Versailles Rehabilitation And Health Care Center
200 Marker Road, Versailles, OH 45380 · For profit - Corporation · 112 certified beds · (937) 526-5570 Medicare & Medicaid certified
This home has serious findings on its record. Read them closely before you consider it.
- 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
- it has abuse, neglect, or exploitation citations (F0600, F0603, F0606) — most recent Aug 2025
- it has a citation for its abuse-prevention policies, restraint use, or reporting and investigating of allegations (F0610) — cited below the harm level, meaning inspectors found the process wanting but did not find a resident harmed
- it has a citation for mishandling residents’ money or property (F0569)
- it has 1 actual-harm citation
- a high number of inspection citations overall (23) — worth reading through, though larger and more-often-surveyed homes tend to accrue more lower-severity tags
- its payroll-based staffing rating is low (1/5)
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.
| Health inspectionSurveyor-assigned, ranked within your stateInspector-verified | 4 of 5 |
| StaffingFrom payroll records (PBJ) | 1 of 5 |
| Quality measuresSelf-reported by the facility | 5 of 5 |
Location & what’s nearby
Open in Google Maps ↗ · Directions ↗ · Larger map ↗
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 | 5 of 5 |
| Long-stay residentspeople who live here | 5 of 5 |
| Short-stay residentsrehab / post-hospital | 4 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.
See all quality measures vs. state & national benchmarks
| Measure | This home | State avg | Typical state | vs typical state |
|---|---|---|---|---|
| Long-stay residents whose need for help with daily activities increased | 5.0% | 5.3% | 15.4% | typical for the state‡ — see note marked double-dagger below the table |
| Long-stay residents who lose too much weight | 3.7% | 6.2% | 5.4% | better |
| Long-stay residents with a catheter left in their bladder | 0.4% | 0.2% | 0.9% | worse than state‡ — see note marked double-dagger below the table |
| Long-stay residents with a urinary tract infection | 0.4% | 0.4% | 2.0% | better than state‡ — see note marked double-dagger below the table |
| Long-stay residents with depressive symptoms | 41.6% | 30.1% | 6.5% | worse than state‡ — see note marked double-dagger below the table |
| Long-stay residents who were physically restrained | 0.0% | 0.1% | 0.1% | better |
| Long-stay residents with falls causing major injury | 0.0% | 3.2% | 3.3% | check this* — see note marked star below the table |
| Long-stay residents whose ability to walk worsened | 11.1% | 6.1% | 16.1% | worse than state‡ — see note marked double-dagger below the table |
| Long-stay residents on antianxiety or hypnotic medication | 25.5% | 25.5% | 18.9% | worse |
| Long-stay residents given the seasonal flu vaccine | 91.2% | 94.5% | 95.3% | typical |
| Long-stay residents with pressure ulcers | 3.7% | 3.4% | 4.7% | better |
| Long-stay residents with worsening bladder/bowel control | 25.5% | 21.4% | 21.2% | worse |
| Long-stay residents who got an antipsychotic medication§ — see the note below the table | 18.5% | 8.8% | 17.1% | typical |
| Short-stay residents who newly got an antipsychotic medication | 1.5% | 1.2% | 1.4% | typical |
| Short-stay residents given the seasonal flu vaccine | 71.4% | 75.6% | 79.4% | worse |
| Short-stay residents rehospitalized after admission | 18.5% | 24.9% | 22.6% | better |
| Short-stay residents with an outpatient ER visit | 11.7% | 12.9% | 12.0% | typical |
| Long-stay hospitalizations per 1,000 resident days | 0.42 | 1.73 | 1.67 | better |
| Long-stay outpatient ER visits per 1,000 resident days | 0.70 | 1.80 | 1.80 | better |
* This home reported 0% on a measure where lower is better. That can mean genuinely excellent care — but because the number is self-reported, a zero can also mean the problem was not recorded. Weigh it against the inspection record above.
‡ 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.
62.4% of the Medicare patients who left this home got back to the community and stayed there for at least 31 days — CMS rates that better than the national rate. This is CMS’s risk-adjusted rate over 99 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.
