Andover Village Retirement Community
ANDOVER VILLAGE RETIREMENT COMMUNITY in ANDOVER, OH — inspection on November 25, 2025.
Found 3 citations. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
Review of facility policy labeled, Pressure Ulcer Risk and Skin Assessment dated 12/17/13 revealed it was the facility policy that all residents would receive routine assessments.
The policy revealed if a CNA observes a skin alteration he/ she would inform the nurse and the identified skin change would be addressed by the nurse with an assessment, documentation in the nursing notes and physician/ family notification.
This deficiency represents non-compliance investigated under Complaint Number 2619877, and 2603148.
Facility ID:
IDENTIFICATION NUMBER:
A.
Building
COMPLETED
11/25/2025
STREET ADDRESS, CITY, STATE, ZIP CODE
Andover Village Retirement Community
486 S Main St Andover, OH 44003
SUMMARY STATEMENT OF DEFICIENCIES
any new skin impairment.
She revealed LPN #616 had stated on Resident #64's return from the appointment she had the area to her right heel.
This deficiency represents non-compliance investigated under Complaint Number 2650968.
Facility ID:
IDENTIFICATION NUMBER:
A.
Building
COMPLETED
11/25/2025
STREET ADDRESS, CITY, STATE, ZIP CODE
Andover Village Retirement Community
486 S Main St Andover, OH 44003
SUMMARY STATEMENT OF DEFICIENCIES
Review of facility competency test labeled, Trach Care Competency dated 04/18/25 and completed by RT #600 with the DON overseeing revealed the staff was to wash their hands, don gown, gloves and mask (if applicable).
The staff was to remove and dispose of the trach dressing while observing the condition of the surrounding skin.
The competency revealed the staff was to remove gloves, wash hands and don sterile gloves and proceed to clean the skin under the flange, pat area dry with sterile gauze and replace sterile trach dressing.
The competency revealed the staff was to dispose of inner cannula and replace with another disposable sterile inner cannula.
The policy revealed the staff was to remove their gloves and wash their hands.
This deficiency represents non-compliance investigated under Complaint Number 2650968.
Facility ID:
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Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.
Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.
Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.