medical record review and staff interview, the facility failed to provide proper justification for the use of medication for dementia. This affected one, (Resident #3) of five residents reviewed for unnecessary medications. The census was 78. Findings Include: Resident #3 was admitted to the facility on [DATE]. His diagnoses were acute kidney failure, chronic obstructive pulmonary disease (COPD), type II diabetes, morbid obesity, muscle weakness, chronic respiratory failure, dysphagia, congestive heart failure, schizoaffective disorder, atrial fibrillation, anemia, anxiety disorder, anemia, acute embolism and thrombosis, osteoarthritis, mild cognitive impairment, hyperlipidemia, peripheral vascular disease, and hernia. Review of his minimum data set (MDS) assessment, dated 06/30/25, revealed he was cognitively intact. Review of Resident #3's current physician orders found he was prescribed the following medications for dementia: Olanzapine (antipsychotic) 5 milligrams (mg) and Namenda (used to treat…

    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.

    Pharmacy Service Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2025-08-11 · tag F0880 — failed to prevent and control infections — isolated
    Provide and implement an infection prevention and control program.
    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, observation, staff interview, and facility policy review, the facility failed to ensure indwelling urinary catheter care was provided in accordance with acceptable infection control practices to prevent infections. The facility also failed to ensure a resident's indwelling urinary catheter's collection bag was maintained off the floor to help prevent infection. This affected one, (Resident #5) of two residents reviewed for indwelling urinary catheters. The facility census was 78. Findings include: Review of Resident #5's medical record revealed he was admitted to the facility on [DATE]. His diagnoses included neuromuscular dysfunction of the bladder, benign prostatic hyperplasia with lower urinary tract symptoms, and urinary retention.Review of Resident #5's physician's orders revealed he had an order in place for the use of an 18 French indwelling urinary catheter with 10 milliliter (ml) balloon related to obstructive uropathy. The orders also included the need to perform catheter care…

    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 · D2024-08-05 · tag F0740 — failed to provide behavioral / mental-health care — isolated
    Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
    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, observation, and interview, the facility failed to provide continued mental health services and implement interventions for a resident at risk of suicide. This affected one resident (#24) of three residents reviewed for depression. The facility census was 74. Findings include: Record review revealed Resident #24 was admitted to the facility on [DATE] with diagnoses including dementia without behavioral disturbance, bipolar disorder, major depressive disorder, contracture of muscle to right lower leg, unspecified personality disorder, and bilateral osteoarthritis of knees. Additional diagnoses of anxiety disorder and brief psychotic disorder were added on 06/19/24. Review of orders revealed Resident #24 had orders in place for Aricept tablet 10 milligrams (mg) one tablet by mouth (06/20/24); sensor bed alarm to alert staff of resident's desire to transfer and check placement every shift (06/20/24); low bed for safety (06/20/24); and lurasidone hci tablet 60 mg give one tablet by mouth once…

    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 · Ecited before2024-06-06 · tag F0880 — failed to prevent and control infections — pattern
    Provide and implement an infection prevention and control program.
    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, medical record review, staff interview, and policy review, the facility failed to maintain an infection prevention and control program to prevent the development and transmission of diseases and infections. This affected one of nine residents on enhanced barrier precautions (Resident #11), one of two residents receiving glucometer checks on the Brookside wing (Resident #15), and one of two residents reviewed for indwelling catheters (Resident #18). Findings include: 1. Review of the medical record for Resident #11 revealed an admission date of 05/10/24 and diagnoses including dementia, diabetes, and alcoholic cirrhosis. The resident also had gastrostomy tube for nutrition. Observations of medication administration on 06/04/24 at 11:30 A.M. revealed Licensed Practical Nurse (LPN) #150 to administer medication through Resident #11's gastrostomy tube. Upon entering the room there was a sign on the door indicating the resident was on enhanced barrier precautions. LPN #150 did not apply a gown…