Met the expected recovery: 46.7% 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 45 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 0.25 therapist hours per resident per day in 2026Q1 — more than 35% of the 13,892 homes that report any therapy hours at all.
Weekend therapy: weekend therapy hours are 13% 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
| Measure | This home | U.S. median | Period covered | CMS’s call |
|---|---|---|---|---|
| Got home and stayed homeRate of successful return to home or community from a SNF | 62.4%CMS range 53.9–71.0 | 51.5% | Oct 2022–Sep 2024 | better than U.S. |
| Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNF | 8.3%CMS range 6.0–12.2 | 10.7% | Oct 2022–Sep 2024 | no 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 discharge | 46.7% | 56.6% | Oct 2024–Sep 2025 | CMS 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 discharge | 44.4% | 52.8% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Moving around at dischargePercentage of residents who are at or above an expected ability to move around at discharge | 31.1% | 50.0% | Oct 2024–Sep 2025 | CMS 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 identified | 98.6% | 98.7% | Oct 2024–Sep 2025 | CMS 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 setting | 100.0% | 100.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this 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 discharge | 100.0% | 98.7% | Oct 2024–Sep 2025 | CMS 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 stay | 0.0% | 0.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| New or worsened pressure ulcersPercentage of residents with pressure ulcers/pressure injuries that are new or worsened | 0.0% | 1.9% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Infections that led to hospitalPercentage of infections residents got during their SNF stay that resulted in hospitalization | 8.4%CMS range 4.6–12.7 | 7.1% | Oct 2023–Sep 2024 | no different from U.S. |
| Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs | 1.28 | 1.02 | Oct 2022–Sep 2024 | CMS 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
How full it usually is: this home is certified for 112 beds and averages 85.9 residents a day — about 77% occupied, or roughly 26 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 3.00 hrs/resident/day is below the 3.48-hour benchmark and RN staffing of 0.34 is below the 0.55-hour RN benchmark and nurse-aide staffing of 1.57 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 2.80 hrs/resident/day on weekends vs 3.09 on weekdays — 9% thinner on weekends. RN hours go from 0.30 to 0.43 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)
This home’s total nursing-staff turnover of 51% is about the same as the national median of 45%.
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
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.
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.
23 citations, most serious first. The 11 most serious are shown; the remaining 12 are one tap away and print in full.
- Actual harm · G2019-04-26 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolatedEnsure 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 medical record review, review of a dietary communication form and staff interview, the facility failed to ensure a cognitively impaired resident was supervised during meal service when being provided with hot liquids. This resulted in actual harm for one resident (#49) when she suffered burns from being served hot liquids on two separate occasions. In addition, the facility failed to ensure a staff member used a gait belt while transferring a second resident (#25) resulting in an avoidable fall that did not result in injury. This affected two (#49 and #25) of three residents reviewed for accidents. The census was 72. Findings include: 1. Review of the medical record for Resident #49 revealed an admission date of 01/13/17. Diagnoses included cerebrovascular disease, transient cerebral ischemic attack, weakness, major depressive disorder, dementia, anxiety disorder, anxiety and adult failure to thrive. Review of the Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #49 was moderately…
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.
- Potential for harm · D2025-08-28 · tag F0600 — failed to protect residents from abuse and neglect — isolatedProtect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
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 reviews, staff interviews, review of a facility self reported incident (SRI), and policy review, the facility failed to ensure residents were free from sexual abuse. This affected two (#26 and #90) out of three residents reviewed for abuse. The facility census was 75. Findings include: Review of the medical record for Resident #26 revealed an admission date of 06/27/25 with medical diagnoses of dementia with psychotic disturbances, chronic obstructive pulmonary disease (COPD), and mood disorder. Review of an admission Minimum Data Set (MDS) assessment, dated 07/03/25, which indicated Resident #26 had severely impaired cognition and required supervision with toilet hygiene and was independent with bed mobility, transfers, and bed mobility. Review of a physician order dated 06/27/25 stated Resident #26 had a mental disorder with diagnosis of behavioral disturbances and met the criteria for placement on the Mental Health Unit (MHU) and would benefit from the structure and activity-based…
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.
- Potential for harm · E2025-05-08 · tag F0603 — failed to not confine residents against their will — patternProtect each resident from separation (from other residents, his/her room, or confinement to his/her room).
What the surveyor found here — an excerpt from the official record, may be distressing
Based on medical record review, staff and resident interviews, observation, and review of policy, the facility failed to ensure residents had orders and were assessed for secured units resulting in involuntary seclusion. This affected two (#60 and #180) of two residents reviewed for involuntary seclusion and had the potential to affect 13 additional residents (#3, #4, #5, #7, #17, #26, #32, #34, #35, #62, #68, #73, and #76) residing in the secured mental health unit (MHU) that did not orders for and were not assessed for admission to the secured MHU. The census was 76. Findings include: 1. Review of Resident #60's medical record revealed an admission date of 01/26/24. Diagnoses listed included epilepsy, hypertension, anxiety, paranoid schizophrenia, and depression. Review of a significant change Minimum Data Set (MDS) revealed Resident #60 had severely impaired cognition and was receiving Hospice services. Further review of Resident #60's medical record revealed no order for admission to secured MHU. There was no documentation of any assessments being completed to ensure 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.
- Potential for harm · D2025-05-08 · tag F0711 — isolatedEnsure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.
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, staff and physician interviews, the facility failed to ensure a resident's physician progress notes accurately reflected an evaluation of the resident's condition and program of care. This affected one (#43) of three residents reviewed for physician services. The facility census was 76. Findings include: Review of medical record for Resident #43 revealed admission date of 09/19/25. The resident was admitted with diagnoses including neurocognitive disorder with Lewy bodies, type two diabetes with unspecified complications, anxiety and hypertension. The resident was admitted to Hospice on 02/06/25 and remained at the facility. The quarterly Minimum Data Set (MDS) dated [DATE] revealed she had severely impaired cognition. She was dependent for eating, toileting hygiene, bed mobility and transfers. A plan of care revealed Resident #43 had a terminal illness care plan which included interventions to notify hospice with any changes, if pain medications were ineffective, and to provide 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.
- Potential for harm · D2025-05-08 · tag F0847 — isolatedInform resident or representatives choice to enter into binding arbitration agreement and right to refuse.
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, review of arbitration agreements and staff and resident interviews, the facility failed to ensure facility staff knew a residents' cognitive status and ability to understand before having the resident sign an arbitration agreement. This affected three (#29, #60, and #66) of three residents reviewed for arbitration agreements. The census was 76. Findings include: 1. Review of the medical record for Resident #29 revealed an admission date of 10/28/24 with diagnoses of pathological fracture, left ankle, subsequent encounter for fracture with routine healing, other fracture of unspecified lower leg, subsequent encounter for closed fracture with routine healing, Alzheimer's disease, and dementia in other diseases classified elsewhere, moderate, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety. Review of the Quarterly Minimum Data Set (MDS) dated [DATE] revealed resident was cognitively intact. Resident was independent with bed mobility and wheelchair…
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.
- Potential for harm · D2025-05-08 · tag F0849 — isolatedArrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice 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 medical record review, staff interview, and review of facility policy, the facility failed ensure Hospice provider contracts, plans of care, and/or communication binders were available at the facility. This affected (#60) of one reviewed for Hospice. The census was 76. Findings include: Review of Resident #60's medical record revealed an admission date of 01/26/24. Diagnoses listed included epilepsy, hypertension, anxiety, paranoid schizophrenia, and depression. Review of a significant change Minimum Data Set (MDS) dated [DATE] and a revealed Resident #60 had severely impaired cognition and was receiving Hospice services. Review of physician orders revealed an order dated 03/22/25 for Hospice services for intracranial hemorrhage. Further review of Resident #60's medical record revealed no documentation of the Hospice provider agreement or plan of care. Resident #60 was unable to be interviewed during the survey from 05/05/25 through 05/08/25 due to her impaired cognitive status. 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.