    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 · D2024-06-06 · tag F0641 — isolated
    Ensure each resident receives an accurate assessment.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on medical record review, resident interview, staff interview, and observations, the facility failed to conduct accurate assessments in the area of hearing status. This affected two of four residents reviewed for communication (Residents #3 and #37). Findings include: 1. Review of the medical record for Resident #37 revealed an admission date of 01/08/17. The resident had a diagnosis on 01/27/23 of sensorineural hearing loss bilaterally (hearing loss caused by damage to the inner ear or the nerve from the ear to the brain). The plan of care dated 05/08/23 stated the resident had sensorineural hearing loss and would participate in audiology services as needed. Review of the annual Minimum Data Set (MDS) assessment completed 07/27/23 revealed the resident had moderate difficulty hearing and had no hearing aid. Review of MDS assessments completed 10/16/23 and 04/15/24 revealed the resident had adequate hearing and no hearing aide. The MDS assessment on 04/15/24 stated a brief interview for mental status score of 15, indicating intact cognition. Observation and interview with…

    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 · Dcited before2024-06-06 · tag F0644 — isolated
    Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
    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 medical record review and staff interview, the facility failed to ensure all resident Pre-admission Screening and Resident Review (PASRR) documents were accurate to resident current conditions and diagnoses. This affected two residents (Resident #45 and Resident #46) of three residents reviewed for PASRR documents. The census was 77. Findings Include: 1. Record review revealed Resident #45 was admitted to the facility on [DATE]. Her diagnoses were COPD, congestive heart failure, muscle weakness, cognitive communication deficit, hypertension, depression, anxiety disorder, atherosclerotic heart disease, atrial fibrillation, and bipolar disorder. Review of her Minimum Data Set (MDS) assessment, dated 03/04/24, revealed she was cognitively intact. Review of Resident #45's significant change PASRR document, dated 03/06/24, revealed under Section D, the diagnoses listed were mood disorder, panic or other severe anxiety disorder, other psychotic disorder, and bipolar disorder. But review of her diagnoses list,…

    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 · D2024-06-06 · tag F0656 — failed to write and follow a full care plan — isolated
    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on medical record review, resident interview, staff interview, and observation, the facility failed to develop a comprehensive care plan in the area of hearing status. This affected one of four residents reviewed for communication (Resident #37). Findings include: Review of the medical record for Resident #37 revealed an admission date of 01/08/17. The resident had a diagnosis on 01/27/23 of sensorineural hearing loss bilaterally (hearing loss caused by damage to the inner ear or the nerve from the ear to the brain). Review of the annual Minimum Data Set (MDS) assessment completed 07/27/23 revealed the resident had moderate difficulty hearing and had no hearing aid. Review of MDS assessments completed 10/16/23 and 04/15/24 revealed the resident had adequate hearing and no hearing aide. The MDS assessment on 04/15/24 stated a brief interview for mental status score of 15, indicating intact cognition. Observation and interview with Resident #37 on 06/03/24 at 2:21 P.M. revealed the resident to be very hard of hearing. The resident had her television volume turned up to 68.…

    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 · D2024-06-06 · tag F0685 — isolated
    Assist a resident in gaining access to vision and hearing services.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on medical record review, resident interview, staff interview, and observations, the facility failed to residents received proper treatment and assistive devices to maintain hearing abilities. This affected two of four residents reviewed for communication (Residents #3 and #37). Findings include: 1. Review of the medical record for Resident #3 revealed an admission date of 07/03/23. A Minimum Data Set (MDS) assessment completed 04/04/24 documented a brief interview for mental status (BIMS) score of 15, indicating intact cognition. Review of the plan of care dated 07/12/23 revealed the resident had trouble hearing and would be referred to audiology for evaluation. Review of a consultation report revealed Resident #3 had an ear care exam on 12/06/23 by a nurse practitioner. The report stated the resident's tympanic membranes were visible in both ears. There was no evidence of a hearing evaluation and the fact that the resident had trouble hearing was not mentioned in the report. Interview with Resident #3 on 06/03/24 at 9:10 A.M. revealed he has difficulty hearing and has had…

    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 · Dcited before2024-06-06 · 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 record review, observation, staff interview, and policy review, the facility failed to ensure residents, who were at risk for falls and had a history of falls, had fall prevention interventions implemented as per their plan of care. This affected two (Resident #18 and #28) of three residents reviewed for accidents. Findings include: 1. Review of Resident #18's medical record revealed the resident was admitted to the facility on [DATE]. His diagnoses included adult onset diabetes mellitus, unspecified psychosis, psychotic disorder with hallucinations, unspecified dementia, Parkinson's disease, insomnia, muscle weakness, unsteadiness on feet, and need for assistance with personal care. Review of Resident #18's annual Minimum Data Set (MDS) assessment dated [DATE] revealed the resident had clear speech. He was able to make himself understood and was usually able to understand others. His cognition was severely impaired and he was known to have other behaviors not directed at others. He also had 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.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-06-06 · tag F0756 — failed to review each resident's drug regimen — isolated
    Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
    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 medical record review, staff interview, and facility policy review, the facility failed to adequately review all medications for proper justification via pharmacy monthly reviews. This affected one (Resident #12) of five residents reviewed for medications. The census was 77. Findings Include: Record review revealed Resident #12 was admitted to the facility on [DATE]. Her diagnoses were type II diabetes, hemiplegia and hemiparesis, chronic bronchitis, COPD, epileptic seizures, allergic rhinitis, hypertension, personal history of traumatic brain injury, insomnia, obesity, age related nuclear cataract, macular degeneration, osteoarthritis of knee, presbyopia, hallux valgus, and dysphagia. Review of her minimum data set (MDS) assessment, dated 04/15/24, revealed she was cognitively intact. Review of Resident #12's physician orders revealed she was prescribed and administered Rifaximin Tablet 550 milligrams (mg) twice daily for prevention. This order was originally put in place on 12/14/20. Review 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.

    Pharmacy Service Deficiencies · Deficient, Provider has date of correction
Show the remaining 13 citations
  • Potential for harm · D2024-06-06 · tag F0881 — failed to use antibiotics responsibly — isolated
    Implement a program that monitors antibiotic use.
    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 medical record review, staff interview, and facility policy review, the facility failed to provide adequate justification and monitoring regarding the use of an antibiotic. This affected one (Resident #12) of five residents reviewed for medications. The census was 77. Findings Include: Record review revealed Resident #12 was admitted to the facility on [DATE]. Her diagnoses were type II diabetes, hemiplegia and hemiparesis, chronic bronchitis, COPD, epileptic seizures, allergic rhinitis, hypertension, personal history of traumatic brain injury, insomnia, obesity, age related nuclear cataract, macular degeneration, osteoarthritis of knee, presbyopia, hallux valgus, and dysphagia. Review of her minimum data set (MDS) assessment, dated 04/15/24, revealed she was cognitively intact. Review of Resident #12's physician orders revealed she was prescribed and administered Rifaximin (broad spectrum antibiotic) Tablet 550 milligrams (mg) twice daily for prevention. This order was originally put in place 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.

    Infection Control Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · F2022-10-04 · tag F0727 — failed to provide required RN coverage — widespread
    Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
    What the surveyor found here — the official record, unedited, may be distressing

    Based on record review and interview the facility failed to use the services of a registered nurse for at least eight consecutive hours a day, seven days a week as required. This had the potential to affect all 88 residents residing in the facility. Findings Include: Review of the nursing staff schedule for 09/2022 revealed on 09/24/22 and 09/25/22 there was not an RN working in the facility. On 10/03/22 at 3:53 P.M. interview with the Director of Nursing (DON) confirmed there was not a RN working on 09/24/22 or 09/25/22 as required. The DON indicated the facility was working on hiring more RN staff.