- Potential for harm · D2025-02-19 · tag F0759 — failed to keep medication error rate low — isolatedEnsure medication error rates are not 5 percent or greater.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on record review, observations and staff interviews, the facility failed to ensure a medications were administered as ordered resulting in two medication errors out of 31 opportunities or a 6.45 percent (%) medication error rate. This affected one (#13) of three residents observed for medication administration. Facility census was 93. Findings include: Review of medical record for Resident #13 revealed admission date of 02/13/25. Diagnoses include fracture of the ninth and tenth thoracic (T-9, T-10) vertebrae, spinal fusion, and surgical aftercare following surgery on the nervous system. Review of Resident #13's admission Minimum Data Set (MDS) revealed the assessment was not completed at the time of the survey. Review of Resident #13's care plan revealed a care plan for impaired skin integrity as evidenced by surgical incision to midline spine, left and right midline spine with interventions which included wound evaluation, dietician consult and medications as ordered. Review of Resident #13's physician orders revealed an order for Magnesium 250 milligrams (mg) give two…
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.
- Potential for harm · D2024-10-03 · tag F0584 — failed to keep a safe, clean, comfortable home — isolatedHonor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
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, resident and staff interviews, and policy review, the facility failed to ensure the facility was free from foul odors. This affected two (Resident #43 and #44) of two residents reviewed for concerns with foul odors. The facility census was 87. Findings include: Interview on 10/03/24 at 9:38 A.M. with Resident #44 revealed concerns with odor in the hall. Resident #44 stated all the time this guy has the hallways smelling like pot [cannabis]. It's ridiculous. Interview on 10/03/24 at 9:53 A.M. with Resident #43 stated she has a concern with the strong odor of cannabis coming into her room from next door. When she exits the room, she has to smell it in the hallway as well. I do not like being around drugs, I'm afraid I will get it into my lungs and my system. Interview on 10/03/24 at 11:21 A.M. with Registered Nurse (RN) #272 confirmed Resident #19 frequently has a strong odor coming from his room and stated room [ROOM NUMBER] does not smell like someone has smoked in the room, it just has 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.
- Potential for harm · D2024-10-03 · tag F0610 — failed to investigate and act on abuse reports — isolatedRespond appropriately to all alleged violations.
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 resident and staff interviews, record review, and policy review, the facility failed to protect the residents and prevent further potential sexual abuse while the investigation was in process. This affected two (Residents #19 and #76) of two residents reviewed for abuse. The facility census was 87. Findings include: Review of the medical record for Resident #19 revealed an admission date of 08/28/24. Diagnoses included type II diabetes mellitus without complications, bipolar disorder, and current episode hypomanic. Review of the admission Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #19 was cognitively intact. Resident #19 was independent with wheelchair mobility and required supervision from staff for bed mobility and transfers. Review of the care plan dated 08/30/24 revealed Resident #19 has behaviors related to refuses medications, resistant care, verbally aggressive toward others, will refuse therapy, and will make false allegations. Review of the medical record for Resident #76…
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.
- Potential for harm · D2024-05-29 · tag F0697 — failed to manage pain — isolatedProvide safe, appropriate pain management for a resident who requires such 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, family member interview, and staff interview, the facility failed to assess for pain, administer medication for pain, and document effectiveness of the pain control interventions for one resident. This affected one (#1) of three residents reviewed for pain management. The current census is 81. Findings include: Review of Resident #1's medical record revealed an admission date of 04/10/24, transferred to the hospital on [DATE], returned to the facility on [DATE], and passed at the facility with hospice services on 05/06/24. Diagnoses for Resident #1 included: urinary tract infection, alcoholic cirrhosis of liver, obesity, cellulitis, and altered mental status. Review of the comprehensive Minimum Data Set (MDS) assessment dated [DATE] revealed the resident had impaired cognition and was a two-person assist for Activities of Daily (ADL). Review of Resident #1's physician ordered medications revealed on 04/10/24, the resident was ordered to receive Acetaminophen 500 milligrams (mg) every 8…
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.
- Potential for harm · D2024-01-25 · tag F0690 — failed to manage incontinence, catheters, and urinary infections — isolatedProvide 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 medical record review, observations and staff and resident interviews, the facility failed to ensure suprapubic catheter care was completed and documented in the medical record. This affected three (#9, #14, #45) of three residents reviewed for catheter care. The facility census was 83. Findings include: 1. Medical record review for Resident #45 revealed an admission on [DATE] with diagnoses including but not limited to bipolar disorder, suicidal ideation's, neuromuscular dysfunction of bladder, anxiety, major depression, history of mental and behavioral disorders, and history of urinary tract infections. Review of the admission Minimum Data Set (MDS) assessment for Resident #45 revealed an intact cognition. Resident #45 is independently ambulatory, and requires set up assistance for eating, toileting, and transfers. Resident #45 has an indwelling urinary catheter. Review of the plan of care for Resident #45 revealed resident has a need for supra-pubic catheter. Interventions include monitor for signs…
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.
Show the remaining 12 citations
- Potential for harm · D2024-01-05 · tag F0755 — failed to provide safe pharmacy services — isolatedProvide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
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, policy review and staff interview, the facility failed to ensure medications were administered per physician orders. This affected one (#2) of 3 residents reviewed for medication administration. The current census is 76. Findings include: Review of Resident #2's medical record revealed an admission date of 12/01/23 and discharged home on [DATE]. Diagnoses for Resident #2 included: aftercare for orthopedic surgery, fracture of femur, hemiplegia, dysphagia, and weakness. Review of the comprehensive Minimum Data Set (MDS) assessment dated [DATE] revealed the resident had impaired cognition, pain, and was a one-person assist for Activities of Daily (ADL). Review of Resident #2's care plans dated 12/04/23 revealed a focus for risk of pain. Interventions include administering medications per physician order, monitoring for pain symptoms, offer non-pharmacological interventions, and therapy as needed. Review of Resident #2's physician orders dated 12/01/23 revealed Resident #2 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.
- Potential for harm · D2023-10-25 · tag F0698 — failed to provide proper dialysis care — isolatedProvide safe, appropriate dialysis care/services for a resident who requires such 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, policy review and staff interview, the facility failed to keep accurate records regarding peritoneal dialysis treatments. This affected one (#79) of three residents reviewed for dialysis. The facility census was 70. Findings include: Review of the medical record for Resident #79 revealed admission [DATE] with diagnoses including but not limited to breakdown (mechanical) of intraperitoneal dialysis catheter, morbid obesity, chronic kidney disease stage five, hyperkalemia, bilateral osteoarthritis of hip, depression, hyperlipidemia, coronary artery disease, fibromyalgia, anxiety, end stage renal disease, atrial fibrillation, hypertension, and dependence on renal dialysis. Review of Quarterly Minimum Data Set (MDS) assessment for Resident #79 dated 08/16/23 revealed a Brief Interview for Mental Status (BIMS) score of 11 which indicated moderate cognitive impairment. No behaviors noted. Resident #79 required limited to supervision of one for Activities of Daily Living (ADL's). Review of 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.
- Potential for harm · E2022-05-23 · tag F0812 — failed to store, cook, and serve food safely — patternProcure 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 observations, staff interviews, and review of facility policy, the facility failed to ensure food was stored in a safe and sanitary manner. This had the potential to affect 70 residents who received food from the kitchen. The facility census was 72. Observations on 05/16/22 from 8:07 A.M. to 8:20 A.M. of the kitchen, with Dietary Manager #394 present, revealed the following food items located in the refrigerator were not dated: a bowl of salsa, a bag of lettuce, a bin of chopped onions, one large tub of sliced cheese, zip locked bag with 10 cooked hamburger patties, a zip locked back with one pound of deli ham, a bin of chopped pears, and a zip lock back of 12 hard boiled eggs. Dietary Manager #394 verified undated food items. Review of facility undated policy titled, Receiving and Storage Policy and Procedure, revealed food would be stored in its original packaging as long as the packaging was clean, dry, and intact. Food that was repackaged would be placed in a leak-proof, pest-proof, non-absorbent, sanitary container with a tight-fitting lid. The container would be…
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.