    Nursing and Physician Services Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · E2022-10-04 · tag F0692 — failed to prevent malnutrition and dehydration — pattern
    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, review of current resident diet orders maintained by the facility kitchen, review of meal tickets and interview, the facility failed to ensure residents received fortified foods as ordered and/or failed to ensure fluids were readily available to maintain hydration. This affected three residents (#13, #50 and #64) of four residents reviewed for nutrition and one resident (#30) of one resident reviewed for hydration. Findings Include: 1. A review of Resident #13's medical record revealed the resident was admitted to the facility on [DATE] with the diagnoses of monoplegia (paralysis of one side of a limb) of an upper limb following a stroke affecting his right dominant side, dysphagia (difficulty swallowing), vascular dementia with behavioral disturbances, major depressive disorder, and adult onset diabetes mellitus. A review of Resident #13's quarterly Minimum Data Set (MDS) 3.0 assessment, dated 07/01/22 revealed the resident did not have any communication issues but his…

    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 · E2022-10-04 · tag F0758 — failed to limit and justify psychotropic drugs — pattern
    Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
    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, facility policy and procedure review and interview the facility failed to ensure adequate indication of use for an antipsychotic medication and failed to ensure specific target behaviors were being appropriately monitored for residents receiving psychotropic medications. This affected four residents (#13, #44, #53 and #77) of five residents reviewed for unnecessary medications use. Findings Include 1. A review of Resident #13's medical record revealed the resident was admitted to the facility on [DATE] with diagnoses including restlessness and agitation, vascular dementia with behavioral disturbances, psychosis, personality disorder, sexual dysfunction and major depressive disorder. A review of Resident #13's quarterly Minimum Data Set (MDS) 3.0 assessment, dated 07/01/22 revealed the resident did not have any communication issues and his cognition was severely impaired. Mood indicators were present and the resident was known to have verbal behaviors directed at others, other behaviors…

    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.

    Pharmacy Service Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2022-10-04 · 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

    Based on observation, record review and interview the facility failed to ensure meals were provided in a timely and dignified manner for Resident #62 and Resident #44. This affected two residents randomly observed for dining in two of three dining rooms observed. Findings Include: 1. Review of the medical record for Resident #44 revealed an admission date of 03/07/22 with diagnoses including dementia with behavioral disturbances, anxiety, adult failure to thrive, depression, and delusional disorder. Review of the quarterly Minimum Data Set (MDS) 3.0 assessment, dated 08/02/22 revealed Resident #44 had severe cognitive impairment with inattention, fluctuating disorganized thinking, delusions, hallucinations, physical and verbal behaviors towards others, rejection of care and wandering. Resident #44 required supervision of set up with meals. An observation on 09/29/22 at 12:15 P.M. of the lunch meal on the Renaissance unit revealed Resident #44 was seated at a table with Residents #21 and #56. The staff started serving lunch trays at 12:20 P.M. and provided a tray to Resident #21 and…

    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 · D2022-10-04 · tag F0583 — failed to protect personal privacy — isolated
    Keep residents' personal and medical records private and confidential.
    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 #78's privacy was maintained in regard to the specific reason the resident was in isolation precautions. This affected one resident (#78) of one resident reviewed for COVID-19. Findings Include: A review of Resident #78's medical record revealed the resident was admitted to the facility on [DATE] with diagnoses including mild intellectual disabilities, unspecified dementia with behavioral disturbances, and schizophrenia. A review of Resident #78's nursing progress notes revealed a nurse's note, dated 09/24/22 at 1:37 P.M. revealed the resident had a non-productive cough and rhonchi heard in her right and left upper lungs. The physician was notified and the resident was placed in droplet and contact isolation at that time. A review of Resident #78's physician's orders, dated 09/24/22 confirmed the resident was placed in droplet and contact isolation precautions every shift for cough and congestion. An order was also noted to…