- Potential for harm · D2022-05-23 · tag F0641 — isolatedEnsure 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 a significant change assessment was completed in a timely manner for a resident. This affected one resident (#16) out of 18 residents reviewed for assessments. The facility census was 72. Findings include: Medical record review for Resident #16 revealed the resident was admitted to the facility on [DATE]. Diagnoses included Parkinson's disease, dysphagia, muscle weakness and psychotic disorder. Review of the comprehensive Minimum Data Set (MDS) assessment dated [DATE], revealed Resident #16 was not receiving hospice services. No significant change or updated MDS assessment was noted in the resident's record after 03/09/22. Review of Resident #16's physician orders revealed on 03/22/22 the resident was ordered to receive hospice services. Review of Resident #16's care plan dated 03/22/22, revealed a focus for terminal prognosis hospice care related to malignant neoplasm of left breast. Interventions included provide care based on end 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.
- Potential for harm · D2022-05-23 · tag F0686 — failed to prevent and treat pressure sores (bedsores) — isolatedProvide 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 medical record review, resident interview, staff interviews, and review of facility policy, the facility failed to ensure wound dressings were applied and completed according to physician orders. This affected two residents (#9 and #56) out of ten residents reviewed for wound care. The facility census was 72. Findings include: 1. Review of the medical record revealed Resident #56 was admitted on [DATE]. Diagnosis included sepsis, emphysema, unspecified protein-calorie malnutrition, chronic obstructive pulmonary disease, panlobular emphysema, acute respiratory failure with hypoxia, muscle weakness, nonrheumatic mitral (valve) insufficiency, supraventricular tachycardia, unspecified atrial fibrillation, malignant neoplasm of bladder, essential (primary) hypertension. Review of the Minimum Data Set (MDS) assessment dated [DATE], revealed Resident #56 was moderately cognitively impaired. Review of the wound evaluation dated 05/11/22, revealed Resident #56 had a stage three pressure wound to the coccyx…
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.
- Potential for harm · D2022-05-23 · tag F0695 — failed to provide proper breathing / tracheostomy care — isolatedProvide safe and appropriate respiratory care for a resident when 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, observation, and staff interview, the facility failed to change/date oxygen supplies. This affected two residents (#1 and #56) out of two residents reviewed for respiratory care. The facility identified five additional residents (#2, #19, #14, #264, and #266) receiving supplemental oxygen. The facility census was 72. Findings include: 1. Review of the medical record revealed Resident #56 was admitted on [DATE]. Diagnosis includes sepsis, emphysema,chronic obstructive pulmonary disease, acute respiratory failure, and essential (primary) hypertension. Review of the Minimum Data Set (MDS) assessment dated [DATE], revealed Resident #56 was moderately cognitively impaired. Review of physician order dated 05/12/22, revealed an order to change oxygen tubing every Wednesday during night shift. Observation on 05/16/22 at 11:31 A.M. revealed Resident #56 had oxygen applied and the oxygen tubing was not dated. Interview on 05/16/22 at 12:32 P.M. Licensed Practical Nurse (LPN) #392 verified…
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.
- Potential for harm · D2022-05-23 · tag F0760 — failed to prevent significant medication errors — isolatedEnsure that residents are free from significant medication errors.
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, observation, staff interview, and review of facility policy, the facility failed to administer medications in a timely manner and prevent significant medication errors. This affected two residents (#24 and #262) out of seven residents reviewed for medications. The facility census was 72. Findings include: 1. Review of the medical record revealed Resident #24 was admitted on [DATE]. Diagnosis included fracture of second lumbar vertebra, neuromuscular dysfunction of bladder, depression, type two diabetes mellitus, chronic obstructive pulmonary disease, paroxysmal atrial fibrillation, chronic pain, anxiety disorder, osteoarthritis, essential (primary) hypertension, and irritable bowel syndrome without diarrhea. Interview on 05/16/22 at 2:33 P.M. Resident #25 reported she had not received her morning medications on 05/16/22. Resident #25 reported she was up for breakfast and had therapy that morning. Resident #25 reported she did take a nap at some point, but did not recall any staff…
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.