    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 · Dcited before2022-10-04 · tag F0644 — isolated
    Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
    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 Preadmission Screening and Resident Reviews (PASARR) were submitted as required for Resident #53 and Resident #24. This affected two residents (#53 and #24) of two residents reviewed for PASARR. Findings Include: 1. A review of Resident #53's medical record revealed the resident was admitted to the facility on [DATE] with diagnoses including bipolar disorder, anxiety disorder, mood disorder and major depressive disorder all present upon his admission. A review of Resident #53's Preadmission Screening and Resident Review (PASARR) Identification Screen, dated [DATE] revealed the PASARR Identification Screen was being completed as there had been an expired time limit for a hospital exemption. The request was to seek approval for a nursing facility admission for an unspecified period of time. Section (D.) of the PASARR Identification Screen assessed the resident as having indications of a serious mental illness. The person completing the screen was…

    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 · D2022-10-04 · tag F0677 — failed to help fully-dependent residents with daily care — isolated
    Provide care and assistance to perform activities of daily living for any resident who is unable.
    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 Resident #30, who required staff assistance with activities of daily living (ADL) care received adequate and timely oral and hair care to maintain proper hygiene. This affected one resident (#30) of four residents reviewed for activities of daily living (ADL) care. Findings Include: Review of Resident #30's medical record revealed an initial admission date of 01/20/21 with the latest readmission of 09/21/21. Resident #30 had diagnoses including schizophrenia, fracture of shaft of right humerus, morbid obesity, unsteadiness on feet, generalized muscle weakness, encephalopathy, mild cognitive impairment, impulse disorder, bipolar disorder, repeated falls, vitamin D deficiency, constipation, intentional self harm, chronic pain, acquired absence of right toes, insomnia, seizures, anxiety disorder, deaf, non speaking, adjustment disorder, osteoarthritis, dental caries, acute gingivitis plaque induced, dementia with behavioral disturbances and unspecified disorder of psychological development. 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 · Dcited before2022-10-04 · 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

    Based on observation, record review and interview the facility failed to timely identify, assess and monitor Resident #9 related to bruising. This affected one resident (#9) of two residents reviewed for skin conditions. Findings Include: Review of Resident #9's medical record revealed an initial admission date of 10/27/21 with the latest readmission of 06/15/22. Resident #9 had diagnoses including chronic obstructive pulmonary disease, pancytopenia, anxiety disorder, schizophrenia, hypothyroidism, dementia with behavioral disturbances, vitamin D deficiency, seizures, peripheral vascular disease, obstructive sleep apnea, onychogryphosis, dependence on supplemental oxygen, peripheral venous insufficiency, personal history of COVID-19 and vitamin B12 deficiency and anemia. Review of the plan of care dated 05/03/22 revealed the resident was at risk for alteration in skin integrity related to cognitive impairment, dementia, history of skin impairment, incontinence, mobility impairment, non-compliance with therapeutic skin regimen, peripheral vascular disease, dry skin, thick yellow…

    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 · D2022-10-04 · tag F0686 — failed to prevent and treat pressure sores (bedsores) — isolated
    Provide appropriate pressure ulcer care and prevent new ulcers from developing.
    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 and procedure review, the facility failed to ensure Resident #9 was provided pressure ulcer treatment as ordered. This affected one resident (#9) of four residents reviewed for pressure ulcers. Findings Include: Review of Resident #9's medical record revealed an initial admission date of 10/27/21 with the latest readmission of 06/15/22. Resident #9 had diagnoses including chronic obstructive pulmonary disease, pancytopenia, anxiety disorder, schizophrenia, hypothyroidism, dementia with behavioral disturbances, vitamin D deficiency, seizures, peripheral vascular disease, obstructive sleep apnea, onychogryphosis, dependence on supplemental oxygen, peripheral venous insufficiency, personal history of COVID-19 and vitamin B12 deficiency and anemia. Review of a skin admission/readmission assessment, dated 10/27/21 revealed the resident was admitted to the facility with an unstageable (full-thickness skin and tissue loss in which the extent 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.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2022-10-04 · 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, record review, facility policy and procedure review and interview the facility failed to ensure a fall was reported and investigated when it occurred and/or failed to ensure fall prevention interventions were implemented as ordered. This affected two residents (#13 and 64) of three residents reviewed for falls/accidents. Findings Include: 1. A review of Resident #13's medical record revealed the resident was admitted to the facility on [DATE] with diagnoses including monoplegia (paralysis that affects one limb) of upper limb following a stroke affecting his right dominant side, unsteadiness on his feet, restlessness and agitation, epilepsy, hypertension, adult onset diabetes mellitus, vascular dementia with behavioral disturbances, psychosis, insomnia, and personality disorder. A review of Resident #13's quarterly Minimum Data Set (MDS) 3.0 assessment, dated 07/01/22 revealed the resident did not have any communication issues but his cognition was severely impaired. Hallucinations,…