- Potential for harm · D2022-05-23 · tag F0880 — failed to prevent and control infections — isolatedProvide 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 medical record review, observation, staff interview, review of facility policy, and review of Centers for Disease Control and Prevention (CDC) guidelines, the facility failed to ensure proper personal protective equipment (PPE) was worn when providing care to new admission residents who were unvaccinated for Coronavirus 2019 (COVID-19). This affected two residents (#264 and #265) of four residents reviewed for COVID-19 isolation precautions. The census was 72. Findings include: 1. Review of the medical record revealed Resident #265 was initially admitted on [DATE] and readmitted on [DATE]. Diagnosis included sepsis, anemia, acute kidney failure, type two diabetes mellitus without complications, essential (primary) hypertension, hypotension, and major depressive disorder. Review of Resident #265's vaccination history revealed the resident refused the COVID-19 vaccination and had no documentation of ever receiving a COVID-19 vaccine. Observation on 05/18/22 at 2:33 P.M. revealed Licensed Practical Nurse…
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.
- Potential for harm · D2019-04-26 · tag F0561 — failed to honor residents' choices — isolatedHonor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
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 resident and staff interview, the facility failed to ensure routine showers were completed as per the resident's schedule/choice. This affected one (#6) of one residents reviewed for showers. The census was 72. Findings include: Review of the medical record for Resident #6 revealed an admission date of 09/17/16 with a re-entry date of 06/06/17. Diagnoses of difficulty in walking, obesity, chronic obstructive pulmonary disease (COPD), diabetes Mellitus (DM) and chronic kidney disease, stage three (CKD). Review of the Minimum Data Set, dated [DATE] revealed Resident #6 was cognitively intact with the need for total dependence with bathing. Review of the plan of care dated 06/07/17 for Resident #6 revealed the resident had a self care deficit due to generalized weakness and decreased endurance related to arthritis to left knee, CKD stage three, obesity, DM, and COPD. Activity of Daily Living assistance varies from one to two staff members. Resident prefers to sleep in 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.
- Potential for harm · D2019-04-26 · tag F0569 — isolatedNotify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
What the surveyor found here — the official record, unedited, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on medical record review, review of resident funds and staff interview, the facility failed to ensure one resident's funds were sent back to the state within 30 days of the resident's death. This affected one (#134) of six residents reviewed. The facility held funds for 45 residents. The census was 72. Findings include: Review of Resident #134's medical record indicated the resident was admitted to the facility on [DATE] and expired on [DATE]. Review of the resident's trust with Business Office Manager (BOM) #413 indicated the facility managed her funds and at the time of her death, Resident #134 had $173.68 in her account. The facility did not send the balance back to the state until [DATE]. Interview on [DATE] at 10:22 A.M. with BOM #413 verified the funds had not been sent back to state until [DATE]. BOM # 431 stated she did know the money had to be sent back within 30 days.
- Potential for harm · D2019-04-26 · tag F0578 — failed to honor advance directives / code status — isolatedHonor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
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 the resident had a valid code status on file. This affected one (#28) of 24 residents reviewed for code status during the annual survey. The census was 72. Findings include: Review of the medical record for Resident #28 revealed an admission date of 02/27/19. Diagnoses included acute kidney failure, psychosis, abnormalities of gait, cognitive communication deficit, repeated falls, Dementia and adult failure to thrive. The record review revealed there was not an order for the resident's code status and there was no code status indicated on the Medication Administration Record (MAR). Review of the Minimum Data Set, dated [DATE] revealed Resident #6 was assessed a being severely cognitively impaired with the need for limited assistance of one person physical assistance in the area of Activities of Daily Living Further review of the Ohio Do Not Resuscitate Comfort Care (DNRCC) identification form for Resident #28 revealed the top…
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.
- No harm found · C2025-05-08 · tag F0606 — failed to not employ staff found guilty of abuse — widespreadNot hire anyone with a finding of abuse, neglect, exploitation, or theft.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on review of personnel files, staff interview, and review of facility policy, the facility failed to ensure new employees were screened against the state nurse aide registry for potential concerns with abuse, neglect, exploitation, mistreatment of residents or misappropriation of resident property. This affected three (#381, #384 and #396) of six personnel records reviewed. This had the potential to affect all 76 residents residing in the facility. The census was 76. Findings include: 1. Review of Licensed Practical Nurse (LPN) #381's personnel file revealed a hire date of 09/24/24. Further review revealed LPN #381 was not screened against the state nurse aide registry upon hire. 2. Review of LPN #384's personnel file revealed a hire date of 09/01/23. Further review revealed LPN #384 was not screened against the state nurse aide registry upon hire. 3. Review of Business Office Manager (BOM) #396's personnel file revealed a hire date of 04/10/25. Further review revealed BOM #396 was not screened against the state nurse aide registry. Interview with Human Resources (HR) #400 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.
- 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.
Fines & penalties
No federal fines in the current CMS record.
Part of a chain
This home belongs to CROWN HEALTHCARE GROUP — 9 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 →
| Rating | This home | Chain avg | |
|---|---|---|---|
| Overall | 4 of 5 | 2.3 | +1.7 vs chain |
| Health inspection | 4 of 5 | 2.4 | +1.6 vs chain |
| Staffing | 1 of 5 | 1.1 | -0.1 vs chain |
| Quality measures | 5 of 5 | 4.4 | +0.6 vs chain |
The other 8 homes this chain runs (chain average 2.3★, per CMS)
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 / manager | Type | Role | Since |
|---|---|---|---|
| CROWN OHIO HOLDCO INC | Organization | DIRECT OWNERSHIP INTEREST | since 09/20/2018 |
| WEINTRAUB, MOSHE | Individual | DIRECT OWNERSHIP INTEREST | since 09/20/2018 |
| CROWN I TBD HOLDCO LLC | Organization | INDIRECT OWNERSHIP INTEREST | since 10/09/2021 |
| CAPITAL FINANCE LLC | Organization | 5% OR GREATER SECURITY INTEREST; OPERATIONAL/MANAGERIAL CONTROL | since 09/20/2018 |
| DAUBENMIRE, KEVIN | Individual | MANAGING CONTROL - GOVERNING BODY; OPERATIONAL/MANAGERIAL CONTROL; LIMITED PARTNERSHIP INTEREST; ADP OF THE SNF | since 09/20/2018 |
| SINGER, MEIR | Individual | CORPORATE OFFICER; LIMITED PARTNERSHIP INTEREST | since 09/20/2018 |
| HUNTER, ROBERT | Individual | OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | since 03/17/2025 |
| MASON, JESSICA | Individual | OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | since 09/16/2024 |
| FRIEDMAN, YISRAEL | Individual | GENERAL PARTNERSHIP INTEREST | since 09/20/2018 |
| MRS FAMILY TRUST | Organization | LIMITED PARTNERSHIP INTEREST; ADP OF THE SNF | since 09/20/2018 |
| BASCH, ZISSY | Individual | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | since 07/23/2025 |
| FEJCC TRUST | Organization | ADP OF THE SNF | since 09/20/2018 |
| MDATAS TRUST | Organization | ADP OF THE SNF | since 09/20/2018 |
CMS files one row per role, so the 21 rows in the source record cover these 13 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.
6 organizational owners 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.
This home reported $1.2M paid to related parties — landlords or management companies under common ownership — equal to about 12% of its total expenses. Money routed to affiliated companies can leave a home’s own books looking lean while owners still profit; it is the mechanism regulators watch most closely in private-equity and REIT deals. 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
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
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.
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 365900. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2025-05-08, 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.