    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 · D2022-10-04 · tag F0695 — failed to provide proper breathing / tracheostomy care — isolated
    Provide safe and appropriate respiratory care for a resident when needed.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, record review and staff interview, the facility failed to ensure Resident #9 and Resident #64's oxygen cannula and nebulizer administration set were stored in a sanitary manner to prevent potential infection. This affected two residents (#9 and #64) of two residents reviewed for oxygen therapy. Findings Include: 1. Review of Resident #9's medical record revealed an initial admission date of 10/27/21 with the latest readmission of 06/15/22. Resident #9 had diagnoses including chronic obstructive pulmonary disease (COPD), pancytopenia, anxiety disorder, schizophrenia, hypothyroidism, dementia with behavioral disturbances, vitamin D deficiency, seizures, peripheral vascular disease, obstructive sleep apnea, onychogryphosis, dependence on supplemental oxygen, peripheral venous insufficiency, personal history of COVID-19 and vitamin B12 deficiency and anemia. Review of the plan of care dated 05/03/22 and last revised on 07/07/22 revealed the resident received oxygen, had COPD, respiratory failure, required the use of a Bipap machine, had obstructive sleep apnea and…

    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 · D2022-10-04 · tag F0700 — isolated
    Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
    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 complete a comprehensive and complete assessment including documentation of the explanation of risks and benefits for the use of a side rail for Resident #77. This affected one resident (#77) of one resident reviewed for side rails. Findings Include: Review of the medical record for Resident #77 revealed an admission date of 03/02/22 with diagnoses including Alzheimer's disease, dementia without behaviors unsteady gait, major depression, mood disorder, unspecified psychosis and anxiety. Review of the plan of care, dated 03/09/22 revealed Resident #77 required assistance with activities of daily living (ADL) related to decreased ADL self performance, cognitive impairment and being uncooperative with care. Interventions included Resident #77 required extensive assistance from two persons for bed mobility and transfers. Review of the significant change in condition Minimum Data Set (MDS) 3.0 assessment, dated 09/22/22 revealed Resident #77 rarely understood or understands and had severe impaired cognition with…

    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

“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.

Part of a chain

This home belongs to FOUNDATIONS HEALTH SOLUTIONS — 64 facilities. Here is how its ratings compare with the chain’s average across all its homes: See the whole chain — ratings, flags, fines and finances →

RatingThis homeChain avg
Overall 4 of 54.1≈ chain avg
Health inspection 4 of 53.9+0.1 vs chain
Staffing 3 of 52.3+0.7 vs chain
Quality measures 3 of 54.3-1.3 vs chain
The other 63 homes this chain runs (chain average 4.1★, per CMS)
1 of 5Inniswood Health and RehabilitationWesterville, OH 2 of 5Canterbury Villa Of AllianceAlliance, OH 2 of 5Park Health CenterSt Clairsville, OH 2 of 5Tuscany GardensPataskala, OH 2 of 5Veranda Gardens Nursing & Rehabilitation CenterCincinnati, OH 3 of 5Arlington Care CenterNewark, OH 3 of 5Bennington Glen Nursing & Rehabilitation CenterMarengo, OH 3 of 5Cumberland Pointe Care CenterSt Clairsville, OH 3 of 5Emerald Pointe Health And Rehab CtrBarnesville, OH 3 of 5Hickory Ridge Nursing & Rehabilitation CenterAkron, OH 3 of 5Home At Taylor's PointeCincinnati, OH 3 of 5McNaughten Pointe Nursing And RehabColumbus, OH 3 of 5Meadow Grove Transitional CareGrove City, OH 3 of 5The Gables Of Marysville Health And RehabilitationMarysville, OH 3 of 5The Gardens Of Fairfax Health Care CenterCleveland, OH 3 of 5Timberland Ridge Nursing & RehabilitationFairlawn, OH 4 of 5Austin Trace Health And RehabilitationCenterville, OH 4 of 5Batavia Nursing Care CenterBatavia, OH 4 of 5Claymont Health And RehabilitationUhrichsville, OH 4 of 5Crown Pointe Care CenterColumbus, OH 4 of 5Florentine GardensLoveland, OH 4 of 5Jefferson Healthcare CenterJefferson, OH 4 of 5Lafayette Pointe Nursing & Rehab CtrWest Lafayette, OH 4 of 5Maria Joseph Living Care CenterDayton, OH 4 of 5Mill Creek Nursing & RehabilitationGalion, OH 4 of 5Respiratory And Nursing Center Of DaytonMoraine, OH 4 of 5Sycamore Run Nursing And Rehab CtrMillersburg, OH 4 of 5Waterview Pointe Nursing & RehabilitationMarietta, OH 4 of 5Woods On French Creek Nursing & Rehab Center TheAvon, OH 5 of 5Admirals Pointe Nursing & RehabilitationHuron, OH 5 of 5Brunswick Pointe Transitional CareBrunswick, OH 5 of 5Capri GardensLewis Center, OH 5 of 5Carington ParkAshtabula, OH 5 of 5Concord Health & Rehab CtrWheelersburg, OH 5 of 5Concord Ridge Health And RehabilitationMentor, OH 5 of 5Country View Of SunburySunbury, OH 5 of 5Darby Glenn Nursing And Rehabilitation CenterHilliard, OH 5 of 5Glen MeadowsHamilton, OH 5 of 5Golden Years Nursing CenterHamilton, OH 5 of 5Highbanks Care CenterColumbus, OH

Showing 40 of 63; lowest-rated first.

A home rated well below its chain’s average can signal local problems; a chain with a low average across the board is a bigger pattern worth researching. CMS chain data under-reports private-equity and REIT ownership, so treat this as a floor, not the full picture.

Who owns this facility

Owner / managerTypeRoleSince
COLLERAN, BRIANIndividualCORPORATE DIRECTOR; CORPORATE OFFICER; OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 01/01/2019
KRYSTOWSKI, JOHNIndividualCORPORATE OFFICER; OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 06/01/2018
FOUNDATIONS HEALTH SOLUTIONS, LLCOrganizationOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 01/01/2019
JONAS, CHRISTOPHERIndividualOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 04/01/2025
LLOYD, JOHNIndividualADP OF THE SNFsince 06/01/2018

CMS files one row per role, so the 12 rows in the source record cover these 5 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.

1 organizational owner listed — a facility can be part of a larger chain. CMS ownership data is known to under-report private-equity and REIT ties; treat as a starting point.

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.

$9.1M
Net patient revenuemost recent cost report
+10.0%
Operating marginrevenue minus expenses
$635K
Related-party expense8% of expenses
Who pays — share of resident-days
Medicaid 82%Medicare 4%Other / private 14%

About 82% of this home’s resident-days are paid by Medicaid, which reimburses well below the cost of care in most states. Heavily Medicaid-dependent homes run on thinner budgets — a context worth holding next to the staffing and inspection record, not a fault in itself. This home reported $635K paid to related parties (affiliated landlords or management companies) in its most recent cost report.

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

$272per resident / day
operating cost
$8,256per month
≈ monthly operating cost
$302per 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 365589. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2025-08-11, 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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